Speech therapy feeding tips for children with Down Syndrome

A Speech Therapist’s Feeding tips for Children with Down Syndrome

Can I just shout from the rooftops that I LOVE Molly over at TheSpeechTeacher? She is the most down-to-earth, sweet and knowledgeable speech therapist I have ever chatted with. I am only saddened by the fact that she lives states away from me and I cannot then employ her as my very own personal therapist for Cedar. However, second-best, is learning from all of her great advice that she offers on her website, Instagram and Facebook pages, be sure to check her out (by the way, her website is the most beautiful, go see it here)

FINE PRINT Affiliate links included and cost you nothing but help to maintain this site when you purchase through links. The information provided by the Speech Teacher is her advice on practical feeding for your child, use common sense.

Here she is…TheSpeechTeacher

Feeding your baby successfully is one of the best feelings in the world! Knowing that you are providing your little one with a full tummy fills you with equal parts relief and pride. I chose those two feelings specifically because there is a common misbelief that eating is instinctive and easy. However, eating is only instinctive in the first month of life. By 6 months of age, eating has become a learned behavior. Additionally, eating is hard! It requires all of our senses, muscles that span half of our bodies, and multiple organs. If you are having a hard time feeding your baby, you are not alone—25% of our little ones demonstrate feeding difficulties. These issues could be sensory, anatomical, or behavioral in nature. Great news is—we can make mealtime less stressful and more enjoyable for children & parents!

WHEN TO KNOW YOUR BABY IS READY

There are a lot of differing opinions when it comes to prescribing a specific age when babies are ready to start solid foods. 6 months is a generally agreed upon age to start the transition. Instead of designating an age, I like to refer to signs that your little one may demonstrate to indicate readiness. For example:

Sitting Up & Holding Head Up: Both of these skills are critical for your baby’s safety when accepting and swallowing solid foods.

Showing Interest in Food: When your little one starts to gaze at food, smile in response to seeing food, and/or reach for your food it is a strong sign.

Tongue Movements: Your baby may start to show you some fun tongue tricks like sticking it out, moving it from side to side, etc. This is great sign that they have increased control of their tongue in order to manipulate food.

Bye-Bye Tongue Thrust Reflex: Your baby has a tongue-thrust reflex, which usually disappears around 4-6 months of age. The reflex is to protect the airway, as the tongue protrudes out whenever something touches it. You will know it’s still there if your baby is constantly tongue-kicking the spoon out!

WHAT A MEAL SHOULD LOOK LIKE

One of my first observations when watching little ones eat is where their feet are. Surprising, right? But it is critical for tiny feet to be supported on a footrest, chair, the floor, etc. If the feet are stable, we can proceed!

I am a big believer in routines for little ones and so I always recommend having a designated “eating chair” where all meals can take place (i.e. highchair, sassy seat, booster chair, etc.) The more routine an activity is, the more likely your little one is to have set expectations and feel comfortable.

Meals should be short—that is less than 30 minutes. Remember eating is hard, it takes a lot of effort, and little ones have much shorter attention spans.

Use fun and positive language during mealtime. As previously mentioned: by 6-months of age, eating is a learned behavior. You have a beautiful opportunity to teach your baby that food is fun and good for us. If you are relaxed, happy, and comfortable during the meal, your baby is likely to mimic those feelings.

You can eat too! I always suggest eating with your little one during meals. Preferably you would be eating the same thing and/or something that you would be willing to feed them if they showed interest (e.g. they are eating a fruit puree while you eat apple sauce). Not only will you be providing a real-time model, but also you are introducing the social element of mealtime early on.

Savory foods are yummy as well! We often introduce sweet fruit purees first, however some of our tiny friends then reject savory purees such as vegetables or meats. Flavoring is often a game of trial and error; try to be mindful of introducing a wide variety of savory and sweet. I often introduce savory purees first to avoid their potential rejection. You can also introduce them simultaneously or in varying combinations depending on your little one’s acceptance and enjoyment.

Here is a quick peek into an actual feeding session where you can see some of the tips in action

THE IMPORTANCE OF PLAY

Making the transition to solid food is a big step for our tiny friends! I like to start with and continue to incorporate play into the equation. That is, before I start to spoon-feed smooth purees, I introduce them on the tray. That way your baby has the ability to feel the new texture in his or her hands first. Additionally, we all know where baby hands end up…the mouth! It’s a win-win for everyone involved. Once your little one has accepted the texture a few times on the tray, then you can start with the spoon. Then each time you are ready to introduce a new texture, start with the tray before the spoon. Playing with food is necessary and yes, messy I know. But when we allow our children to play with food, we are providing them with awesome opportunities to explore with all of the senses, feel more relaxed, and enjoy themselves!

A NOTE ON POUCHES

Pouches are growing in popularity and the options are endless! I love that there are healthy and pure versions—however, the overall design has not yet changed for the better. Pouches have a short, wide, and often hard spout that allows for the puree to zoom to the back of the throat without much effort or oral movement. Kids just have to suck and swallow, which is a behavior we want to advance away from when starting solids. The puree inside of pouches is usually one note in flavor (i.e. sweet!) These pouches are a picky eater’s dream! They require little effort, underwhelm the taste buds, and have no textural differentiation. To be fair, many kids grow up eating pouches and have no issues transitioning to new flavors or textures. However, I do recommend using pouches only in times of convenience. Spoon-feeding and providing starter finger foods will expose your little one to new flavors, textures, and necessary oral motor movements to become an awesome eater!

Additionally, there are very easy pouch adjustments that can be made on a daily basis:

Put a regular straw inside the pouch and have your little one drink the puree from the straw instead of the spout.

Use an attachable spoon (Munchkin, ChooMee, and Infantino make them).

Pour the pouch contents into a bowl and spoon-feed.

TEXTURE TIMELINE:

Here is a basic timeline for introducing different types of foods! Remember each little one is unique and this is just a guideline J

6 Months:	Smooth purees
8-9 Months:	Lumpier & chunkier purees, meltable or dissolvable finger foods, and ground or mashed table foods
12 Months:	Chopped table foods and easily chewed meats (i.e. ground, shredded, slow cooked)
12-18 months:	All textures!
18-24 Months:	Meats that are harder to chew and tough solids such as raw vegetables

TOOLS THAT I LOVE:

Here are some of my top recommendations for parents who are starting solid foods!

Num Num GOOtensil: A perfect, flat, textured starter spoon! Babies just have to grab & dip for success! The flat, textured design is also awesome for teething gums.

Num Num Beginner Bowl: This beginner bowl is uniquely designed for little ones with its no slip bottom and sloped walls! It pairs perfectly with the Gootensil as well.

Nuby Mash & Serve Bowl: This masher is wonderful for quick and easy meal prep! Great for mashing up fruits, veggies, or any table foods to introduce to your little as a smooth or lumpy puree.

Munchkin Mesh Food Feeder: A safe way to introduce new foods and new textures! Works well with fresh fruit and veggies. I also use it with kids who are having difficulty accepting dry crunchy finger foods (cheerios, puffs, etc.) It allows them to experience the new sounds and textures without the risk of choking or gagging.

Boon Pulp Feeder: This is a silicone feeder & teether in one! Allow your little one to experiment with new flavors, textures, and temperatures without the worry.

EZPZ Mat: This is a wonderful bowl and placemat-in-one! It suctions to the table creating less clean up. It is perfect for introducing new textures to allow little ones to play with their hands first. I also love that the smile makes for perfect food sections.

The Big Book of Organic Baby Food: This is an amazing resource for recipes & helpful tips on food transitions for your little one!

Molly is a New York City-based Speech Language Pathologist and Feeding Therapist. She is ASHA (American Speech and Hearing Association) Certified and trained in the SOS (Sequential Oral Sensory) Approach to Feeding. She received her Masters in Speech Language Pathology from Teacher’s College, Columbia University, and her Bachelors in Speech and Hearing Science from George Washington University. She currently works with the birth-5 population conducting evaluations & providing speech and feeding therapy in NYC. Molly provides therapy in the home as well as in a special needs preschool setting. You can find her on Instagram @thespeechteacher where she posts daily pops of knowledge and connect with her on her site as well as Facebook.