Today we’re covering all those “what do I do when…” questions that come up for so many babies and toddlers who are learning to eat solids. When babies or toddlers aren’t proficient in chewing certain textures yet…they can pocket food in their mouths. What to do?? When they’re unsure of what to do with solids or need help exercising their mouth muscles…they may hesitate to chew food and just spit it out. Again..what to do?? When they’re still learning how to take appropriate sized bites and/or get SO excited about the food they’re eating…they can take giant bites that have our mama hearts pounding so fast we might just die! Again…what do we do??
But fear not… in today’s post I’ve invited my friend and speech language pathologist Catherine Callahan MS, CCC-SLP, CLC from Chikids Feeding to give us her tips and tricks to help troubleshoot all these feeding issues. Below are the most common issues and questions that come up and she’s given amazing and detailed answers to help you out.
Let’s dive right in with her answers!
How can I help teach my baby to chew?
Babies begin with a simple up and down motion of their jaw that begins to come under their control between 5 and 9 months. They then advance to a diagonal jaw movement starting around 7-9 months, and later to a circular movement, which is fully developed by about 24 months. Watch for your baby to increase the number of chews and varied size and rhythm, and to advance from up and down to eventually a circular movement by the time she is 2.
Control and advancement of chewing starts with mouthing. If your baby doesn’t put teething toys or tools in her mouth yet, or your toddler never did that, start there.
Give your child a variety of stick shaped teething toys to chew on daily. If she won’t put it into her mouth on her own, help her. Our goal is to place these tools between the gums or molars on the sides of her mouth.
If your baby won’t chew on a teething toy or tool:
- Bring it to baby’s mouth and wait for her to open and accept it. This should be enjoyable and not forced. Try singing, playing games, and moving up from her hands, arms, and shoulders, to her mouth. Once she will allow it in her mouth, place it on her gums in the molar area. Hold it between her gums and wait for her to bite down. If she won’t bite, then give a little gentle downward pressure to her lower gums, and upward pressure to her upper gums. Use slow and steady pressure.
If your baby is chewing on teething toys and tools, but won’t chew food, try these strategies:
- Dip stick shaped teething tools in puree, roll tools in a soft smashable solid (like avocado or banana), or roll in crumbs of a meltable solid (only with this texture after she is crawling), and help your child place this on her molar area for chewing. As described above, hold the tool between her gums and wait for her to bite down. If she won’t bite down, apply a little gentle downward and upward pressure to her gums.
- Offer stick shaped foods that are soft (starting after she is sitting up) and meltable (after she is crawling). When you offer these foods, guide her to put them between her molars. By placing between the molar area, baby will naturally learn to bite and chew with her teeth vs. smashing with her tongue.
- Once baby is crawling (around 8-9 months), place small pieces of soft smashable solid (a small cube of soft fruit or vegetable about the size of your pinky fingernail that you can easily squish between your fingers) or a meltable solid (a small piece of a dissolvable puff) between her gums on the sides. When you place a piece of food to the side, baby will bite down, and will shift her tongue to the side you place the food. When she shifts her tongue, her jaw will shift, advancing her chewing skills. Alternate sides to teach the back and forth motion of the tongue and jaw.
MLE feeding tip: Model chewing during meals in an exaggerated way and get silly with it! I say “Chew Chew Chew!” and then imitate big up and down chewing motions to the baby, maybe smacking my lips to get their attention and look at my mouth. Try it!
How do I teach my baby or toddler to take appropriate sized bites?
Babies are typically able to take a controlled bite from soft solid beginning between 7 and 12 months.
Teaching a baby to take bites and to chew, also starts with mouthing. If your baby hasn’t done that or if she skipped that step, start there.
Once baby is regularly mouthing and chewing on tools, help her to learn this skill by offering stick shaped foods. If she needs help, guide these over to her molar area to take bites.
If your child is chewing tools regularly, but is still not biting pieces off, or is taking overly large bites:
- For a baby or younger child, offer a stick shaped food and hold it for your child very close to the top, so she is only able to bite off beyond your fingers.
- For an older child, make a line on the food so your child can see where to bite. You can use a toothpick to draw a line, or a fork to make a dotted line. I like to tell kids these are the teeth marks, and ask them to bite on the teeth marks.
- Teach your child about bite size. You can show a picture of a mouse and tell her that a mouse “takes small bites” and a picture of a lion, who “takes very big bites”. Talk your child about the best bite size for her mouth, and then rehearse by having her identify mouse vs. lion bites on herself and you.
What tips will help for preventing mouth stuffing?
First, work on improving your child’s oral awareness (the ability to understand and feel food in her mouth, and the borders of the inside of her mouth). Babies learn this through mouthing, typically by 5-9 months.
Help your child improve her oral awareness by:
- Brushing inside her mouth (on the top and sides of her tongue, inside her cheeks, and along her gums) with a finger brush or child sized toothbrush. Do this with tooth brushing and/or just prior to meals to “wake up” her mouth and get her ready to eat.
- Just prior mealtime while you are preparing a meal, give your child a stick shaped teething tool to bite on for chewing practice. Make this part of your mealtime routine.
While your child is working on improving her oral awareness and sensation in the mouth, help her to learn small bites by only offering 1-2 bites on her tray at a time. It sounds simple, but most of the time, we just need to break the habit and allow baby to practice one bite at a time. Keep her plate of food over to the side, and add new bites to her tray as she eats.
For an older child, talk about small bites one at a time, and use pictures (like the lion and mouse described above) to help her understand the difference.
For any age child, offer foods with stronger flavors to boost the sensation or feeling in the mouth. When a child can feel the food, she’ll be less likely to overstuff.
Head over to this blog post to learn more about my Brush-Bite-Boost method (BBB) to help with overstuffing food.
MLE Feeding Tip: If your baby is eating at such a quick pace that they’re gagging and it scares you, try slowing them down further by offering them a child safe food pick or a utensil to pick their food up with. It may just be that eating with their hands is too easy, so having a bit more of a challenge with food picks may do the trick as it takes more concentration!
How do I deal with food pocketing?
With pocketing, I’d recommend the same strategies as described above with mouth stuffing. Start with mouthing, brushing, and chewing practice. Again, the key here is oral awareness and that starts in infancy with mouthing.
With pocketing, again offer 1-2 bites on the tray at a time, but this time also offer a cup of cold water for sips between bites. Cold water is best because it can increase sensation and be alerting for a child’s mouth. Practicing sips between bites will get the child accustomed to the feeling of a clean mouth.
Teach an older child to use her tongue to clean her mouth between bites. Show her how you move your tongue to the side and then push it into your cheeks to clear food out. I like to tell a child that the tongue is like a broom, cleaning the food around the mouth. Cue your child to “use your broom” when you notice pocketing. You can also provide a touch cue to the outside of a child’s cheek to remind her to move her tongue to that side.
Use a mirror with meals or snacks every once in a while. You can keep a small handheld mirror at the table, or move your table so a mirror is across from your child. Cue your child to look in the mirror to “make sure your mouth is all clean” between bites. If your child’s oral sensation is reduced, this visual cue will be very helpful.
What to do about my baby/toddler chewing foods, spitting it out and then asking for/takes more…only to do the same thing?
Chewing and spitting out food is very common for toddlers. We often see toddlers doing this with new foods, harder to chew textures, or when they are not hungry. If it’s happening every once in a while, or for a brief period of time, it is completely normal. However, if this persists, or your child is not swallowing any foods, then further evaluation by a professional is warranted.
If your child is doing this, stop the behavior by changing her focus. Offer a sip of a drink, place a different food on the tray, or start a conversation to redirect her. If she continues to do it, then end the meal. I tell families to say something like, “I can see that you are all done, let’s clean up”. Keep it neutral and avoid making a big deal about the spitting, as this can only increase the behavior (if baby enjoys the attention they get from the reaction). I like to go with a “two strikes rule”. As described above, if baby continues after two attempts to redirect or change things, then the meal is done.
If you notice your child is always spitting a certain texture, make that texture easier for your child to manage by chopping it smaller or cooking it down to a softer consistency, or by adding a dip or sauce to soften it.
Catherine is a Speech-Language Pathologist, Pediatric Feeding Specialist, Certified Lactation Counselor and mom of three. She resides in Chicago, where she works at a top 10 US Children’s Hospital and owns her own business, ChiKids Speech & Feeding, LLC. Head to her blog to sign up for one-on-one virtual feeding consults, and follow her on Instagram, on Facebook for everyday feeding strategies and mealtime advice.