Weakness in drinking occurs mainly in premature infants and corresponds to a reduction in the sucking reflex. Causes may include lesions of the central nervous system, infections, or medication taken by the mother during breastfeeding. Treatment is by gastric tube if necessary.
What is weakness in drinking?
Infants have more reflexes than adults. This excess of reflexes is related, on the one hand, to the still insufficient maturation of the motor neurons and, on the other hand, is intended to ensure the infant’s survival. One reflex that is vital in evolutionary biology is, for example, the sucking reflex, which moves infants to suckle at the mother’s breast. The reflex is triggered by a touch stimulus on the newborn’s lips. So-called drinking weakness involves disturbances of this reflexive sucking movement. Drinking weakness manifests itself in the neonatal period and corresponds to a sometimes pathological symptom, which manifests itself in the form of a reduced sucking reflex. Weakness in drinking may be symptomatic of a superordinate disease and thus refer to a syndrome, for example. However, the reduction of the sucking reflex may also be an acquired phenomenon. A discreetly reduced sucking reflex does not necessarily have pathological value. Weakness in drinking is particularly frequently observed in premature infants.
Causes
Each reflex corresponds to a reflex arc. At the beginning of the reflex arc is a stimulus that is received by sensory cells and causes them to form an action potential. Via sensory afferent nerve pathways, the stimulus information reaches the central nervous system, where it is wired to motor nerve pathways and finally travels to the muscles involved. In this way, a stimulus triggers a motor reflex response in the sense of a movement or a sequence of movements. A reflex arc also underlies the infant’s sucking reflex. Weakness in drinking corresponds to a disturbance of the reflex arc, which is either congenital or acquired. The cause is damage to the nerve tissue involved in the reflex. This damage may correspond to traumatic, inflammatory, toxic or genetic damage. Genetically caused forms are usually underdevelopments of the involved nerve structures. Apart from these causes, weakness in drinking may refer to infections. The drinking reflex may also be diminished in weakened infants. In addition, drinking weakness may be associated with maternal medication use during lactation.
Diseases with this symptom
- Malnutrition
- Tetanus
- Meningitis
Diagnosis and course
When the maternal breast touches the mouth of infants or their mouth is gently touched by a finger, this touch triggers the sucking reflex in a healthy infant. A newborn with a feeding weakness does not suck, or at least sucks with reduced force, despite the touch. This raises feeding problems. For this reason, the most common accompanying symptom of weak drinking is malnutrition, which can further weaken the infant’s constitution. There is no talk of pathological weakness in drinking until a certain degree is reached. If the infant remains asymptomatic despite a slight reduction in suckling, the weakness in drinking does not usually have any pathological value. If accompanying symptoms or marked weakness are present, there is disease value. In addition to weakness due to malnutrition, other symptoms may develop, each depending on the cause of the reflex reduction. The first suspicion of a weakness in drinking is developed by the physician during the anamnesis. Visual diagnosis can also provide crucial clues, such as when malnutrition, abnormal weakness, or symptoms of a particular syndrome with symptomatic weakness in drinking are evident. The extent of weakness in drinking can be determined by performing a provocation test in the form of touching the mouth. To determine the cause of poor drinking, wide-ranging investigations take place. Imaging of the brain and spine, for example, reveals lesions of the central nervous system. The presence of infection can also be confirmed or ruled out by clinical examination. The prognosis for infants with weakness in drinking depends on the extent of the reflex reduction.
Complications
Many different complications can occur with poor drinking, depending greatly on the severity of the poor drinking. However, weak drinking always represents a very unhealthy condition for the human body and therefore must always be treated. Without treatment, weak drinking can lead to serious consequential damage that is no longer reversible. As a rule, drinking weakness results in severe headaches and other discomforts. The patient often feels tired and depressed, and a general feeling of illness sets in. Patients should drink fluids especially during flu and colds. In case of a drinking weakness, sports activities can only be carried out under severe restrictions, because the patient does not have enough water to sweat. In the worst case, this can lead to circulatory collapse if the heat cannot be properly dissipated. Mostly a drinking weakness is treated during psychological conversations, because it often has a psychological cause. In many cases, just a few conversations help to eliminate the weakness in drinking. Parents also play an important role in preventing the development of poor drinking in their child. Most of the time, however, the disease progresses positively and does not lead to further complications if it is treated in time.
When should you go to the doctor?
Weakness in drinking occurs in most cases in infants. In this case, the swallowing reflex is not developed at all or only partially. For this reason, there are problems and complications with feeding. If affected parents notice this clinical picture in their own child, a doctor must be consulted immediately. Only appropriate treatment can provide a remedy. Anyone who forgoes treatment or a visit to the doctor at this point is taking a dangerous risk. Under certain circumstances, malnutrition can occur, which can have serious consequences, especially at this early stage of development. Nutrient deficiencies can lead to permanent damage, making a visit to the doctor imperative. Thus, the following applies: Most nutrients are absorbed by infants through drinking. For this reason, it is immensely important that infants consume sufficient fluids. If this process is restricted by a weakness in drinking, extreme caution is required. In such a case, a visit to the pediatrician should not be put on the back burner. Only early treatment can prevent permanent consequential damage. If you wait too long at this point, you must expect permanent consequential damage for your child.
Treatment and therapy
The therapy of a drinking weakness depends sometimes on the causes and the extent of the weakness. In the case of a decently pronounced weakness in drinking, the infant first receives the bottle with the required amount of milk. The choice of teat is crucial in this case. The teat is chosen in a design that makes it easier for the infant to suck. If these measures are not sufficient to secure feeding, a feeding tube may be used to stabilize the constitution. The tube is usually inserted through the nose and reaches the digestive tract through the nose. Through this tube, the infant is fed for as long as necessary. In most cases, pronounced weakness in drinking is treated as an inpatient in the hospital. If, instead of damage to the brain, the mother’s medication causes the drinking weakness, the bottle feeding of foreign milk is usually sufficient for treatment. In the case of infections, treatment in most cases corresponds to the administration of antibiotics or anti-inflammatory drugs if infectious inflammation is present. Thus, causal treatment of weakness in drinking is only given in cases of weakness in drinking due to maternal medication or general weakness and in cases of reduced reflexes due to infection. In the context of lesions of the central nervous system, the weakness can only be treated symptomatically.
treated symptomatically.
Outlook and prognosis
Weakness in drinking can lead to various complications and further discomfort. In many cases, the weakness to drink improves and disappears on its own, so no additional treatment is needed. If the weakness in drinking is not treated, the body will permanently receive too little fluid. This has a negative effect on the individual organs and the quality of life.In many cases, weak drinking thus leads to headaches and a general feeling of weakness. In the case of very severe weakness in drinking, certain organs can also be damaged by the lack of fluid. In some cases, sufferers also experience fainting spells. In most cases, treatment leads to success and does not entail further complications. However, in some cases it must be done psychologically, if the weakness in drinking has arisen due to a psychological problem. Parents must teach their children that weak drinking can be dangerous for their own bodies. Thus, they bear a great responsibility to avoid this symptom.
Prevention
Weakness in drinking can be prevented only to the extent that measures are available to prevent infection or maternal medication during breastfeeding. Genetically determined lesions of the central nervous system are difficult to rule out completely. However, abstinence and a balanced diet during pregnancy, among other things, can be broadly understood as a preventive measure.
What you can do yourself
If there is a suspicion of drinking weakness, a pediatrician must be consulted promptly. In everyday life, it is useful to check the child’s weight regularly and observe the behavior. If the child gains weight, there is hardly any danger. If the child is very restless, gets tired quickly, sleeps excessively, can hardly be woken up – then it is necessary to consult the pediatrician. Together it can be decided whether breastfeeding is sufficient, or whether supplementary feeding is necessary. Even a feeding tube is an option temporarily. When milk is given from a drinking bottle, it is easier to control the amount taken. More frequent smaller meals of thin-bodied milk are good for weak-drinking infants. The size and type of teat can also have a positive effect on drinking behavior. Before meals, stimuli placed in the mouth area are helpful in developing the swallowing reflex. Light finger pressure on the lips, gentle massages on the floor of the mouth or small taste stimuli on the tip of the tongue promote awareness in the mouth. The little finger strokes the gums, circles the cheeks, applies gentle pressure to the palate and tongue. Often the child then begins to suck on the finger and is then alert enough to eat.
