From the first trimester in utero, each of us seeks oral stimulation for comfort. Babies seek pacifiers often for comfort. Pacifiers are a personal choice for self soothing, therefore I will not provide a definitive age as to when the use of pacifiers should discontinue but provide insight on limitations pacifiers may have on oral development and some suggestions to reduce potential speech and feeding difficulties.

Pacifiers become problematic for two reasons. The first being the amount of time the pacifier is used, second the size and shape of the pacifier. As the baby matures, the input to the mouth changes. This especially happens during the transition to chewing. During this time the increase in jaw stability is important. Sucking on a pacifier shows minimal jaw movement, reducing opportunities for development of oral patters towards sides and back portions of the mouth causing weakness in those muscles this could potentially cause future speech and feeding complications. Second the shape of the pacifier is important to consider. The pacifiers with the large rounded shape on the top and flat surface on the bottom limits the variety of tongue movement.

2 Pacifier Tips:

1. Limit the amount of time the pacifier is used. The goal is to provide a variety of movement opportunities to build a variety of oral skills. If the pacifier is used the majority of the day and night, important opportunities for oral development are lost.
2. Use the pacifiers that have the shape that is rounded on all sides. This allows for a more natural positioning of the tongue during no nutritive sucking.

Watch this webisode of Pediatric Therapy Tv about taking away a pacifier

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In today’s webisode a Pediatric Occupational Therapist gives practical tips for a child with Sensory Processing Disorder to get the most out of attending birthday parties. To read a blog on SPD and parties click here.

In This Video You Will Learn:

• How to prepare your child with SPD prior to the party
• Strategies on how to calm your child down during the party
• How to make your child feel involved at the party

It is often assumed that eating is a natural instinct children are born with and that difficulties in this area are rare. Not so. Various studies into feeding disorders have identified a wide variety of prevalence statistics. It is known that some children are at an increased risk for feeding difficulty; those who are born prematurely, experience early medical complications, or children with neurological disorders. But even for children without any medical or developmental diagnoses, feeding may be a very tricky skill to acquire.

Currently available data suggests the incidence of children who experience feeding difficulty is as follows:

• Manikam & Perman, 2000: Pediatric feeding disorders are common. 25% of children are reported to present with some form of feeding disorder. This number increases to 80% in developmentally delayed children.
• Lewinsohn et al 2005: up to 45% of children at 36 months of age exhibit some “picky eating” as defined by food refusal, or accepting food one day and denying it another.
• Emond, Emmett, Steer, & Golding, 2010: This study compared the eating habits of children diagnosed with Autism to a sample of typically developing children at multiple ages. Children with ASD experienced feeding difficulty much more frequently and to a greater degree. Using a parent-completed questionnaire, typically developing children were identified as “very choosy” eaters as follows:
• o 15 months: 5.4%
• 24 months: 9.5%
• 38 months: 15.5%
• 54 months: 13.9%

Parents of picky eaters, the underlying message here is: you are not alone. If your child is experiencing feeding difficulty, seek out the advice of a professional- your pediatrician, an occupational therapist, speech-language pathologist, and nutritionist are among the qualified individuals who can help you to better understand and navigate the factors that impact your child’s feeding abilities.

Resources:

Emond, A., Emmett, P., Steer, C., & Golding, J. (2010). Feeding symptoms, dietary patterns, and growth in young children with autism spectrum disorders. Pediatrics, 26, 337-342.

Lewinsohn et al. (2005). Prblematic eating and feeding behaviors of 36-month-old children. International Journal of Eating Disorders, 38, 208-219.

Manikam, R., & Perman, J. (2000). Pediatric feeding disorders. Journal of Clinical Gastroenterology, 30, 34-46.

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