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Three Things to Know About Neonatal Speech Therapy

Think speech therapy is only for big kids? Ashley Emmett, speech pathologist at HCA Houston Healthcare West, explains how speech therapists prepare premature babies for life outside the womb.

As the new parent of a premature newborn, people may expect any number of specialists to knock on their door; however, a speech therapist is typically not one of them.

While Hollywood may have relegated the role of speech therapy to childhood speech impairments, such as stuttering or lisping, the role of these professionals is actually quite broad. Neonatology is just one area in which collaboration with speech therapists can be critical to health, and at times, even survival.

As a speech pathologist at HCA Houston Healthcare West, I have the privilege of working with the oldest and youngest among us, and everyone in between. While the caregivers of my elderly patients expect to see me, I often encounter initial resistance from the parents of the babies I treat. This is perfectly understandable – after all, who would expect a baby who can’t yet talk would need a speech therapist? – however, it’s important that these parents quickly come to terms with the vital role of speech therapy, so they can begin to collaborate on the long road of preparing their newborns for the outside world.

I find the first step to parents’ accepting my position on their babies’ care team is understanding that speech therapy for babies is actually much more common than they may think. Speech therapists are experts at working with the muscles involved in speech and swallowing, which are often underdeveloped in premature babies. For this reason, a neonatal speech therapy program is actually a requirement in Level III NICUs.

While not all parents of premature babies will need to work with a speech therapist, those who do can expect their support with:

  • Ensuring healthy weight gain: As mentioned above, premature babies may have trouble swallowing due to poor or undeveloped muscle tone. This may prevent them from eating and gaining enough weight, putting them at risk for complications. Speech therapists observe babies who are struggling to eat and help their parents work through challenges, such as cleft lips and/or cleft palates, tongue ties (a congenital condition which restricts the tongue’s range of motion), and other anatomical abnormalities, to promote healthy eating.
  • Learning nonverbal cues: Sometimes a baby’s reluctance to eat comes down to discomfort. Because newborns can’t communicate with their parents, however, it can be easy to mistake this stubbornness for something more serious. Speech therapists help parents decode their baby’s nonverbal cues so they can address their baby’s needs. For example, does baby always fall asleep during feedings? It’s possible they’ve had enough to eat and require shorter, more frequent feeds. Is baby’s nose flaring, body tight, and eyes blinking slowing? Baby may be stressed. Simple adjustments to positioning, or for bottle-fed infants, nipple style, may help.
  • Minimize stress for parents and babies: Sometimes premature infants can struggle to regulate their breathing while they feed, which can reduce their oxygen and cause their heart and respiratory rates to increase. Speech therapists empower parents with information and techniques to minimize stress for both parents and their babies, so families can focus on bonding. These professionals also work with care teams to reduce stimulation for infants, leveraging swaddling and positioning tools to simulate the womb and support healthy brain development for infants who missed those final weeks of gestation.

In general, one of the most important roles of speech therapists is as an educator. In addition to giving parents the tools for a successful stay in the hospital, these professionals are part of the team that helps ensure a seamless transition home and a solid foundation for healthy growth. Speech therapists, in particular, may arm parents with exercises and warning signs for different stages of development to ensure their infants continue to progress well through speech milestones.

While speech therapy for infants is most common in the NICU, any parent with concerns about their infant’s growth should consult their pediatrician to determine whether speech therapy may be a fit.

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