And You May Ask Yourself, How Did I Get Here?
Lauren Lagin, M.S, CCC/SLP, CLC, Orofacial Myologist
So here it goes, I figured if I am going to write a blog post now and again, I should probably start at the beginning. How did I get here?
Many moons ago, a bright-eyed baby girl was born to two loving parents in Harrisburg, Pennsylvania. This baby (me!) was an avid thumb sucker (so much so that if we ever meet in person, you may notice that my thumbs are different shapes). I was breastfed (thank you, Mom), but I refused to take a bottle. I mean, I literally never took a bottle. When I ask my mom how she fed me, if I wouldn’t take a bottle, she seems to think it was via cup, but she can’t remember. I sucked my thumb for a very long time.
My brother was also a thumb sucker and bottle refuser. However, my parents mentioned the word “braces” to him, and out came his thumb. But not this girl. I had the honor of having that gross yucky-tasting stuff painted on my thumb. I remember strangling my stuffed animals; the bigger, the better, so I couldn’t get my thumb near my mouth. I don’t recall what actually worked to get me to stop sucking my thumb. Regardless, the damage was done.
Enter 10-year-old Lauren, prancing around with her huge round glasses and braces. I was the girl who was so excited to have glasses and braces. I could change the colors of the bands on my braces – awesome. Even today, glasses are like my favorite accessory. I change mine all the time.
On top of being an excellent glasses and braces wearer, I was the BEST neckgear wearer in my orthodontist’s office. I figured out how to chat for hours on the phone wearing that thing. Sleeping with metal around my mouth, I was golden. And much to the delight of my parents, when my Bat Mitzvah rolled around two years later, I had beautiful straight teeth! But at what cost?
Already, from infancy, there are red flags in my story. Why was I sucking my thumb? Why did it continue long past the age of six months? Why did I refuse a bottle? What impact did the braces and head/neck gear have on my airway? How come no one thought about this when treating me?
Babies love to suck. Sucking is soothing and comforting; it is great for mouth and jaw development, and let’s be honest, most babies look so adorable with that thumb in their mouth (or pacifier). When a baby is sucking, either the thumb/fingers/tongue or foreign object (e.g., pacifier) presses into the hard palate (the top of the mouth), and endorphins are released. It feels great, who doesn’t love a good endorphin rush. This is why breastfeeding is so good for mouth, jaw, and face development. However, a breast is very different than a thumb, pacifier, or even a bottle.
In my practice, I encourage parents to decrease the use of pacifiers and thumb sucking between six and nine months, bottles by 12 months. The longer these behaviors continue, the more likely they are to become habits that are hard to break as a child gets older. In addition, noxious oral habits such as thumb sucking, and pacifier usage have a negative impact on mouth development. (See above – best neckgear and braces wearer in my orthodontist’s office right here!)
On the other side of this, if your adorable baby cannot keep a pacifier in their mouth or can only use a specific pacifier, this is also a red flag. Why are they having difficulty holding the object in their mouth? What is the shape of the nipple? Full disclosure, I prefer a round nipple such as the one on the Soothie brand, but please cut the dangling stuffed animal off the pacifier! In my practice, we also discuss ways to use a pacifier therapeutically to improve oral function.
Now let’s talk bottle refusing.
In most cases that I see, a bottle has been introduced to a baby sometime between birth and six weeks of age. A baby with typical mouth and oral skill development should have no difficulty switching between a breast, bottle, pacifier, thumb, whole hand, or finger to suck on. Yes, there are different muscle groups used for breastfeeding and bottle feeding, but it should be a smooth transition for most babies. When a baby refuses or more accurately demonstrates difficulty or the inability to take a bottle, but is showing successful breastfeeding, that is a red flag. My first thought is to look and feel in the baby’s mouth to determine what may be going on. Is there muscle weakness? Is there disorganization of the suck, swallow, breathe pattern? Is there a coordinated suck happening? What is going on with the tongue?
Yes, of course, as babies get older, they can develop a preference for a breast or a bottle. However, they should be able to switch between them and eat from both. Just like I prefer to drink from a cup with a straw, but can easily switch between an open cup. Your baby should be able to do the same.
This is just the beginning of my story. But it is also the first (and hardly the only) reason why I went from working in schools to a private practice devoted to helping moms, babies, older children, and even adults, to improve their oral function and feeding skills. Stay tuned because it involves a tongue tie, palatal expansion, and my own myofunctional therapy as an adult. As often happens, I am a guinea pig for how I can help people when they are young to hopefully avoid some of the things I have gone through as an adult.