Transition from Breast or Bottle Feeding
to New Utensils: An Oral Motor Perspective
By: Debra A. Beckman, MS, CCC-SLP
Speech Language Pathologist
Oral Motor Specialist
For many children with motor delays due to low muscle tone or
cerebral palsy, the journey from breast or bottle to new utensils such as
a cup or straw can be challenging. As your child begins attending preschool
and then kindergarten, he or she will be expected to drink independently,
as most day care and school staff will have limited time to assist children
during snacks and lunch. Drinking enough during the day is very important
for the health of all children. By working together with your therapist, you
can help to make this journey toward independence easier for your child.
Why would using new drinking utensils be difficult? For most children, it
is no problem. But children with oral motor impairment need to develop the
muscle control needed to open the jaw, close the lips around the cup or straw,
and control the lips, cheeks and tongue to draw the fluid into the mouth while
breathing and swallowing.
Often, a child with mild oral motor impairment has steady weight gain, but
slow. Real problems do not emerge until time to transition to new food types
and utensils. It is important to find the utensil that is easiest for your
child to use for drinking as you and your therapist work to change the child’s
muscle control, so that your child will be able to drink from any utensil,
or no utensil - for example - at the water fountain.
The easiest drinking utensil is a flexible straw in a closed container, a
straw bottle (see illustration). While the care giver controls the amount
of liquid coming into the mouth, your child needs to be able to do the following:
 |
1. Lift the tongue to the roof of the mouth To drink from a regular straw in an open container, like
a 1. Lip strength to maintain lip seal around the straw |
To drink from a regular cup, your child needs even more control:
1. Head/neck control for extension/flexion
2. Internal jaw stability (strength)
3. Lip strength to maintain lip seal on the rim
4. Lip rounding
5. Negative pressure to pull the liquid into the mouth
6. Lift the tongue to the roof of the mouth
7. Control the liquid as it comes into the mouth
8. Coordinate sucking, swallowing, breathing
To improve your child’s oral control, you and your therapist work together in therapy and outside of meal time using Beckman Oral Motor Interventions. As you and your child work together with your therapy team, day by day, your child can develop the muscle control needed to drink easily from anything, even from a water fountain.
When your child is ready to begin drinking from an open cup (not a sippy cup), it may be helpful to start out with a cut-out cup (see illustration). It is easy to make one out of a paper cup. Cut one side of the paper cup ½” lower than the other side so that as you tip the cup up, the cup does not hit the nose. This way, your child’s head can stay level, as you present the liquid. If you sit behind your child, you can better support the child’s head. Place the cup gently to his/her upper lip while waiting for the lower lip to seal around the cup. Tilt the cup so that the liquid touches the upper lip. This will usually cause the lower lip to lift up to the cup with the tongue staying inside the mouth, not sticking out under the cup. Never push or force the head back. This is dangerous and can cause choking. Practice this technique a little every day until your child is drinking several ounces. Next, encourage your little one to place his or her hands around the cup with yours and practice until there is enough of a comfort zone to permit complete independence. And there you have it, a successful developmental milestone accomplished!
More information about oral motor patterns and Beckman Oral Motor Assessment
and Intervention is available on the web site ww.beckmanoralmotor.com