by Marcy Martin OTR/L
> 4 Tips to Help a Child Transition into Chewing
There’s no doubt a mother feels the pressure when her child is not able to eat age-appropriate foods.
Giving nourishment to a child is an innate desire God has placed within mothers, so few things frustrate a mother more than experiencing feeding problems with a child. Add to those frustrations the pressures from relatives, friends and sometimes even complete strangers who love to give unsolicited, “helpful” advice on the topic, and you have a very discouraged and exasperated mom who feels like she already tried every trick in the book.
If your child has significant feeding issues that you feel may be affecting his or her nutrition or weight gain, you should talk to your pediatrician about possible causes and request a referral to a Feeding Therapist, Dietician, and/or Gastroenterologist.
In the meantime, here are 4 simple recommendations to try if your child is having trouble transitioning to foods that require chewing:
1. Come to the table: Placing a child in a chair with hips at a 90-degree angle with the back supported and the feet flat on a surface will provide a firm foundation. A good supportive foundation is important structurally to allow children to develop oral motor skills and control. Create this position for your child by adjusting the high chair, putting a stool under your child’s feet or allowing your child to eat at a kid-sized table.
2. Change the cup: As odd as it may sound, sometimes a problem with chewing could stem from a pattern of drinking–especially drinking from a sippy cup. Sippy cups are convenient for mothers on the go, and as a mom of three boys I understand and would never deny you the convenience. However, if a child is not chewing food, taking a look at the type of sippy cup you are using as well as the frequency of use is important because children sometimes get “stuck” in the reflexive pattern of sucking. While this sucking reflex is useful for infants, when toddlers chose to suck rather than chew whole foods, they will be at a very high risk for choking.
• Type: Choose a sippy cup that does not have a spout. The rimmed style of sippy cups encourages management of the liquid from the whole mouth. With a spout or straw, a child only learns liquid management in the midline.
The Platex Coolster Tumbler and Munchkin 360 are some examples of rimmed based sippy cups that have all the beloved spill-protection without the spout.
• Frequency: Try to use sippy cups for times away from home. Sippy cups are convenient for times on-the-go, but do you find yourself using them all the time? Allow your child to drink from an open cup or choose a transition cup that helps your child learn to control the liquids flowing into her mouth. This liquid control prepares children to be able to control the position of a food bolus in their mouth.
An easy way to make your own transition cup is to remove the sippy device from the Coolster pictured above. For recommended transition cups, you can try one of the cups pictured below. Some spill may occur in this transition, but the mess will be reduced with the OXO trainer or a kid’s Tervis tumbler with a control slide button on the lid to adjust the flow.
3. Play tongue games: In order to chew, children first must be able to move the food from the middle of the mouth to the molars toward the back of the mouth. If a child’s tongue has only learned the sucking movement pattern, he may not have developed oral motor control of the tongue to be able to manage the food for correct placement to chew. Learning this control is best done initially without food, and there are a couple of easy ways you can work with your child to help him acquire this control.
• In and out. Have your child practice sticking out his tongue. A lollipop can be a nice target for the tongue to try to reach.
• Side to side. Sit in front of your child and show him how you can move your tongue from one side of your mouth to the other. See if your child can imitate this motion, moving his tongue from side to side outside of the mouth. Licking yogurt or peanut butter from the corners of his mouth can be another way to teach this oral motor skill.
4. Stop the food sucking. We live in a day where toddler food is packaged like an MRE (Meal, Ready-to-Eat) for a solider headed into battle without a known food source for months. This kind of packaging is super-convenient, but we can find things to pack for our child’s snacks or lunches that don’t require children to use a sucking pattern in order to obtain food. Pureed food should always be given from a spoon as this delivery format encourages the child to develop oral motor skills necessary for progressing to a higher texture of food.
Most full-term babies are born with an ability known as suck-swallow-breathe; it is this ability that allows a newborn to bottle- or breast-feed successfully. Giving your child prepackaged pouch foods with straws prolongs the sucking pattern innate to newborns and ultimately inhibits the development of the oral motor skills necessary for chewing. If your child is already having trouble chewing, it is best to stay away from toddler foods packaged with straws similar to one pictured below.
in the Quiver
in the Quiver 