Oral Exercises help babies improve feeding skills!

The uterus is a tight place, and birth is a bumpy ride! All babies need some time and a bit of help, to “unwind” post-birth - some more/some less. For babies with oral tension and/or ties, torticollis and other body tension/asymmetry, bodywork and oral exercises are especially important to get to know your baby’s movements, and help to start new motor patterns for better feeding. As you work with your baby note their strength and symmetry - and how they change over time - this will help you to see how much you are helping your baby to change and grow.

Feeling overwhelmed? I totally get it - this is a lot!

Start with the with the ideas below marked with ***. Be silly and have fun - stick out and “cluck” your your tongue for your baby to copy, make silly sounds, sing songs!

Start with the basic set of skills

Tongue side to side motion (lateralizing)
Tongue extension, cupping and suckling/undulation
Good lip and cheek tone
Rhythmic jaw motions and chewing (phasic-bite reflex)
A palate that can be touched to elicit suckling without gagging

Here are some videos to help

Infant Oral Exercises (***) and Infant Suck Training by Lisa Lahey, RN, IBCLC, OMT
Infant Suck Training Exercises, and Facial Massage and Oral Exercises by LA Lactation
Facial Massage and Oral-Motor Exercises by Mighty Kiddos

Think of these as quick/playful “can you follow my finger?” sessions during diaper changes, when baby is on your lap, etc.

Then add “suck training’

When baby is suckling on your finger from the above video ideas:

*** Do “tug of war” to strengthen the suction (slightly pull your finger out so baby suckles back in response)
Feel for their tongue to:
- Stay cupped and adhered to your finger the whole time (think of your finger as the hot dog and the baby’s tongue as the hot dog bun).
- Stay forward (tip of the tongue between their gums and your finger)
- To undulate from front to back (while staying in place, not retracting).
You should not feel air intake, or the tongue tip flick/retract back, or be able to very easily pull your finger out while the baby is suckling.
These ideas can also be done with pacifiers or empty bottle nipples

Challenge their ability to suckle with a wider mouth

Baby’s need to be able to do all of the above, but with a wider mouth when feeding (breast or bottle). To help with this:

*** Tug down on their chin while doing “suck training”.
Look for them to keep their tongue fully extended, lifted up and cupped even as you challenge them (here’s a baby having trouble with this skill)

Promote closed tongue/palate contact, closed mouth breathing, and tongue lift strength

*** Sleeping Tongue Posture Hold (also excellent for post-frenotomy (tie-release) stretches) -
Resting Tongue Posture

If your baby is not doing some of these skills

There are many exercises to help - we will choose them to specifically work certain motions. Here’s one example - these Infant Oral Exercises by Bryna Sampey, IBCLC - showing ideas to aid a baby having trouble with tongue lateralization and cupping.

Enhance oral exercises with oral/motor implements (toys, teethers and pacifiers)

Three great videos by LA Lactation - one, two, and three
Instagram video with overview of oral motions and how to use toys/teethers to enhance them
Instagram posts showing toys/teethers in use - One, Two, Three
Use vibration! Hold something in your hand that gently vibrates (toothbrush, vibrator, or even one of these “oral jiggers”) - the baby will feel your finger vibrating as you do the exercises, which may stimulate their movements even more. You can also use direct vibration if it’s gentle like this infant toothbrush.
Specific oral/motor toys and teethers. Note - these are just examples, and there are many more options - feel free to find any toy/teether that is similar!
- For tongue exploring (extension, lateralization, etc) - the O-ball, or any ball with texture (like these), this Innobaby “Star" Teether, these Fruit Teethers, or really anything the baby can push their tongue toward, into and around is great.
- Tongue lateralizing, phasic bite/chewing and palate desensitizing - these Teething Tubes (also great for tongue exploration!), this Comotomo Teether, the “Bunny” teether, the Zoli teether, Banana Teether, this Nuk Brush. Really any teether/toy that has extensions to mouth, chew, and explore. This Round Teether with a wooden ring has shorter projections for a baby with a particularly sensitive gag.
- Suckling - this Penguin Teether, and this ”Chicken" Teether are suck trainers and teethers/chewers at the same time. The Ninni pacifier is unique - it’s wider/softer than other pacifiers so it’s a bit more challenging to hold. Putting your finger inside of the Ninni can help them use it at first, and then progress from there (see an example in my video library.
- Babies have a great grasp reflex, so anything that has a thin “bar” or graspable holds is easy for a baby to hold on their own (for how long depends on their age) - many examples above are in this category!