Tongue thrusting in babies refers to a common reflex or habit where the tongue pushes forward against or between the front teeth during actions like swallowing, resting, or speaking. This pattern is frequently observed in infants and is considered a normal part of their early development.
Understanding Tongue Thrusting in Babies
The tongue’s forward movement is a natural and necessary reflex for infants, aiding in feeding. It helps prevent choking by pushing food or liquid away if the baby is not ready to swallow.
This reflex usually begins to diminish as babies develop, particularly around 4 to 6 months of age, coinciding with the introduction of solid foods. At this stage, babies develop the coordination needed to move food from the front to the back of the mouth for swallowing, leading to a more mature pattern. While normal in infants, persistent tongue thrusting beyond this period may signal an underlying issue.
Common Causes and Recognizable Signs
Several factors can contribute to tongue thrusting persisting beyond the typical developmental stage. Prolonged use of pacifiers, extended bottle feeding, and thumb sucking are common habits that encourage the tongue to maintain a forward position. Allergies, chronic nasal congestion, or enlarged tonsils and adenoids can also lead to mouth breathing, which positions the tongue low and forward, interfering with normal swallowing. Anatomical differences, such as a narrow upper jaw, crowded teeth, or a condition like tongue-tie, where the tissue beneath the tongue is short, can also influence tongue placement. Rarely, certain neurological conditions, including cerebral palsy, Down syndrome, or autism spectrum disorder, may impact muscle control and contribute to persistent tongue thrusting.
Signs of persistent tongue thrusting include the tongue being visible between the teeth during speaking, swallowing, or at rest. An open bite, where the upper and lower front teeth do not meet when the mouth is closed, is a frequent dental sign. Children might also have difficulty closing their lips completely or exhibit messy eating habits, with food often falling out of their mouths. Speech sound challenges, such as a lisp or difficulty producing sounds like “s,” “z,” “sh,” “j,” “t,” “d,” “n,” and “l,” are also common indicators.
How Persistent Tongue Thrusting Can Affect Development
If tongue thrusting continues past the typical developmental window, it can influence oral development. The constant pressure from the tongue against the teeth can lead to dental alignment issues, such as an open bite, protrusion of the front teeth, or general misalignment and crowding. This prolonged pressure may also affect jaw development, sometimes contributing to an elongated facial structure.
Speech articulation can also be impacted by persistent tongue thrusting. Children may develop a lisp or experience difficulty producing specific sounds because the tongue pushes forward instead of making the correct contact points in the mouth. Feeding can also become challenging, with children exhibiting messy eating, prolonged sucking, or problems chewing and swallowing solid foods effectively.
Addressing Concerns and Seeking Professional Support
Parents should consider consulting a healthcare professional if their child is older than 2 or 3 years and still exhibits persistent tongue thrusting. Professional guidance is also advisable if dental or speech issues become evident, or if the child experiences feeding difficulties. A team of professionals can offer support, including pediatricians, dentists, orthodontists, and speech-language pathologists.
Diagnosis typically involves observation of swallowing patterns and an oral examination. Management approaches can include oral myofunctional therapy, which involves exercises to retrain the tongue, cheeks, and lips. Habit correction, such as addressing prolonged pacifier or thumb sucking, is also part of the plan. In some cases, dental appliances like tongue cribs or braces may be recommended by an orthodontist. Addressing tongue thrusting early can help prevent more significant dental, speech, and feeding complications.