Swallowing Disorders vs. Feeding Disorders in Children

Swallowing Disorder and Dysphagia are terms that are used often to specifically describe difficulty eating as a result of physiological or anatomical baby eatingissues. These issues result in the inefficiency or inability of a child to safely ingest an age-appropriate diet that meets all nutritional needs. For example, an infant who is unable to coordinate the actions of sucking, swallowing and breathing to nurse may aspirate during meals (when liquid or food enters the windpipe, and may eventually reach the lungs). This could be due to physiological dis-coordination and anatomical weakness. We all have experienced a “Dysphagia moment” before due to this type of dis-coordination which results in “down the wrong pipe” discomfort and, usually, a coughing fit. However, this example is just that- one example of the multitude of ways a child’s swallowing pattern may be negatively altered and result in Dysphagia. It is not always obvious (i.e., silent aspiration will not result in a coughing fit) and has many causes and signs.

What Is A Feeding Disorder?

A feeding disorder is a more broad term that is used to describe the difficulty a child may have accepting a varied and age-appropriate diet. A feeding disorder may best describe a child who shows strict texture and food preferences. A feeding disorder may also describe a child who shows signs of aversion to being fed or feeding themselves. Feeding disorders in children can sometimes develop due to a child’s history of Dysphagia and the uncomfortable eating situations they have experienced. This history will likely impacted their flexibility and acceptance in trying new foods.

How To Identify Swallowing And Feeding Disorders?

A very broad and simplified way to differentiate between these types of feeding difficulties is to consider where the breakdown lies. A child who experiences difficulty getting food from a plate to their mouth for manipulation exhibits a feeding disorder, whereas a child who experiences difficulty getting food safely from their mouth into their digestive system exhibits Dysphagia.

Feeding and swallowing difficulties must be identified and treated as soon as possible for the greatest success of a child. If you have any concerns with your child’s abilities or behavior during meal times, seek out the advice of your pediatrician. An evaluation with a Speech-Language Pathologist, Nutritionist or Occupational Therapist may be warranted to ensure the development of age-appropriate feeding skills and the acceptance of a varied diet.

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Snacks for Kids: How Much, When, and What to Give Them

Snacks are an important part of a growing child’s diet. It is important to set boundaries around snacking in the household, as eating too many caloriesfrom snacks can lead to excessive weight gain. Also, “grazing” on small snack foods all day can decrease appetite at mealtimes. Beloware the general “snacking guidelines” by age.

Snack Suggestions for ages 1-2:

Snacks should be offered twice a day, between meals. At this age, they still need somewhat frequent feedings, as eating every few hours supports their growth and energy needs. Make sure that snack times have defined starting and ending times (about 15 minutes), so that the child isn’t grazing all morning or afternoon.

boy and girl with snack

Smart Snack Choices:

  • fresh fruit
  • dried fruit (once they are able to chew it well)
  • pretzels
  • whole grain or rice crackers
  • rice cakes
  • dry whole grain cereal
  • string cheese
  • only offer water to drink between meals

Portion sizes: ½ piece fruit, ¼ cup dried fruit, 1/3 cup pretzels, crackers or cereal, 1 rice cake, 1 piece of string cheese.

Snack Suggestions for ages 2-4:

Growth rates slow quite a bit during these years, compared to the rate of rapid growth in infancy. Hopefully, up to this point, your child has been offered meals and snacks at regular, scheduled times daily. He or she should have a good sense of when mealtimes are coming and what behaviors are expected at meals. At this age, your child may not need snacks between every meal to support growth. This is the age of picky eating, so be sure your kids have a good appetite for meals by not giving them unnecessary snacks.

Smart Snack Choices:

  • fruit or vegetables
  • granola bars
  • yogurt
  • string cheese
  • rice cakes
  • whole grain crackers
  • only offer water to drink between meals

Portion sizes: 1 piece of fruit, 6 mini carrot sticks, 1 granola bar, 4 oz yogurt, 1 string cheese, 6-10 crackers, 1 rice cake.

Snack Suggestions for ages 4-8:

Growth occurs at a somewhat slower rate during these years. However, kids at this age should be very active. Often, kids will say they are hungry after coming home from school. Do not allow them to come home, get a bag of chips, and sit in front of the TV munching. Instead, offer a small snack, a glass of water, and tell them to go play until it’s time for homework or dinner.

Smart Snack Choices:

  • fruit or vegetables
  • granola bars
  • yogurt
  • string cheese
  • rice cakes
  • whole grain crackers
  • only offer water to drink between meals

Portion sizes: Pick one or two of the choices listed above, based on how hungry your child is and how soon the next meal will be.

Snack Suggestions for ages Pre-puberty and Puberty:

Children start puberty at different ages, and this is another time of rapid growth. Kids in or entering puberty often feel hungry all the time, especially if they are very active. Be sure to have quality snacks available to them. Refrain from stocking the house with junk food, because that is exactly what they will go for first.

Smart Snack Choices:

  • peanut butter spread on whole grain bread or fruit
  • trail mix with nuts and dried fruit
  • cheese and whole grain crackers
  • rice cakes or veggies and hummus
  • smoothie with 1 cup yogurt + ½ cup frozen berries + ½ banana + handful baby spinach leaves
  • granola bars
  • hard-boiled eggs

Portion sizes: ½ sandwich, 1 piece of fruit with 1-2 tablespoons peanut butter, ½ cup trail mix, 1 piece of cheese and 6-10 crackers, 1 rice cake with 2 tablespoons hummus, smoothie per recipe above, 1 granola bar such as a Clif Bar or Larabar, 1 hard boiled egg with ½ piece of whole grain toast.

Children at any age who are overweight or obese should choose fresh fruits and vegetables as their snacks. Children who are underweight should always be offered snacks between meals, and the snacks should include a combination of carbohydrates, fat and protein. If you need more guidance on this issue or on meal planning for your family, make an appointment to see a registered dietitian at North Shore Pediatric Therapy.

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Is Gluten Bad For You?

Recently a colleague asked me: “is gluten bad for you”? I know this question is stemming from the popularity of gluten-free diets. My guess is that many people do not know what exactly gluten is and when a gluten-free diet is actually appropriate. So to answer the question, no, gluten is not bad for you inherently, although it does make some people sick.

Gluten is a protein fraction found in wheat. Yes, gluten is actually a protein. Gluten itself is not a carb. Gluten is found in a carb, and wheat is a major staple carb source in most Americans’ diets multiple times per day. This is why sometimes people lose weight when they go gluten-free, because they are cutting out lots of starchy calories.

How Gluten May Make People Sick:

As I said, gluten can make some people sick. Gluten is the protein culprit that causes the devastating autoimmune response in the gut for people with Celiac disease. Our gut is lined with tiny villi that look like millions of fingers, and these villi contain important enzymes for digestion and also absorb all of the vital nutrients from food that our body needs to function. When someone with Celiac eats gluten via wheat, the gluten causes an immune reaction where the villi are destroyed. On a biopsy under a microscope, the villi will actually look flat and blunted.

gluten diet

Photo from www.marquettenutrition.com

This causes significant symptoms, which vary by person, but can include nutritional deficiencies such as iron deficiency anemia, weight loss, growth stunting, diarrhea, abdominal pain, and vomiting. Celiac disease is also genetic. Some people live with Celiac disease and the accompanying symptoms for years before getting diagnosed. There is more awareness now of Celiac disease, so more people are getting diagnosed. The gold standard of diagnosing Celiac is with a biopsy of intestinal villi by a gastroenterologist. The treatment is life-long strict avoidance of all gluten, and education is provided by a registered dietitian.

What is a Wheat Allergy:

Wheat allergy is one of the top 8 most common food allergies diagnosed in children. A wheat allergy is different than Celiac in that it is not a genetic, auto-immune mediated response, but rather an immune response where IgE antibodies react to wheat proteins as foreign antigens, and mount a response that produces symptoms. These can include eczema, diarrhea, abdominal pain, vomiting, and more. A registered dietitian can help families navigate the difficult wheat-free diet in this case as well.

Finally, many people try a gluten-free diet because they suspect gluten or wheat intolerance. With a gluten intolerance, the immune system is not involved as with allergies or Celiac. But nevertheless, people find that consuming wheat products makes them sick in one way or another. When they stop eating wheat for a couple weeks, they notice many positive changes in their health and the way they feel. For some people this can mean fewer headaches, or less stomach aches, or more energy, or rashes that disappear, and so on.

To reinforce the point, gluten is not bad for you or your kids to eat, unless one of the above scenarios applies. Wheat should be eaten in moderation however, and I recommend rotating different types of grains into your family’s diet for well-rounded nutrition and to prevent over-exposure to one particular food. Some different grains to experiment with include quinoa, amaranth, rice, buckwheat, and millet.

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Arsenic found in over 200 rice products tested, including infant rice cereal!

Recently, Consumer Reports released their findings of arsenic in rice and rice-containing foods that are commonly eaten, including infant rice cereal, Arsenic in Ricerice cakes, white rice, brown rice, organic rice, rice pasta, and more. When I heard about this on the news, I thought about three sectors of the population I work with who would be affected based on their dietary intake of rice: infants who eat rice cereal as a staple in their diet; kids on gluten-free diets who eat rice products as an alternative grain; and ethnic groups who traditionally eat rice daily.

What did the study find?

Click here to see Consumer Reports‘ results table with all the foods tested, including brands, and the level of arsenic found per serving. There are two types of arsenic: inorganic arsenic which is known to cause cancer, and organic arsenic which is also considered toxic. Both types were found in all of the rice products in the study.  The question is what level of arsenic in foods is safe? There are no federal standards set at this point for acceptable levels of arsenic in foods; however, there are arsenic regulations for drinking water.  New Jersey has the most conservative allowed amount of arsenic in water which is 5 ppb. In the table of results, Consumer Reports used 5 ppb as a standard of comparison, and found that many rice foods had levels >5 ppb of inorganic arsenic per serving and many foods having total arsenic levels in the hundreds ppb. Brown rice was found to have more arsenic than white rice, which is because white rice has had the outer layers stripped in processing, thus stripping some of the absorbed arsenic.

What does this mean for your family?

It is important to consider how much rice you or your child is eating. If it’s daily, you should consider decreasing that intake to weekly instead, until the FDA responds with regulations for arsenic in foods. In the case of infant rice cereal, switch to baby oatmeal cereal or make your own infant cereal by grinding whole, dry quinoa, millet or amaranth in a coffee grinder, then cook with water per the directions. Once cooled, stir in breastmilk or formula to desired consistency. Talk to your pediatrician or registered dietitian about more sources of iron in your child’s diet if taking out iron-fortified rice cereal is a concern. On another note, although brown rice was found to have higher arsenic levels than white rice, brown rice is better nutritionally than white rice because it has more fiber, naturally occurring vitamins and minerals, and small amounts of healthy fats.

How does this affect children?

As I mentioned, inorganic arsenic is a known carcinogen. Children and especially infants have immature organs and detoxification processes compared to adults, so exposure to toxins like arsenic can be more harmful for the very young. At any age, eating a variety of grains is healthy and based on the study results, decreasing rice intake and replacing with other grains would be advisable.

Here is a list of different types of grains that could substitute for rice:

  • quinoa
  • amaranth
  • millet
  • oatmeal
  • buckwheat
  • corn or grits

This study demonstrates the need for regulations on allowable levels of these kinds of toxins in our food supply. This would need to include regulations on arsenic and other potentially harmful toxins in pesticides, fertilizers, as well as drugs and feed given to animals. To find out more about what is being done and how you can get involved, go to ConsumersUnion.org/arsenic. We all need to have a better awareness of what is in the foods we eat and feed to our kids, even beyond the major nutrients and ingredients. For nutrition counseling to evaluate and improve your family’s diet, contact North Shore Pediatric Therapy for an appointment with one of our registered dietitians.

What is GERD and how does it affect babies’ eating habits?

Gastroesophageal reflux disease, or GERD, is a fairly common condition in infants. To be clear, almost all babies will have typical infant reflux, or Acid Reflux Baby“spitting up” to some degree, because their gastroesophageal sphincter muscles are still developing. More severe infant reflux will be painful, causing fussiness and sometimes interfering with successful feeding and weight gain.

Signs that an infant has more serious reflux issues are:

  • Frequent spit ups, with crying and fussiness before, during and after spitting up
  • Back arching during feeds
  • Eyes watering during feeds
  • Face turning red, along with grimacing and signs of pain during and after feeds and/or spit-up episodes
  • Frequent hiccups
  • Fussiness when lying down that improves when upright
  • Baby refusing breast or bottle feeds
  • Infant not meeting weight gain or growth goals at pediatrician visits

Most of the above symptoms are a direct response to the burning pain the baby feels when acidic stomach contents are refluxing up into the esophagus. In severe cases of reflux, the infant begins to develop a strong negative association of pain with breast or bottle-feeding. The infant will begin to refuse feeds in order to avoid this pain. This response becomes a learned habit, and over time, results in lower intake, slower weight gain, and dehydration in extreme cases. A baby who is refusing feeds can cause alarm for parents, who then might try forcing feeds in desperation, which can be distressing to the infant and cause further negative association with feeding. Parents should be aware of these signs of GERD and contact the pediatrician right away.

Diagnosis and Treatment of GERD:

Reflux is more common in premature infants since their gastrointestinal tracts are immature compared to term infants. It can also be a symptom of food allergies, in which case the infant may be allergic to the milk proteins in formula, or proteins from foods passing through mother’s breastmilk. In any case, a pediatrician can discern symptoms and diagnose GERD. Treatment protocols for infant GERD usually include a medication, such as ranitidine (also known as Zantac) or lansoprazole (also known as Prevacid). In some cases, the infant needs a special formula or mom may need to eliminate food allergens from her diet. A registered dietitian can help moms navigate special diet needs related to GERD, as well as ensure proper growth and transition to solids if these areas have been affected. Also, the pediatrician can educate parents on “reflux precautions”, which include feeding the baby at a more upright angle, not lying baby flat on their back after feeds, burping baby well, etc.

Sometimes the painful association of GERD creates long-term feeding issues with infants and kids. In these cases, children will continue to have “oral aversion” to eating. Signs of oral aversion stemming from reflux include difficulty transitioning to solids, very picky eating, refusal to put objects in their mouths in general, etc. If your child has signs of feeding difficulties, or if his or her growth has been impacted by GERD, contact North Shore Pediatric Therapy. A multi-disciplinary team including registered dietitians and speech therapists can work with your child to ensure adequate nutrition, growth, and development related to feeding skills.

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Breakfast for a Better Kid and Day!

Breakfast often gets skipped in the haste of the typical morning. Mom and dad are getting themselves ready, getting the kids ready, and tying up loose ends around the house. Many people report not having an appetite in the morning. Often, this is caused by over-eating in the later part of the day. family breakfastKids will model their parents, so think about what example you may be setting for your kids. In any case, the fact is, this morning a lot of kids woke up late and got breakfast at a fast food drive thru or ate nothing at all.

Studies show that kids who eat breakfast do better on tests in school. Nourishment in the morning provides brain fuel needed for concentration and energy. Even behavior and general attitude is better. Have you been around a hungry, tired kid lately? Not so fun and probably not the kid who’s skipping to the head of the class, so to speak.

Not only do kids who eat breakfast do better in school, but kids who eat breakfast tend to have healthier BMIs. It’s hard to say exactly why this is, but likely it has at least something to do with kids having less energy during the day to be active, and then over-eating later in the day. Eating in a balanced way throughout the day will prevent over-eating later, and leave room for a good appetite in the morning.

Here are some tips for a breakfast for a better kid:

  1. Change your morning so that breakfast is a requirement. Would you let your kids go to school in their pajamas? Just like getting dressed is a morning requirement, eating breakfast should be too. Carve that time into the morning, for yourself and your kids. Remember you are the most important role model in shaping their eating habits.
  2. Make breakfast count. Breakfast is just as important as lunch or dinner in terms of creating a complete, healthy meal. Strive for the healthy plate model at breakfast, which is to include whole grains, a protein source, and plenty of fruits and veggies. Vegetables are not typically the stars of the breakfast show, but try things like homemade hash browns or omelets with a variety of veggies. Potato pancakes are usually a hit if you have time to make them.
  3. Something is better than nothing. I would really recommend avoiding the fast food drive thru breakfast. Usually this isn’t going to be the healthiest food, but also, eating on the run results in poor digestion and tummy aches.If on occasion, you are late and have to do breakfast in the car, try a trail mix with dried fruit, nuts, and cereal. Another option would be a Clif ™ bar or Larabar ™ with a string cheese.
  4. Use the weekend to make breakfast a special meal for your family. The weekend breakfast can be such a fun family (and friends) tradition. Eating breakfast at home gives kids another chance to have a family meal at the table, which builds good habits, communication skills, and relationships. Breakfast foods tend to be popular with kids, and can be made with a healthy spin.

Examples of a Better Breakfast for Children:

  • Multigrain pancakes with blueberries and scrambled eggs. Try a maple-agave syrup blend (it’s less expensive than 100% maple syrup but still contains whole ingredients instead of high fructose corn syrup). Another healthy topping is homemade strawberry-rhubarb syrup which you can make by simmering chopped rhubarb and strawberries with a few tablespoons of water.
  • Granola, fruit, and yogurt parfait. Make it seasonal by stirring in pumpkin spice granola or farmers market fruit. Make it a winner by setting bowls of yogurt at the kids’ places at the table, and allow them to pick from an array of mix-ins on the table that they can spoon in themselves.
  • Organic bacon or sausage, whole grain English muffin spread with fruit preserves.
  • Whole grain toast, egg scramble or omelet with any of the following: chopped peppers, spinach, broccoli, peas, mushrooms, onions, tomatoes virtually any vegetable, black beans, cheese.
  • Oatmeal, berries, and nut butter mixed in. Top with homemade coconut whipped cream, which can be made by whipping canned coconut milk with beaters on high until foaming and thick.

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What is Failure to Thrive and What Can Be Done About It? | Pediatric Therapy Tv

In today’s Webisode, a Registered Dietitian discusses Failure to Thrive and how you can help.

In this video you will learn:

  • The causes of Failure to Thrive
  • Steps and measures to take when your child shows signs of Failure to Thrive
  • How a dietitian and a doctor can help when your child has Failure to Thrive

Video Transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide
audience, this is Pediatric Therapy TV where we provide experience and
innovation to maximize your child’s potential. Now your host, here’s Robyn.

Robyn: Hello, and welcome to Pediatric Therapy TV. I’m your host, Robyn
Ackerman. I’m standing here today with a registered dietician, Stephanie
Wells. Stephanie, can you tell us what failure to thrive is and what can be
done about it?

Stephanie: Sure. Failure to thrive is diagnosed in children that are less
than two years old when their weight for length is less than the fifth
percentile on the growth chart and for kids that are over two years old, if
their BMI is less than the fifth percentile on the growth chart.

So in terms of what can be done, first a doctor and a registered dietician
can assess if there are any medical factors that are causing the failure to
thrive and then address those medical issues if that’s necessary. Second,
then a dietician can meet with the parent and the child and put together a
high calorie, high protein diet that includes three meals and two to three
snacks per day. Third, often these children need to be on some sort of a
high calorie, high protein formula or oral supplement beverage which the
dietician can recommend and get a prescription for, if needed. And then
from there, the dietician and doctor will closely monitor the child’s
weight and growth to make sure that they’re moving in the right direction
and meeting the goals that the dietician has made for the child.

Robyn: All right. Thank you, Stephanie, for that explanation and thank you
to our viewers. And remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of mind
to your family with the best in educational programming. To subscribe to
our broadcast, read our blogs, or learn more, visit our website at
learnmore.me. That’s learnmore.me.

Food as Medicine

The seasons are about to change, school has resumed, and it’s only a matter of time before kids start getting sick. You can do your best to try to shave off those dreaded illnesses by ensuring proper nutrition and rest every day. But there’s just no avoiding it sometimes. Try not to get too stressed if your child has decreased intake when he or she is ill. It’s normal, and likely they will rebound after and make up for it by eating more of what they need for re-nourishment. Drinking adequate fluids is very important, however, as dehydration can have serious consequences. Also, adequate hydration helps the body “flush out” the bacteria, viruses, and immune factors causing symptoms.

sick child eating

For the following illnesses, here are some nutrition considerations:

Sore Throat. Eating and drinking can obviously be painful. Focus on cold, liquid foods.

  • Applesauce. Stir in quinoa for extra protein. Just cook the quinoa, let it cool, refrigerate, and stir into applesauce when your child is interested in eating.
  • Yogurt
  • Smoothies, made with yogurt, frozen fruit, and baby spinach leaves.
  • Gazpacho
  • Frozen bananas
  • Frozen fruit puree popsicles
  • Pediasure, especially if your child is on the low end of the growth chart, has other chronic medical issues, or otherwise has poor nutrition.

Diarrhea and/or Vomiting.

Gastrointestinal illnesses can occur for a variety of reasons. Likely eating or drinking will induce nausea. Hydration and electrolyte balance/replenishment are important with prolonged diarrhea and vomiting. Call the pediatrician if the vomiting or diarrhea persists longer than 24 hours. Seek medical care immediately if you see blood in the stool or emesis, and also if your child seems dehydrated. Some signs of dehydration are decreased urine output, darker colored urine, urine with a strong odor, dark circles under the eyes, lack of tears when crying, “tenting” of the skin (when you pull it up it doesn’t retract quickly), dry mouth, and lethargy. The best you can do is to encourage drinking fluids and eating small amounts as able. Focus on easily digested foods that are low in fat.

  • The BRAT diet (bananas, rice, applesauce, toast). These foods are easily digested, and the bananas and applesauce contain soluble fiber, which absorbs fluids in the gut and promotes a bulkier, more formed stool. This counteracts loose, watery diarrhea.
  • Congee is used to treat diarrhea, and versions of it are used in African, Indian, and Asian cultures. It’s basically rice that has been cooked for a long time with extra water so that it boils into a soupy mixture that is easily digestible .
  • Offer electrolyte replacement beverages, such as those discussed in my exercise hydration post. A great, natural option is called Recharge and can be found at Whole Foods and other natural grocery stores.
  • Some studies have shown improvement in duration of gastrointestinal symptoms with taking probiotics. See my probiotics blog for more recommendations.

Common cold or flu. Warming, soothing foods are usually best accepted.

  • Soups or stews. Take advantage of the opportunity to get some quality nutrition in these meals. Butternut squash soup is a good source of vitamin A, tomato soup is a good source of vitamin C, potato soup is a good source of potassium, and beef or chicken stew provides good protein.
  • Bone broth. This traditional soup is made by actually boiling bones for a prolonged time, which creates a broth full of the nutrients stored in bones. You can use bones from a whole chicken after cooking it and using the meat for another meal. Put them in a crock pot on low over night or simmer on the stove for 8-12 hours. Use the broth to make soups, noodles, congee, or drink it warmed.
  • Offer good vitamin C sources such as fresh citrus fruits.

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What is Tongue Thrust?

A tongue thrust, also commonly referred to as a reverse or immature swallow, occurs when the tongue protrudes out of the mouth or forcefully against the back of the front teeth when swallowing or talking. baby tongue thrustAdditionally, the body of the tongue may sit too far forward in the mouth and stick out between the teeth when at rest, and tongue thrusting can also be commonly observed when a child is talking or swallowing. During infancy, a tongue thrust is considered normal, however when children begin to transition to first foods they have typically outgrown this pattern. Some children do continue to present with a tongue thrust until age six without any impact on speech production, though if a child continues to present with the tongue pattern after this point, it can reek havoc on speech skills and dentition later on as the alignment of teeth can be significantly affected.

How does a tongue thrust affect speech?

If the pattern of the tongue thrust is not corrected, speech production and intelligibility may be negatively impacted. Children with a tongue thrust often present with errors on certain sounds, such as: /s, z/ and productions are often substituted with a “th”, due to the placement of the tongue when speaking. Other sounds involving the tip of the tongue may be impacted as well, such as “sh” or “ch”. Therefore, children often present with a “lisp” because of the placement errors and consequent production of certain speech sounds. In addition, if the tongue applies excess amount of pressure onto the teeth daily, this can have a profound effect on the placement and growth of teeth. Children with a tongue thrust may require additional orthodontic treatment to help resolve the misalignment of the jaw and teeth that may result from the increased pressure that is being placed upon by the tongue.

What can I do to help my child with Tongue Thrust?

  • Have your child evaluated by a licensed Speech-Language Pathologist to develop an appropriate treatment plan for your child.
  • Have your child evaluated by an Otolaryngologist (Ear, Nose, Throat doctor) if you have not already done so, in order to assess your child’s adenoids and tonsils.
  • Your child’s Dentist and/or Orthodontist will likely be the one who initially diagnoses the problem, but they will be an integral part of the therapeutic team in order to help monitor your child’s jaw development and alignment of teeth as you move through therapy.

A big step with remediating a tongue thrust is consistent speech therapy to address retraining the position of the tongue as well as to correct the subsequent speech sound errors. A specific home program will be developed for your child and you will be encouraged to practice in order to facilitate carry-over. While a tongue thrust is able to be corrected with intervention, it is imperative that you seek help as soon as you have concerns. The longer you wait to seek treatment, the more difficult a tongue thrust is to remediate. For more information on tongue thrusting, please reference the American Speech-Language Hearing Association’s website, and speak with your child’s pediatrician or a licensed Speech-Language Pathologist about your concerns.

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5 Ways To Make Meal Time Easier With Your Child

  1. Sit as a family: When juggling work, sports, and multiple schedules, it can be difficult to get food on the table, let alone sit down as a family.  Sitting as a family offers many benefits including conversation time, modeling good eating habits, and introducing new or non-preferred foods. Family mealEncourage your child to talk about their day without being interrupted.  Taking your time and chewing thoroughly while eating are good eating habits to model. When new foods are introduced, your child is more likely to try these foods if they observe you or siblings eating them as well.
  2. Turn off the TV: In order to eat without distraction, it is important to turn off of the TV during meal time.  Subsequently, ask your child to eat at the kitchen table rather than in the family room.  Eating in front of the TV may distract your child from the food on their plate, particularly if non-preferred food is offered.  Additionally, eliminating this distraction allows your child to concentrate on safe eating habits.
  3. Make it fun: Make meal time fun by introducing animals and characters.  First, tell your child there is a party in their tummy and all their food wants to be a part of it.  Encourage your child to eat more by taking a mouse bite (little bite) or a dinosaur bite (large bite).  Characterizing food can make food seem not so scary to children.  Call broccoli “trees”, or make Mickey Mouse shaped sandwiches or pancakes.  Fun utensils such as lizard forks or airplane spoons make meal time more fun too!
  4. Give your child choices: Getting your child to eat vegetables or a new food can be as difficult as taking them to the doctor.  Giving your child choices when it comes to their meals not only gives you full control, but it allows your child to feel like they have a part too. If vegetables are typically refused, introduce these foods as a choice rather than telling your child what they have to eat.  “Do you want broccoli or carrots?” or “Do you want ranch on the side, or do you want to eat your vegetables plain?”
  5. Include Child in Preparation: Encourage your child to help you prepare the food.  Allow your child to help add ingredients, add food to each plate, set the table, and clear the dishes.  Similarly to giving your child choices, let your child help choose what to eat for a meal.  When your child is included in the preparation, they are more likely to participate during meal time.

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