Feeding Blog
how to raise a happy healthy eater
Oral motor issues that affect feeding often also affect feeding and sometimes speech as well! In a perfect world, when we are not speaking or eating, we breath through our nose alone, mouth closed! When this doesn't happen, we say that a person is a mouth breather, meaning they have an open mouth posture at rest and this can happen during the day or a night, or both!
Scientists are discovering that there's a link between mouth breathing and one's ability to focus and pay attention along with a host of other things! Why? Well, mouth breathing brings less oxygen to your brain and we know we need oxygen to do anything well. Nasal breathing is significantly more beneficial to the body and mouth breathing is quite harmful actually. In most cases, mouth breathing is a temporary solution for a child who has blocked nasal passages from a cold or allergies. However, if mouth breathing persists over time, it can be a sign of sleep apnea, a deviated septum, tongue-tie, enlarged tonsils, or sinus polyps. Although snoring and mouth breathing are common now in children, physicians don’t usually screen for sleep-related breathing disorders. Parents should share ALL symptoms with their child's doctor at their next appointment. ADHD and mouth breathing share some common symptoms, including:
How to Tell If Your Child Is Mouth Breathing When they are awake:
Why is ADHD and Mouth Breathing Connected? Mouth breathing brings less oxygen to the brain compared to nasal breathing. Less oxygen, along with poor sleep creates a perfect storm for an unfocused day. One study proved that mouth breathing brings less oxygen to the brain compared to nasal breathing, which adversely affects brain function and gives rise to ADHD symptoms. It also found that, “Children with sleep-disordered breathing were from 40 to 100 percent more likely to develop neurobehavioral problems by age 7, compared with children without breathing problems.” It’s not uncommon for a medical provider to prescribe medication for this condition, but it is not also a condition that warrants medication. It requires a closed mouth! Many countries require a sleep test in children before these medications are given, but the United States is not one of them. It is important to explore all reasons for attention disorders before starting medication that may cause other effects. Why is Mouth Breathing and Feeding Connected? Mouth breathing happen with the jaw is low and usually the tongue comes along with it. When the tongue and the jaw are not doing what they are supposed to do, it indicates weakness, possible restrictions (ties) and instability. When you are that, it means the oral motor skills are generally poor and poor oral motor skills means difficulty moving food around in the mouth. This can create a negative experience with food and lead to children pushing out foods from their diet until they are left with a minimal number of 'safe' foods. What's The Solution? Helping your child stop mouth breathing can be done in a number of ways, depending on your child’s specific needs. It starts with an airway and a myofunctional assessment to determine what is exactly going on. Then, some options include myofunctional therapy to strengthen the tongue, a frenectomy to release a too-tight tongue, or other orthodontic appliances to expand the mouth and airway. If your child has been diagnosed with ADHD or has ADHD symptoms, and if you think they may breathe through their mouth, schedule an evaluation with us! We can asses your child's oral motor status virtually or in person. This will require a team approach though! Usually an ENT and orthodontist are an integral part of this team to remediate fully. Give us a call to schedule today 516-669-0434
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If you are struggling to figure out your child's pick eating habits, oral motor may not be an area you have explored enough. In fact, I can almost guarantee you haven't explored this enough! Why? Because most people pay it no mind. I know I didn't for many years until I took more focused training courses. I talk a lot about ties in my podcast and newsletter when I discuss oral motor, it's just bound to come up. It's been so prevalent in my work that it's impossible to ignore. I get into some theories about why ties are becoming so "popular" these days. A tongue or lip tie occurs when the connective tissue under the tongue doesn't recede in utero and attaches further forward than it's supposed to. In infancy, it can impact breastfeeding, and as the child grows, it can impact feeding, speech, sleep, and result in the need for orthodontic treatment. Here are some red flags on a possible tongue and/or lip tie that may need to be addressed:
impacts
If you feel as though your child has some of these red flags, look into getting a myofunctional evaluation with someone who has training and specializes in oral motor issues.
You can also listen to the podcast episode where I break this down further! Click the link here. 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.
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.
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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. Archive
April 2023
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