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Debbie's Blog - feeding therapy

Oral Motor Staples for Babies Who Have Down Syndrome


Hello!  About 1 week ago my husband and I got a confirmed diagnosis of Down syndrome for our upcoming baby girl.  I want to help my little flower as much as possible and start as soon as possible!  What tools are recommended for starting at an early age?  We are very excited to help our little girl be the best she can be and we want to start right away if it is safe.

Congratulations on your soon-to-be-born baby girl!  You have such a blessing on the way!

I’m glad you reached out, there are definitely some things you can do early on and along the way.  I’d recommend reading  this blog post first - I wrote that for a new mom who asked a similar question.

That article will explain in more detail the products and skills touched on below, but to summarize the recommended products and approximately when to use them:


Oral Motor Staples for Babies Who Have Down Syndrome


As early as possible, the proMini and proPreefer are great to provide input as early as possible.

At about 5-6 months old, providing mouthing experiences via teethers is very important.  Textured ones are especially good because they provide extra sensory input / stimulation.

At about 6 months old, cup drinking can start (best not to use spouted sippy cups).  Flexi Cups are great beginner cups since they have a cut-out for the nose, and they’re flexible so you can help guide the liquid.  

At about 8-10 months old, straw drinking can begin.  The Bear Bottle is a great way for beginners to start learning straw drinking.  Be sure to get the ultra version as it comes with a Lip Blok.  

It can vary depending on the child and their therapist’s recommendations, but a lot of people start using the  Z-Vibe at about 6-8 months to help “wake up” the mouth and/or de-sensitize.  The Z-Vibe has lots of different kit options with lots of different tip attachments.  I'd recommend the Carry Kit, customized with a Soft Mini Tip, Soft Brush Tip (for gum massage), and Hard Textured Spoon Tip.  Plus if budget allows, a Soft Mouse Tip (sold separately from the kit) is fun and functional, too.  Down the road, her therapist may recommend other tip attachments depending on what other skills she might need to work on, but those are great all-around starter tips for now.

When she starts eating with a spoon / puréed foods, use the Z-Vibe with the Textured Spoon Tip attachment to provide more input (with the Z-Vibe on or off). 

When she’s old enough to follow directions,  this book has a lot of great info for working on oral motor skills.

Usually at about 2 to 2.5 years old you can graduate from baby teethers to chew tools for older kids (like the Grabber or Y-Chew). These can be used to work on specific oral motor skills as well as building oral tone in general.  

Just keep all of the above in mind with a grain of salt - as the age recommendations are general guidelines and may vary.  

Ideally the best thing would be to find a speech therapist with oral motor experience who can guide you through all of the above and make more specific recommendations tailored to her needs.  But I hope some of the above is helpful in the meantime :)

Congrats again!



When Kids Think Feeding Utensils Are Food

Question: I work with a child who has Down Syndrome. She is 16 months old. She presents with open mouth posture and tongue thrusting not during feeding. Mom purchased a Z-vibe and I saw your article on using the Z-vibe to promote lip closure. Only problem is....anytime we go near her [...]

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Feeding Problems - When It's Psychological

Question:  I've read your Food Refusal article, that feeding problems are usually related to oral motor or sensory problems.  But can it be psychological?  I’ve searched the internet and can find very little practical advice about addressing the fear of solid foods for an infant/toddler. Our son (3 and 1/2 now) is still eating pureed food [...]

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Feeding Therapy - Moving Beyond Food Prep

Question: I am working with a 7 year old girl in feeding therapy who is refusing to open her lips and just purses. She has been involved heavily in food preparation which she enjoys foing and shows great participation.  However when it comes to the taste testing part she refuses all foods. She does [...]

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Food Aversions & Spoon Feeding Issues

Question:  Hi, I have a toddler who is almost 2 years old, have sensory processing disorder.  He also has feeding aversion. and super sensitive to texture & taste.  Some goals I am looking to achieve: desensitize the oral aversion, teaching him to eat different textures, making spoon-feeding fun (he is now fighting spoon-feed) and teaching [...]

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75+ Feeding Therapy Tips & Strategies

For any therapist seeking to specialize in feeding, the best piece of advice I could give you is to become a sponge.  Take courses and workshops, read as many articles as you can, talk to and learn from your colleagues, join special interest groups on Facebook and ASHA etc., follow blogs, observe other therapy sessions, [...]

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The Oral Motor Benefits of Straws

Whenever a parent asks me what they can do to improve their child’s oral motor skills, one of my first questions is usually:  Are they drinking from straws yet? Drinking from a straw is a very simple yet effective way of improving one’s oral motor skills.  It works on lip seal, tongue retraction, cheek strength, correct [...]

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Feeding Issues from Reflux

Question:  I’m seeking help for our son. The short story is that my son was born at 25 weeks and was in the nicu for 3.5 months and has overcome many things.  When he left the nicu he was always a tough feeder (fussy) but always ate plenty by bottle. Then during a re admission, his [...]

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Food Pocketing in the Lips, Cheeks, and/or Gums

Question:  My four year old daughter pockets food in her lower gums.  Foods like pizza, chicken, egg whites, etc. (that do not melt like crackers or cookies).  She will simply let it stay in her gum pockets until she looks like a chipmunk and eventually we will have to remove it with our fingers.  She is not able [...]

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The Right and Wrong Way to Spoon Feed

Did you know that there is a right and wrong way to spoon feed?  The wrong way involves lifting your hand upward as you remove the spoon from the child’s mouth.  This method scrapes the spoon against the teeth, gums, and/or upper lip to get food off of the spoon. . . Scraping is not the normal, natural [...]

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