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If you go down any feeding aisle in any baby store, you are sure to see about 30 different types of cups. Don't even start typing it into Amazon! You will be in a never ending rabbit hole of drinkware. But when and what type of cup to get? How soon is too soon? Let's dive into the details! WHAT DOES A TYPICAL SIP OF LIQUID LOOK LIKE? By 12 months of age, your child will begin to develop a mature swallow pattern rather than suckling with their tongue, which is used when your baby is breastfeeding or feeding from a bottle nipple. When taking a sip from an open cup, the head is in a neutral or slightly tucked position. The tongue is initially retracted, then the tip of the tongue will elevate to touch behind the teeth to swallow the liquid. The tongue should not go into the cup and does not rest on the rim of the cup. When taking a sip from a straw, the head is again in a neutral or slightly tucked position. The straw will touch the lower lip, then the lips will round around the straw. The tongue again stays initially retracted, then the tip of the tongue elevates to touch behind the teeth to swallow. The tongue should not stick out and the tongue should not wrap around the straw. It is important that your child elevates their tongue tip behind the teeth to ensure safe and effective chewing and swallowing. If the child pushes their tongue forward when taking a sip or if they continue to rest their tongue on the rim of the cup or straw, they may develop a low resting tongue posture and/or tongue thrusting over time. These immature postures can cause significant feeding, airway, and speech and language difficulties. When first introducing a cup to your baby around 6 months of age, start with an open cup where they can take small sips a few times throughout the day, such as during mealtime. Then, between 6-9 months of age, introduce a straw cup that assists their ability to sip through a straw by priming liquids into the straw (e.g., Honey Bear Straw Cup or Rubbermaid Juice Box Straw Cup). After they can successfully and consistently take sips from this type of cup with a straw, you can start to introduce more advanced straw cups that require your baby to independently sip through the straw. It is recommended that you continue to offer a variety of cups (i.e., open cups and straw cups) that promote a mature swallowing pattern and appropriate tongue placement rather than focusing on use of a single cup. This allows your baby to learn to use and become comfortable with various cups, just like us. If you have concerns related to your baby’s feeding and/or swallowing, reach out to your pediatrician or to a speech language pathologist in your area, or contact our office. If you’re interested in how your baby’s development relates to feeding and swallowing, you may want to check out, “Feed Your Baby & Toddler Right: Early Eating and Drinking Skills to Encourage the Best Development” by Diane Bahr. If your child is struggling to master this or you just want some personalized guidance, Contact us to work with us directly, and if your child is a picky eater, you can also learn how to work with your child yourself using our proven strategies in our self-paced parent course.
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WHAT ARE ORAL HABITSWe’ve likely all engaged in oral habits at some point or another. There are some oral habits that are considered developmentally appropriate as long as they resolve before our mouth and jaw finish developing. Oral habits are repetitive, automatic actions or patterns of behavior surrounding the oral structure. These may include thumb sucking or lip biting. Oral habits often develop as soothing mechanisms during infancy and childhood, however prolonged use of oral habits can significantly alter how the teeth, mouth, face, and airway develop and lead to oral dysfunction, tongue thrusting, poor sleep, and more.  COMMON ORAL HABITS & POSSIBLE IMPACTS Biting Nails - Regularly biting your nails is not only unsanitary, but it can cause:
Lip sucking, cheek biting, and lip biting
Chewing on Straws
Thumb sucking - Although thumb sucking during infancy helps the infant become ready for feeding and can help soothe them, prolonged thumb sucking can cause:
ADDITIONAL PROBLEMS THAT CAN ARISEAside from the significant impacts to the teeth, mouth, and face listed above, failure to address these can create additional problems.
HOW CAN WE HELP?We will help you or your child eliminate poor oral habits. The ideal time to start Orofacial Myofunctional Treatment is 7-8 years of age, but adults and children as young as 4 can benefit from support in oral motor development and elimination of poor oral habits. We don’t stop there though! It’s important to treat all resulting factors and therefore treatment targets may also include establishing correct resting tongue posture, establishing nasal breathing, learning to chew and swallow correctly without tongue thrusting, and correcting speech sound errors. If your child is struggling to master this or you just want some personalized guidance, Contact us to work with us directly, and if your child is a picky eater, you can also learn how to work with your child yourself using our proven strategies in our self-paced parent course.
 So your little baby is growing up fast, and it's already time for them to start drinking from a cup! At 6 months of age, we want to start teaching them how to use cups and straws, right when they start solid foods!
Just because a cup is on the market doesn't mean that it's good for your baby. In fact, many cups on the market today HINDER your baby's oral motor development. It’s best to avoid cups that promote continued use of an immature swallow pattern which utilizes the tongue for control as opposed to the lips and other facial muscles. This can lead to a prolonged tongue thrusting pattern that eventually is no longer developmentally appropriate. This behavior has the potential to lead to additional difficulties later related to eating, drinking, speech, and more. Here are some examples of items to avoid: Spouted sippy cups are very common, however, they are not ideal for mouth development. Spouted sippy cups promote jaw thrusting when sucking and require the tongue to protrude out under the spout to engage in a suckling pattern to take a sip of liquid. This promotes your baby to maintain use of an immature sucking and swallowing pattern and can lead to prolonged tongue thrusting. In addition, the head must tilt back, which extends the neck. This can open the airway and allow liquids to enter the airway rather than traveling down the esophagus. Cups with a top membrane, such as the Munchkin 360 cup, may also promote an immature swallow pattern. Your baby must tilt their head and extend their neck to take a sip, similar to a spouted sippy cup. Additionally, you must press your upper lip into the top membrane of the cup and suckle the rim of the cup to take a sip of liquid, which again promotes an immature sucking and swallowing pattern. While we have discussed some straw cups recommended for your baby, be careful when choosing a straw cup. There are some straw cups that promote suckling and immature swallow patterns. Here are some considerations when choosing a straw cup: Consider the length of the straw. Short straws promote a mature swallow pattern and reduces the likelihood of the child biting the straw or using the straw on one side of their mouth. Instead, the child must use their lips as well as their supporting facial muscles to take a sip and a short straw ensures use of the straw in the center of the lips which supports balanced facial muscle development. Avoid cups with soft straws, such as the Dr. Brown’s straw cup which has a soft, silicone straw. Soft straws often collapse when you try to take a sip as expected (i.e., straw touching the lower lip and the lips rounding around the straw) and therefore no liquid will go through the straw. However, if you suckle the straw, you’re able to get sufficient liquid through the straw, prompting continued use of an immature sucking and swallowing pattern and tongue thrusting. There are additionally some weighted straws that similarly collapse while your child takes sips of the liquid from their cup causing them to rely on sucking. It’s recommended you try out the straw ahead of time to ensure that the straw does not collapse or require suckling to access the liquid. Also consider the diameter of the straw. Monitor your child’s sips. Straws with a large diameter are great for drinks such as smoothies, but a larger diameter allows for a greater amount of a thin liquid, such as water, to move through the straw. You may need to choose a straw with a more narrow diameter to restrict the flow of liquid if your child is coughing or showing other signs that the amount of liquid is overwhelming. As a parent, I know how much worry and planning goes into every detail of your child’s life. We want the best for them at every turn, and there are so many decisions to make! Hopefully, we have helped narrow down some options for this one topic, and guided you on the right path so you can check this off your list! Contact us to work with us directly, and if your child is a picky eater, you can also learn how to work with your child yourself using our proven strategies in our self-paced parent course.
We also want to give you recommendations for straw cups that promote healthy oral-motor skills:
For some of the options above, your baby can squeeze each of these cups to help prime the liquid into the straw, which encourages and eases them into straw drinking. You might be asking, why the emphasis on short straws? Short straws will continue to promote a mature swallow pattern through facilitating the use of lips and other facial muscles when swallowing; not the tongue. For the more advanced straw users:
These options of cups with straws are great for a child with a more mature swallow pattern, where they are able to utilize lip and jaw strength with more consistency and have moved away from the suckling pattern with the tongue. Some are faster flow, which also requires more control and strength.
Studies have shown that more than 75% of children present with some kind of malocclusion and between 57-59% of children need some kind of orthodontic correction. I don’t know about you, but that sounds like a lot of time, money and pain! But, research has proven that the need for orthodontic correction actually is not hereditary or caused by big teeth or small jaws. Research has instead found that the real causes are incorrect myofunctional habits, such as mouth breathing, tongue thrusting, reverse swallowing, and thumb sucking. By addressing these underlying causes, the teeth are able to come in straight - often without braces! As a result, there may be another option to prevent the need for traditional braces: Myobrace®. Myobrace® is a preventative pre-orthodontic treatment that focuses on improving incorrect myofunctional habits which can cause crooked teeth and poor jaw development. It consists of a series of removable intraoral appliances that you wear overnight, while you’re sleeping, and for approximately 1-2 hours each day. There is an additional patient education program (Myobrace® Activities) which focuses on a series of breathing, tongue, swallowing, lip and cheek exercises that the child completes twice daily with the Myobrace ® appliance in place. Myobrace® treatment focuses on correcting poor oral habits, developing and aligning the jaws, straightening the teeth, optimizing facial development, improving overall health, and promoting healthy eating habits through four stages.  The first stage focuses on habit correction. This stage focuses on any poor oral habits the child engages in by teaching the child to breathe through their nose, retraining the tongue to correctly rest in the roof of the mouth, swallow correctly, and keep the lips together at rest.
The second stage focuses on arch development. If needed, an appliance and technique can be used together to widen the upper jaw to allow sufficient space for the teeth and tongue in the mouth. The third stage looks at dental alignment. This stage does not occur until the last of the child’s permanent teeth are coming in. The appliance aligns teeth to their natural position. Depending on the child’s individual needs, it is possible that braces may be needed in conjunction with the Myobrace® for Braces for final alignment, although it’s typically for a much shorter period of time. And finally, the fourth stage is all about retention. This stage ensures that your child continues to use good oral habits, which often prevents the need for a permanent retainer or wire for a long time. As long as the child continues to demonstrate a high level of compliance with the treatment process and engages in good oral habits, Myobrace® treatment leads to more stable orthodontic results. Plus, Myobrace® not only decreases the need for orthodontic correction by addressing incorrect myofunctional habits, but it can support your child’s health too. Myobrace® addresses issues related to airway dysfunction (resulting in better sleep and therefore, better overall daily functioning!) throughout treatment and teaches your child about good dietary habits via the nutrition program. When can you start Myobrace®? The earlier the better! Myobrace® is best suited for children between the ages of 3 and 15 years old, but it’s important to note that the child must demonstrate compliance throughout the entire process and cannot be started until the child can engage in the exercises provided and is willing to wear the brace overnight and for a portion of the day. Because of this, the optimal range to start treatment is between 6-7 years old. So, what are you waiting for? If you’re interested in additional information about Myobrace®, visit this website: https://myobrace.com/en-us/what-is-myobrace or contact our office. We evaluate and remediate myofunctional disorders for children and adults. Contact us to work with us directly, and if your child is a picky eater, you can also learn how to work with your child yourself using our proven strategies in our self-paced parent course.  Introducing solid foods is a fun and exciting stage in your baby’s development! But, it may also invoke a little anxiety. And maybe even a little confusion with the number of baby books and amount of information out there. Here are 5 tips to help get you started:
1. Focus on food exploration - Transitioning to solids is a huge step! It’s important to introduce your child to the foods on their plate. Let them explore the various tastes, smells, and textures without worrying about the amount of food they are eating. Remember that your child is still learning to eat, so it’s ok if they have 1 bite of food or 10 bites - that’s why they still have their milk available to them. 2. Get messy! - It’s important to let your child explore their food, not only with their mouths, but with their hands too! Allowing your child to play with their food lets them explore all their senses and become familiar with each food item in front of them. It also helps them find enjoyment in the routine. Go slow and give them time to feel comfortable. Plus, let’s be honest, if they have some food on their hands - it’s likely going to end up in their mouth too! Try to avoid cleaning them up in their chair after and instead, bring your child to the sink for clean up. Getting messy really is a big part of learning about food and we don’t want them to associate negative feelings with meal time. 3. Always wear a smile! - Have you ever noticed that when you’re on high alert, your child is too? Kids pick up on cues that let them know when we are happy, mad, sad, etc. If you’re not happy, then your child won’t be happy either, which leads to an unenjoyable mealtime for everyone. Try to use positive language throughout the meal to help make your child feel happy and comfortable. 4. Model tasting foods – Think about that time your friend made a disgusted face after taking a bite of food and said, “you should try it”. Did you want to try it after that? This goes for your child too! If you won’t eat it, why would they want to? Have them try foods/flavors that you’re interested in too and remember, model with a smile - they’re only as excited as you are! 5. I’ll have what you’re having! - Kids should ideally be eating as many home cooked meals as possible! Eating too much food from jars and pouches limits flavors and variety while home cooked meals allows for the greatest variety of flavors. You want to be sure to avoid too much salt early on, but make sure you’re keeping all those other flavors in your child’s food. Spices (even spicy flavors) are all beneficial. Plus, when you’re eating the same foods as your child, it’s easy for you to model tasting those foods. Remember to have fun with it and enjoy this fun stage in your child’s development! You’re holding your little bundle of joy and you’re so excited to bond with them. But, as you begin breastfeeding, your baby isn’t latching properly. Or maybe is hungry a lot more often than expected. *Cue frustration, worry, and that mother’s intuition that deep down you know something is up. Just know - you are not alone! There are many different reasons for difficulty with feeding. One reason may be tethered oral tissues (TOTs). The most well-known TOT is a tongue tie (lingual tie). But it’s also possible for your child to have a buccal (cheek) or labial (lip) tie. Now the presence of a piece of tissue, otherwise known as a frenulum, does not automatically mean that your child has a “tie” that affects the function of your body in some way. We have to look and see if your child’s tie impacts their feeding (breast or bottle), chewing/swallowing, breathing, sleeping, speech, or even body movements or posture. Now, like most people, you’re probably Googling a course of action. And “AHHH!” there is so much conflicting information out there! Now what? Seek out a professional who will appropriately assess your child’s oral function before immediately recommending surgery. Here are some professionals or types of therapy may need to search for:
SO, WHAT IS AN ORAL FUNCTIONAL EVALUATION?
AND WHY DOES YOUR CHILD NEED ONE?After an oral functional evaluation, you and the specialist can work together to create goals to help you an d your child. This may mean implementing strategies or writing goals to support body tension and posture, speech, or progression of feeding. If you’re thinking about a frenectomy (tie removal/release), it’s crucial you get an oral functional evaluation first. A TOTs release should be due to functional impact! It is also likely that you will still need to see a specialist following a frenectomy to support your child’s oral function – it won’t magically fix itself. WHAT TO LOOK FOR?There are several symptoms that may indicate that your child has TOTs. These don’t necessarily mean that they do and these don’t necessarily mean you need to look into a release. But if you are seeing some of these symptoms at home, you want to seek out a professional.
Don’t forget- everyone’s experience is different – what your child needs (including their TOTs) may be very different from the next. To find a provider near you, check out the International Consortium of Tongue-Tie Professionals (ICAP). https://tonguetieprofessionals.org/ We teach you how to move your child from being 'picky' to exploring and enjoying all types of foods and help with pre and post tongue tie remediation. Contact us to work with us directly, or you can also learn how to work with your child yourself using our proven strategies in our self-paced parent course.
 If you are like a lot of families out there, you have probably screamed out, "Help! My child only eats chicken nuggets? What can I do?!" This is such a common question I hear quite often. The dreaded chicken nugget food jag. You tried making your own chicken nuggets, different brands of chicken nuggets, making chicken nuggets into fun shapes, pretending the store ran out of chicken nuggets, tricking your kids with a vegetable version of the chicken nuggets, punishing them for not eating foods other than chicken nuggets.....Usually, it doesn't work. *sigh* So what's so darn special about chicken nuggets that kids won't eat anything else?? The answer is kind of complex actually! You first have to really understand the chicken nugget. Now when people say chicken nuggets, that is pretty broad. They usually mean : A Tyson chicken nugget from the brown box with the dinosaur shapes in the 2nd aisle into the frozen food section, baked at exactly 350 degrees for exactly 15 minutes. Kind of specific, right?
They are referring to something fairly uniform in shape, easy to fit in the hand of a child, very soft, and usually found in the frozen food aisle. This is different than to say a small piece of chicken from a restaurant, or a home cooked chicken nugget. Kids can spot the imposter nugget a mile away! A chicken nugget from McDonald's, or in the frozen food aisle, those squishy things with a little crunch on the outside, that is basically predigested food. No, I don't mean someone ate them - ew! I mean the consistency is that of predigested food. It is already mostly broken down. Your child barely has to do any work at all to get those things down. It's also comforting because the shapes and size is consistent. It is 'safe' in their eyes. Their body can handle it, they don't have to think too much- it's a winner. The reason this type of nugget is special to your child has to do with your child's sensory and oral motor needs and abilities. Children with poor oral motor skills that have difficulty properly chewing food and moving it around in their mouth will gravitate towards these softer, easier foods to eat because it requires less work. That's why it is so important that when you see a child who's diet is mainly soft predigested foods like chicken nuggets, or hard but meltable foods like puffs and veggie sticks, or soft pureed foods, you get them into feeding therapy STAT! These are all red flags that the child's body is struggling to properly chew and manipulate food in their mouth. To find a provider near you, check out the SOS feeding therapist provider search! SOS therapists are trained specifically in techniques to tap into your child's sensory system to desensitize them while also targeting the oral motor skills needed to advance the child onto more complex foods and textures. Please take the questionnaire found here! We teach you how to move your child from being 'picky' to exploring and enjoying all types of foods. Contact us to work with us directly, or you can also learn how to work with your child yourself using our proven strategies in our self-paced parent course. |
AuthorChristine Miroddi Yoder is a parent and feeding expert. She is the author of the book Mealtime Mindset and the Podcast How to Un Picky Your Picky Eater and owner of the feeding clinic Foodology Feeding Therapy. Archives
December 2022
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