Oral Reflexes and Feeding

Babies are born with seven reflexes that assist them with feeding. In the typical developing baby, these reflexes integrate or “disappear,” and the baby then takes over with the skill. For babies delayed in feeding and not picking up a skill, it can be devastating to the feeding process when a reflex integrates without the baby first learning the craft. 

Feeding therapists must be aware of these reflexes. It is often the explanation for why a child becomes frustrated with feeding during the first year of life. If the child learns the reflex without learning the skill prior, intensive therapy must teach the baby the talent to progress with feeding. Two of these reflexes, the swallowing reflex and the gag reflex, continue throughout life. Here are explanations of these reflexes:

The rooting reflex: The baby moves toward the source when you touch his cheek or lips. This helps the baby locate the breast or bottle for feeding. This reflex “integrates” between 3 and 6 months.

Suck reflex: Happens when you place your finger, bottle nipple, or breast nipple in the baby’s mouth. Suckling is the front-to-back movement that seals and unseals the back 1/3 of the tongue. It allows the baby to feed on the breast or bottle. Suck/swallow integrates between 3 and 6 months. For babies that don’t develop this skill before integration, you will typically see a baby refusing the bottle and breast even if the child was taking the breast and/or bottle previously.

A child eating becomes frustrated as they do not know what to do with the nipple in their mouth. The reflex assisted them prior, but now they are left on their own. The reflex is often more active if the child is sleepy or sleeping. Parents will often feed their babies while asleep as they do better than when awake. This is due to the sucking reflex integration process.

Tongue Reflex: This is the front-to-back wavelike movement that helps the baby suckle. It allows for cupping of the tongue around the nipple. It’s apparent by 12-18 months.

Suck/ Swallowing Reflex: The swallow occurs when food, liquid, or saliva reaches your baby’s throat. It continues as an essential reflex throughout our lives. Your baby comes under the control of this reflex by 18 months.

Phasic Bite Reflex: Your baby opens and closes his jaw to “bite” up and downs when you apply pressure to his gums. This reflex integrates by 9-12 months.

Lateral Tongue Reflex: The baby moves his tongue to the side when he receives touch, food, or taste on either side of the tongue. This reflex disappears between 7-9 months of age. If a baby is not consistently eating solids up to this point, they will not develop tongue tip lateralization. They will instead pool the bolus on the midline of the tongue, facilitating the gag reflex. For a baby to successfully eat, they must develop a rotary chew and tongue tip lateralization around 9-12 months of age. Suppose the reflex integrates before skill development. In that case, it leaves the baby unsure of how to chew or move the bolus for safe swallowing.

Gag: The gag reflex protects the baby’s airway from swallowing items that are too large. The baby’s gag reflex is located in the front of the tongue and “moves” back to the back ¼ of the tongue –(top the pharyngeal wall) with experiences in the mouth. The gag reflex continues throughout our lives. If a child is not developing the proper feeding skills, their gag will remain anterior and is easily elicited. A child that gags often will typically develop anxiety towards eating. It is essential to focus on minimizing the gag reflex and moving it posteriorly for successful feedings. The gag is moved posteriorly by frequent deep pressure and oral motor exercises.

Many infants are born with a lip, cheek, or tongue-tie. If the baby’s tongue is restricted and the tie is undiagnosed, it could severely impact feeding. In addition, if the baby cannot move the tongue, most of these reflexes integrate without the skills ever developing.  

Suppose your child is struggling to eat and is not developing the skills needed to chew and swallow safely. In that case, you should seek an Occupational or speech pathologist specializing in feeding. Sensory Solutions, LLC has highly trained therapists whose focus is on teaching children to eat once these reflexes integrate.

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