What are the tongue movements in an infant for drinking and chewing?

This post goes out with a very special thank you once again to Sara Rosenfeld-Johnson from www.talktools.com.  I am finishing up another one of her classes…well I finished this class…but often times I like to go back and take it again..because there may be pieces that I missed the first time around.  The class I had taken was in reference to the therapeutic straw drinking offered through Talk Tools.   I have posted about one of the eight straws..and promise to complete the rest of them as soon as I can.  Click on this link to find more information about the straws

In working with little ones with Down Syndrome…I felt like I needed more information in reference to the movement of the tongue in infants during bottle feeding, breast-feeding, spoon-feeding, cup drinking and straw drinking.  This post below is specific to your infant’s tongue movement during bottle/breast-feeding, cup drinking, spoon-feeding and chewing.  I find the information very interesting…not only regarding children with Down Syndrome, any child with low tone..and children presenting with an interdental lisp or a vocalic R.  And knowing all of this information just continues to support the need for therapeutic straw drinking..for children with Down Syndrome…children with low muscle tone…and children with an interdental lisp or the dreaded vocalic R.  I hope you find it helpful too!

 

Development and movements of tongue:

1.  Bottle/Breast Feeding:

During bottle feeding or breast-feeding the tongue does a back and forth motion in order to draw the liquid from the breast or bottle.  There is 50% retraction of the tongue and 50% protrusion of the tongue.  This is the normal movement of the tongue during bottle or breast-feeding.    I was able to get specific information from Lori Overland (I like the specific details…so thank you once again Lori for getting back to me so quickly when I have a question!!).   Okay so here are the more specifics: the motor skills for sucking from a bottle are slightly different from motor skills for breast-feeding.  During bottle feeding there is more use of the buccinator and orbicularis oris muscles and less use of the masseter and mentalis muscles.

 

Okay…now some anatomy!

 Buccinator Muscle-

Its purpose is to pull back the angle of the mouth and to flatten the cheek area, which aids in holding the cheek to the teeth during chewing.  It aids in whistling and smiling and in neonates it is used to suckle.

 

 

Orbicularis Oris Muscle-

This muscle closes the mouth and puckers the lips when it contracts.

File:Orbicularis oris.jpg

 

 

Masseter Muscle-

The masseter muscle is the primary chewing muscle, and covers the sides of the jaw just behind the cheek.

 

 

Mentalis Muscle-

The Mentalis is a paired central muscle of the lower lip, situated at the tip of the chin. It raises and pushes up the lower lip, causing wrinkling of the chin, as in doubt or displeasure. It is sometimes referred to as the “pouting muscle.”

File:Mentalis.png

 

 

 

Lori also stated that it was thought that milk was released because of a wave-like movement of the tongue.  However, more recent ultrasound studies revealed that is not true.  Milk flows due to negative pressure created when the back of the tongue and jaw drop during sucking.  If a baby is unable to breast feed…it is prefered that the Platex nurser is used for a number of reasons: shape, size, seal, and the option of using pressure on the bag to help the infant draw the liquid. 

All of that being said…it is especially important to me to understand actually what the tongue is doing during eating…so I can then help…far in advance with speech production.

 

Okay…back to the tongue and what it is doing….

Now around three months of age…the hyoid bone…which was up higher in the throat prior to the three-month mark…is now in a different position… At 3 months the tongue base pulls back into the laryngeal cavity.  During feeding you will see less of your little one’s tongue in between her lips…she still is presenting with 50% retraction and 50% protrusion. 

 

 

 

 

2.  Spoon feeding and cup drinking:

When spoon-feeding and cup drinking is introduced your little one will anticipate either the spoon or the cup.  This anticipation will promote 75% retraction of the tongue and 25% protrusion of the tongue…great because this is what we want…she will be developing the muscles of the tongue for the right amount of protrusion and retraction.  So…spoon feeding and open cup drinking will help with this skill.

 

3. Finger feeding with foods such as Cheerios:

When a little baby first starts finger feeding with cheerios…she is learning the very first level of tongue retraction…which is…as she is chewing on the cheerio..and her tongue is retracting to the 75% position and stabilized…her tongue will/should naturally go from midline to the right and midline to the left.  When she puts the cheerio in her mouth on the right side (for example)…the cheerio will stimulate the chew and the tongue will then move to the place of stimulation…great!  The tongue is lateralizing to either the right side or the left side from midline. 

So during chewing…when the cheerio is in her mouth…she will retract her tongue to the 75% position and stabilize it their..Great again!!…and then lateralize to the right or left from midline…another important skill.  You can see why feeding is a prerequisite for speaking…everything your tongue is doing during eating…will help her with speech production.  Awesome!  With the 75% retraction and stability of the tongue the tongue will not only go from midline to the right or left…it will also then go across midline.

 

4.  Next….with 75% retraction and stability of the tongue…this will allow the tongue tip to elevate and depress.  Another important skill for speech production.  If you do not have 75% retraction with stability you will not see elevation and depression of the tongue….which is needed for speech production!!!

5.  Finally….the sides of the tongue become so strong that you will see side spread of the tongue.  That is the lateral margin spread of the tongue.  This movement is needed for the production of the following sounds: SH, CH, J and the vocalic R. 

 

All of this information I believe is very important in understanding what exactly is happening to children that have Down Syndrome or children with low muscle tone…specific to how their tongue is functioning with regard to strength and mobility.  This is also important to the children we may see presenting with an interdental lisp, tongue thrust or the dreaded vocalic R.  Knowing all of this information…helps me to better understand the necessity of following the straw hierarchy….as I said…I only have posted about one of them…but will do the 7 others as soon as I can.

I hope this was helpful..it was for me!!!

Best,

Kim

About Kim

My name is Kim Marino and I have been practicing as a licensed speech and language pathologist since 1993. I work on Long Island providing diagnostic evaluations and services to children from birth to age 21. My experience is vast and am proud to say that I work with children that may present with articulation and phonological concerns, oral motor feeding concerns, Down Syndrome feeding, cognitive rehabilitation, auditory processing delays, receptive language delays, cleft palate feeding and sound development and expressive language delays. Most importantly, I am the mother of four amazing children and am happily married to my childhood sweetheart. I feel blessed to have my four children and so lucky to share this journey in life with my husband. I always had it somewhere in my head that I wanted to develop a blog or a website of some sort so that I could provide families with an additional resource....so that parents could help their little ones become a better communicator. And as I was developing this blog....I realized that I also needed to share the stories about my life and my children....and the funny things along the way that help to keep me smiling. Whether you are a working mother or not...finding balance between home, children and life can be a challenge....I hope that my blog helps to bring a smile to your face..and also some tools to help you help your little or big one. I hope you enjoy! Kim
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