Hi Robynne, I've got another one for you.

Allie is about 22 months old and cannot "chew" anything - she tries, but it just ends up coming back out of her mouth - it's like she's 4 months old and still has the tongue thrust reflex - she can't keep her tongue in her mouth when she does take a bite, so it takes forever to get her to 1 ounce of pureed food (which I make myself and is pretty much a stage 1-2 consistentcy). She will now voluntarily open her mouth for food (yea! a huge step for us - a few months ago, she would never take even one bite!). I can usually get about 20-40 bites in her per feeding, but she doesn't seem to retain it, so most of what I get in comes back out. She also does not open her mouth very wide at all, just a teensy bit. Most of the time, when I get the spoon in her mouth, she will immediately turn away from the spoon (I think this has to do with the fact that she is not completely over her aversion to solid foods).

When she takes a bite of a cracker, most of it ends up getting spit out (I think that this in involuntary, and so does DH). She seems interested in the taste and wanting to eat, but just doesn't know how.

I'm worried that she is never going to learn how to eat, or how to retain food in her mouth. I really, really want to get her off of the bottle (as you know from my other post) but don't think that this is a possibility until she learns how to chew.

We are currently doing beckman oral motor exercises to her mouth using a nuk brush, and we push on the sides of her tongue with the brush before a meal.

Do you have any ideas to help Allie learn how to keep food in her mouth?

Thanks! I really, really appreciate your help.

Christyn

Hi Christyn:

Without truly seeing Allie clinically, I can only make a couple of suggestions. First of all, I would thicken up her puree closer to a pudding consistency so she can retain more of it. Once saliva mixes with a thinner puree, it will run out the mouth, especially with her excessive lingual thrust.

The other thing I would do is use a flat therapeutic maroon spoon and apply downward pressure to the anterior first third of her tongue when presenting the spoon with food. By doing this, you are "blocking" her tongue from protracting or thrusting. The desired response is for Allie to use her lips to remove the food from the spoon. Leave the spoon in the front of her mouth, as not to set off her gag, but long enough for her to move the food back for the swallowing phase.

Enough with the Nuk brushes! What are they doing for her at this point? Have you tried a mesh bag feeder with solids? Go to a baby store and buy one or to Talk Tools online. Place pieces of juicy fruit, bananas, crackers, etc. in the mesh feeder.

I teach chewing by presenting solids such as Twizzlers and Cheeto Puffs to the molars. Those are our "chewers." If a child has significant lingual thrust, you must carefully present foods at the molars where the food is ground up and prepared for swallowing. I hope you have luck Christyn. It sounds like little Allie has come a far way thanks to such a great Mama! :party0049: