A newborn may present with a G-tube and have the inability to swallow and/or a weak cry. I will discuss important anatomical aspects and then suggest some therapeutic approaches.
Anatomy and Physiology
The function of the suprahyoid and infrahyoid muscles are critical for proper swallowing. The hyoid bone is the only bone in the body not attached to another bone.
The involved fascia needs to be loose. When an infant cannot swallow and requires a G-tube, please think of restricted fascia in the hyoid area.
The epiglottis is often a forgotten organ on which our lives depend. When we are breathing, it needs to remain in an open position where the air can pass through to the lungs.
When we eat or drink, it needs to be loose enough to flip over that airway opening and allow the food and drink to travel down the esophagus to the stomach. Fascial strain in this area can create difficulty for the epiglottis to function optimally.
The voice box and the folds above it must function well for optimal vocalization. In addition to a weak cry, laryngomalacia and stridor can involve tight fascia in this area.
Gillespie Approach Therapy
The goal of therapy is to become strain-free in the above areas. Please remember that in the full-body fascial web, strain from anywhere can pull into the throat area—these issues are not just a local problem.
I often have mom or dad help me by holding three separate areas with a finger while I am listening in an another area of the body. The first technique is behind the chin on the outside of the floor of the mouth. The second is just above the Adam’s apple in the epiglossal region. The third is on the Adam’s apple, just over the voice box. I always like the parents being involved in therapy and part of their child's solution.
The ultimate answer is to check each newborn on day one to deal with the problem immediately. Gillespie Approach Training is a must for newborn providers.
