Your Baby’s Tongue Should Come Out Past Their Lips
Most babies have the ability to stick out their tongue. By sticking out their tongue past their gums they are showing appropriate motion to use it. There are 3 key reasons why sticking out the tongue is important: creating a seal while feeding, providing feedback to limit biting of the breast or bottle, and to allow for the tongue to create suction. When a baby is unable to bring their tongue forward feeding difficulties can occur. This can result in reflux, lower GI distress, difficulty transferring milk, and difficulty swallowing. This movement that many people take for granted can result in an uncomfortable and difficult to soothe baby.
Create A Seal
Creation of a seal while nursing/feeding is important. It allows a baby to create suction and draw milk into the mouth. Without a seal the baby may be unable to bring in enough milk to grow. This increases the frequency of feeds. The result can be a cycle where they become too tired to effectively feed. We often think about what the lips are doing while feeding and being wide to allow depth. Without the tongue coming forward to rest between the gums, even with a wide mouth, there is not enough control. The result is milk loss and/or air being swallowed. A good seal is key and it starts with the tongue coming forward.
Benefit From Feedback
Feedback is essential for babies. Responses are reflex based and require adequate feedback. Without feedback the jaw does not know how much pressure it is creating. This can cause pain with breastfeeding and an overuse of the muscles of the jaw. Overworked muscles present as quivering or shaking and are a sign a baby does not have enough strength, control, or endurance to meet the needs of feeding. If a baby is able to stick out their tongue they get better feedback from their tongue. An easy way to feel this yourself is to bite down on your teeth then try it again on your tongue. The nerves in the tongue provide feedback to control the tension. Without the tongue coming forward between the gums a baby is likely to create more compression of their jaw resulting in biting and pain. Teaching a baby to bring their tongue forward goes a long way in helping them improve their efficiency and control of nursing/feeding.
Last but not least the tongue is responsible for creating suction. If the tongue is forward, and stays forward, while nursing it gives a strong foundation to move from and allows a drastic change in pressure in the mouth. Movement of the tongue up and down is responsible for creating suction and extracting milk from a bottle or breast. If the tongue does not have enough motion, or does not use it, less suction is created. When there is less suction less milk is extracted. Overall this results in lower transfer and substitution of muscles of the jaw and neck in an attempt to increase transfer. A baby unable to stick out their tongue needs help to break out of this pattern.
Get the Tongue Moving
If a baby is unable to stick out their tongue it is a sign that they need support. I work with families to reduce tension in their babies’ bodies. This reduces substitution and allows the tongue/jaw to move more freely. For babies with some tongue motion but not the desire to move their tongue I have seen it help immensely and within 1-2 weeks seeing drastic changes to feeding.
Is The Motion Restricted Due To A Tongue Tie?
This is an important question. I have a number of families familiar with this after they go to have their frenotomy only to be told that there is not a significant tie. Confusion occurs as other providers may have led them down this path. This is because tongue movement is that of a muscle. The tongue attaches to bones in the neck, jaw, and skull. The tongue stretches and moves but if these bones are not allowed to move the tongue is unable. This results in the tongue and muscles that stabilize it to become overworked. To break out of this cycle the muscles of tension need to be identified and a more efficient movement taught. This is where pediatric physical therapy treatment helps.