Happy New Year!! I know the holidays have just ended and most of us ate our way through November and December without one thought as to how complicated it actually is to eat! I definitely didn’t have any trouble eating all the wonderful holiday treats! The ability to eat and swallow our food is not innate, unlike breathing. Feeding is a learned behavior that develops gradually from infancy to 3-years of age. This gradual progression of feeding skills can be negatively impacted by too many factors to list, but let it be said that considering how many there are, it is amazing most of us learn to eat without any difficulty!
Let’s start from the beginning! Mom and dad are so excited to have this little adorable wonder in their home and are surprised how frequently that tiny little body needs to eat at all times of the day and night! They are amazed that they just have to touch their baby’s lips and she opens her mouth to take the nipple and sucks until she is satiated. When the baby is suckling, her tongue cups the nipple forming a channel for backward movement of the liquid and simultaneously the cheeks, tongue, jaw and lips create negative pressure that draws the liquids out of the nipple and the liquid moves back stimulating the swallow reflex. The baby’s jaw, tongue, lips and cheeks all work as one unit. Whew!
Then comes the day when mom and dad can give their little pumpkin a spoonful of rice cereal! Little Pumpkin is 6-months old and so excited and ready, her legs are kicking and her arms are flaying in the air! She sees mom scooping up some cereal and she opens her mouth as wide as she can and leans towards the spoon…then closes her mouth and WOW that was yummy! She mashes the cereal against the roof of her mouth and eventually moves it back and Walla! She swallows!! So easy. Let’s be honest, it is incredibly messy….but fun! With more practice Little Pumpkin will be able to calmly use her lips to clear the food off the spoon without involvement of the jaw. She is able to move her upper lip outward and downward and her lower lip outward and upward. Fancy girl!! She has developed the ability to move her lips independently from her jaw. Things are not working as one unit anymore! During this same time she will start showing off and blowing raspberries (bubbles) and saying “mamamama” or “babababa” as often as she can! Maybe she should try drinking from a cup!!
This next part is scary but exciting for mom and dad. Is it really o.k. to give our Little Pumpkin some real food? Like a cheerio or a small piece of a banana? She is only 8-months old! Yes!! She is ready to try more exciting fare, she is past that puree stuff. Mom and dad offer her a Puff and she loves it and eventually gets really good at eating them! She says “mamamama”, “dadadada” and they turn to look at her, she puts a cheerio in her mouth and uses her tongue to move it to her new molar and moves her jaw up and down and then moves the chewed cheerio to the middle of her mouth, places her tongue tip up on the “spot” behind her upper front teeth and maybe closes her mouth and swallows. Unbelievable! Such Skill! Mom and dad are so proud!! Their Little Pumpkin has learned to move her tongue independently from her jaw! What a feat!! Now she is ready to make T, D and N!
Over the next 1 ½ years Little Pumpkin will refine her feeding skills as well as her speech. Whew! Who would have thought it would take that much learning just to EAT? Not me!!
As a Speech-Language Pathologist who is trained in feeding, I get to evaluate and treat many children of different ages, who did not develop normal feeding skills and are unsafe feeders and may or may not have sensory or behavioral issues related to food. It is my job as a feeding therapist at Kid Talk to evaluate, along with occupational therapy, what is the main reason or reasons a child might not be eating.
Diagnosing a feeding disorder is like solving a puzzle there are so many factors; are their lips, tongue, jaw and cheeks working as they should, what is the mealtime experience in the home environment for that child, will they only eat foods that are white or crunchy, is their swallow functioning safely? Frequently, children who are having trouble with eating tend to act out at mealtime because they are unable to tell us that they feel food going into their airways every time they swallow or they are unable to chew certain foods so the food gets to a consistency that is easy to swallow or maybe they are allergic to the food and it makes them feel sick. Through observing them eating foods they like, we are able to tell whether or not the cheeks, jaw, tongue and lips are working properly. While being exposed to foods they refuse to eat, it gives us information as to what consistent factor might be impeding the ability of the child to want to eat that particular food or foods; such as they won’t eat any meat or hard to chew foods. If all of this looks normal than appropriate referrals are made to gastroenterologists, allergist or other physicians to investigate further. Based on the information gleaned from the evaluation process a therapy plan will be devised and then the real fun starts!!!
Feeding Therapy at Kid Talk is fun and rewarding for the children AND the therapist!! If you feel your child has a problem with eating please call Kid Talk for a Feeding Evaluation and we will help your child enjoy eating so they too can enjoy all those holiday treats next year with you!!