Many people are unaware that a speech pathologist also treats feeding difficulties, including working with infants who have trouble drinking from a bottle or breast. Using different bottle nipples, positioning and external supports can remediate feeding issues. When these changes do not improve feeding other treatment modalities can be implemented.
One aspect is oral motor therapy. This type of therapy involves pressure to the muscles in the jaw, lips, cheeks and tongue. This deep pressure activates the sensory response within the muscle which activates the muscle. In this way we can build strength in the muscle to improve feeding for the infant and prevent or reduce difficulties with speech and feeding as the child grows older. Since the deep pressure is a passive movement (meaning the movement is preformed by someone else, not the child) these exercises can be performed on newborns.
Another component of therapy with infants can be maintaining early reflexes necessary for the development of proper feeding skills. A baby is born with many reflexes that help them survive. For example, the phasic bite which is present to help a baby learn to chew, typically disappears around 10 months of age. If for whatever reason a child isn't exposed to soft solid foods that require chewing before 10 months of age they may lose the ability to learn to chew on their own. Therefore, a therapist will implement exercises to maintain the phasic bite and transverse tongue reflex until the child is determined to be safe to eat solid foods. Listed below are all of the reflexes your baby is born with to help them learn to become successful eaters:
Rooting reflex- your baby will turn to which ever side of the face is stimulated and will begin sucking motions to ensure successful breast or bottle feeding. This reflex disappears around 3-6 months of age.
Suckle and suckle-swallow reflexes- with the suckle reflex, a baby will suck on anything that touches the roof of their mouth. With the suckle-swallow reflex, once the baby sucks liquid from a nipple and the milk enters the mouth the swallowing reflex initiates. The suckle reflex disappears around 6-12 months of age, but the swallow reflex is present throughout our lives. Pay attention the next time you swallow, once your tongue pushes the food or liquid into your throat the swallow is reflexive and you can't stop it.
Tongue reflex- your babies tongue moves in a front to back wavelike movement to help them suck liquid from a nipple. This reflex disappears around 12-18 months of age.
Gag reflex- at birth the gag is on the front 1/3rd of the tongue. This is to prevent the baby from choking on anything other than liquid that may enter their mouth. As the baby grows and begins to mouth toys, hands, etc. the gag will move to the very back of the mouth. This reflex is present for our entire lives.
Phasic bite reflex- this is a rapid, rhythmical up and down movement of the jaw when the gums are stimulated. This phasic bite is present to help children begin to learn to chew. This reflex disappears around 9-12 months
Transverse Tongue reflex- your babies tongue will move to the side that is stimulated. This is another important reflex to assist your baby when they learn to eat solid foods. Next time you eat something pay attention to what your tongue does, it moves food to the molar area and helps keep food there in order to chew. This reflex disappears around 12-18 months.
If your infant is having difficulty with breast or bottle feeding a speech pathologist may be able to help. Request an evaluation with a speech pathologist who has experience treating feeding issues in infants and children.
References:
Bahr, D. (2011). Nobody Ever Told Me (or my Mother) That!: Everything from Bottles and Breathing to Healthy Speech Development.
Katie is the owner of Katie Carney Speech Therapy, LLC, where she provides play based and family centered speech and feeding therapy on the south side of Chicago. Katie has a passion for proper oral motor, feeding, and speech development. To contact Katie visit her website at katiecarneyspeech.com, call her at 773-914-2194, or email her at info@katiecarneyspeech.com.