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Feeding Therapy for Infants: Overcoming Oral-Motor Issues with Occupational Therapy Support

by | Feeding Therapy, Occupational Therapy

Feeding an infant can sometimes be more complex than anticipated, especially when oral-motor issues are present. Oral-motor issues involve the muscles and movements in the mouth, jaw, tongue, and lips that are crucial for sucking, swallowing, and other feeding activities. These challenges can make feeding difficult and may lead to long-term eating and speech issues if not addressed properly. Fortunately, occupational therapy (OT) can provide targeted interventions to help infants with oral-motor difficulties overcome these challenges. We’ll dive into the types of oral-motor issues that can affect infants, how feeding is impacted, and how occupational therapy at Michigan Pediatric Therapy (MPT) can help resolve these issues.
infant feeding therapy

Types of Oral-Motor Issues in Infants

Oral-motor issues in infants can range from mild difficulties to more severe impairments. Some common types include:

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Weak Sucking Reflex:

Description: Infants rely on a strong sucking reflex to effectively feed, whether breastfeeding or bottle feeding. A weak sucking reflex can result in inefficient feeding, where the infant struggles to extract enough milk, leading to poor weight gain and nutritional issues.

Signs: Difficulty latching, prolonged feeding times, or inadequate milk intake may be signs of a weak sucking reflex.

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Tongue Tie (Ankyloglossia):

Description: This condition occurs when the tissue connecting the tongue to the floor of the mouth is too tight or short, restricting the tongue’s movement. It can interfere with breastfeeding and bottle feeding, as the infant may have difficulty latching properly and maintaining a good seal.

Signs: Limited tongue movement, pain during breastfeeding for the mother, and difficulty with sucking are common indicators of tongue tie.

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Lip Tie:

Description: Similar to tongue tie, lip tie occurs when the tissue connecting the upper lip to the gums is tight or restrictive, making it hard for the infant to flange the upper lip properly during feeding. This can lead to poor latch and ineffective feeding.

Signs: Difficulty latching onto the breast or bottle, a shallow latch, and excessive gassiness from swallowing air during feeding.

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Low Oral Tone:

Description: Oral tone refers to the strength and coordination of the muscles in the mouth and jaw. Low oral tone can result in weak sucking, poor coordination of sucking and swallowing, and difficulties transitioning to solid foods later on.

Signs: An infant with low oral tone may struggle with keeping the nipple in their mouth, have frequent choking or gagging episodes, and may have a droopy appearance to their facial muscles.

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Oral-Motor Incoordination:

Description: Oral-motor incoordination occurs when an infant has difficulty coordinating the movements required for sucking, swallowing, and breathing. This can be seen in premature infants, infants with neurological conditions, or those with developmental delays.

Signs: Frequent coughing or choking during feeding, a weak suck, and difficulty pacing their feeding may be signs of oral-motor incoordination.

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Hypersensitivity and Hyposensitivity:

Description: Hypersensitivity refers to an exaggerated response to stimuli in the mouth, while hyposensitivity refers to a diminished response. Both can make feeding difficult.

Signs: Infants with hypersensitivity may gag or vomit frequently, while those with hyposensitivity may seem indifferent to the nipple or bottle in their mouth.

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Cleft Palate or Cleft Lip:

Description: These congenital conditions affect the structure of the mouth and can significantly impact feeding. Infants with cleft palate or cleft lip may have difficulty forming a proper seal around the nipple, leading to inefficient sucking.

Signs: Difficulty with latch, excessive air intake, and milk coming out of the nose during feeding are signs of cleft-related issues.

feeding therapy oral motor

How Infant Feeding is Affected by Oral-Motor Issues

When infants experience oral-motor issues, feeding can become a frustrating and challenging task for both the baby and the caregiver. The following are common ways oral-motor issues affect feeding:

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Difficulty Latching:

Infants with oral-motor issues such as tongue tie, lip tie, or low oral tone may have difficulty latching onto the breast or bottle properly. This can result in prolonged feeding times, poor milk transfer, and the infant not getting enough nourishment.

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Fatigue and Poor Weight Gain:

Feeding becomes a tiring activity for infants with oral-motor issues. The effort required to suck effectively can cause fatigue, leading to shorter feedings and inadequate caloric intake, which can result in poor weight gain and developmental delays.
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Frequent Coughing, Gagging, and Choking:

Infants with oral-motor incoordination or low oral tone may struggle to coordinate their sucking, swallowing, and breathing. This can cause frequent coughing, gagging, and choking during feedings, making the process distressing for both the baby and the caregiver.
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Air Intake and Gas:

Poor latch and oral-motor control can lead to excessive air intake during feeding. This can result in gassiness, colic-like symptoms, and discomfort for the baby.
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Difficulty Transitioning to Solid Foods:

Infants with oral-motor issues may struggle to transition to solid foods later on. Issues like low oral tone, hypersensitivity, and oral-motor incoordination can make it difficult for them to manage new textures and learn to chew and swallow efficiently.
infant feeding therapy breastfeeding

Interventions for Oral-Motor Issues in Infants

Early intervention is crucial for addressing oral-motor issues and preventing long-term feeding and developmental challenges. The following interventions can help infants work through these difficulties:
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Oral-Motor Exercises:

Our licensed and trained occupational therapists use specific exercises to strengthen the muscles in the mouth, tongue, and jaw. These exercises can help improve sucking strength, coordination, and overall feeding efficiency. Techniques may include using a pacifier for sucking practice, gentle tapping or stroking around the mouth to increase awareness, and jaw stabilization exercises.
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Positioning and Pacing Strategies:

Proper positioning during feeding is essential for infants with oral-motor incoordination or low tone. Our OTs guide parents on how to hold their baby in an optimal position to support effective sucking and swallowing. Pacing strategies, such as offering breaks during feeding, can also help prevent choking and allow the infant to regulate their feeding better.
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Sensory Integration Techniques:

For infants with hypersensitivity or hyposensitivity, sensory integration techniques can be used to help normalize the oral sensory system. Our OTs may introduce different textures and temperatures during feeding in a controlled manner to help the infant adapt to various sensations and reduce gagging or oral aversion.
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Feeding Therapy with Adaptive Equipment:

Some infants with oral-motor issues may benefit from adaptive feeding equipment. This could include specialized bottles or nipples designed to facilitate better latch and milk flow or using feeding tools like a Haberman feeder for babies with cleft palate. MPT’s occupational therapists can recommend and train parents in the use of these tools.
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Tongue and Lip Tie Release (Frenectomy):

In cases of tongue tie or lip tie, a procedure known as a frenectomy may be recommended to release the tight tissue restricting movement. Our OTs work with the infant both before and after the procedure to ensure optimal feeding outcomes. Pre-frenectomy exercises can help prepare the muscles, while post-frenectomy therapy focuses on retraining the infant’s oral-motor patterns.
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Parent and Caregiver Education:

Education is a key component of intervention. MPT’s occupational therapists work closely with parents and caregivers to teach them techniques and strategies to support their infant’s feeding. This might include guidance on bottle selection, how to support oral-motor exercises at home, and how to monitor for signs of progress or concern.
infant feeding therapy oral motor

How Occupational Therapy Can Help with Oral-Motor Issues

Occupational therapists (OTs) are uniquely equipped to address oral-motor issues in infants. They bring a holistic approach to therapy, considering not just the feeding difficulties but also the overall development and well-being of the child. Here’s how occupational therapy can help:

Comprehensive Assessment

Our OTs conduct thorough assessments to identify the root cause of the feeding difficulties. They evaluate the infant’s oral structures, motor skills, sensory responses, and overall development to create a personalized intervention plan.

Targeted Interventions

Based on the assessment, our OTs develop targeted interventions that focus on improving the infant’s specific oral-motor challenges. Whether it’s through strengthening exercises, sensory integration, or feeding strategies, the therapy is customized to meet the child’s needs.

Holistic Support

Our OTs consider the whole child in their approach. This means addressing not only the oral-motor issues but also any related challenges, such as sensory processing difficulties or developmental delays, that may be contributing to feeding problems. By taking this holistic view, they ensure that therapy supports the child’s overall growth and development.

Family Involvement

Occupational therapy emphasizes family involvement in the intervention process. Our OTs educate and empower parents and caregivers to implement therapy techniques at home, creating consistency and promoting progress outside of therapy sessions. This family-centered approach ensures that the child’s entire support system is working together toward the same goals.

Collaborative Care

Occupational therapists often collaborate with other professionals, such as speech therapists, lactation consultants, and pediatricians, to provide comprehensive care. This multidisciplinary approach ensures that all aspects of the child’s feeding and development are addressed, leading to better outcomes.
infant feeding therapy oral motor

Conclusion

Oral-motor issues in infants can present significant challenges when it comes to feeding. These difficulties can range from weak sucking reflexes and tongue-tie to sensory sensitivities and oral motor incoordination. Addressing these issues is crucial for ensuring that your child receives adequate nutrition and develops the necessary feeding skills to support their overall growth and well-being. Occupational therapy offers a comprehensive approach to addressing these challenges, with interventions designed to strengthen oral-motor skills, improve feeding coordination, and support sensory integration.

Michigan Pediatric Therapy’s occupational therapists work closely with families, empowering them with the knowledge and techniques they need to support their child at home. By taking a holistic approach and collaborating with other professionals, our OTs can help infants overcome oral-motor difficulties and set them on the path to successful feeding and development.

If your infant is struggling with feeding due to oral-motor issues, consider reaching out us for a personalized assessment and intervention plan. With the right support, your child can develop the skills they need to thrive, both now and in the future.

Michigan Pediatric Therapy
📍 27655 Middlebelt Rd., Suite 130, Farmington Hills, MI 48334
📞 (248) 939-4030
🌐 mipediatrictherapy.com

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