Removal of food from the spoon

"Removal of food from the spoon" refers to the ability to take food off a spoon efficiently with the lips. This skill requires the smooth organization of jaw, cheeks, and lips, and it takes practice to master.

How Does It Develop?
Most doctors suggest introducing strained foods between 4 and 6 months of age, depending on the baby's nutritional and growth needs. By 6 months, babies are usually physically developed enough to take the foods with some coordination.

Presenting strained foods before a baby is physically ready doesn't help them learn the skill sooner. It just gives them more practice taking strained foods in an immature way. When strained or pureed foods are first presented, babies usually try to suckle, eating the food with the same in-and-out motion the tongue used when sucking.

The suckling tongue action begins as soon as the spoon touches the lips. The upper lip moves forward toward the presented spoon but does not yet move downward on the spoon to remove the food. The feeder has to gently scrape the food off on the baby's upper lip, and the food usually has to be put back in several times after the baby has spit it out.

This spitting out is usually a result of immaturity rather than a dislike for the food. This is a messy time! The closer the baby is development/ally to 6 months, the shorter the messy period, and the sooner the baby gains more control. Over time, babies acquire the ability to work upper and lower lips together to take food off the spoon. They gradually learn to move their upper lips forward, downward, and inward, which are the basic skills needed for efficient food removal from the spoon.

But some children have delays or muscle imbalances with tightness or weakness that interfere with this skill. An abnormally tight pull on the upper lip muscles, or weak, nonactive lip muscles both serve as roadblocks to good food removal from the spoon. There are ways to encourage food removal from the spoon with children for whom this is a challenge.

What Can Be Done to Improve It?
Be sure your child is sitting in a comfortable, well-supported posture with trunk mostly upright and chin tucked before trying any of these suggestions. Your child's feeding therapist will help you decide which of these activities assist you child.

Massage!
uscle tightness that pulls the lip and cheek muscles away from a closed mouth interferes with your child's ability to close lips on the spoon. Children may need to have their faces massaged toward a closed-mouth position prior to the feeding. This massage before the meal can help your child stretch out the tight muscles. It also helps your child feel what it is like to have lips touching and closed before needing to use that skill for taking food off the spoon.

Alert!
When children have muscles that are too floppy or weak, they may need to have their faces "wakened up" with a brisk washcloth rub before the presentation of the food.

Pause!
Some children just need the feeder to pause with the spoon resting on the lower lip. This provides a little extra time and the incentive for your child to bring the upper lip down to help. If you scrape food off onto the upper lip, your child doesn't need to help with the removal process. If your child understands that participation is expected, you may quickly see the more mature skill.

Help Close the Jaw
When the food is presented try helping your child close the jaw while giving it support. Closing the jaw helps lips touch. Here are several different ways jaw support can be given. Your child may need a lot of support with your whole palm or three fingers, or maybe just a little, as with the thumb.

Help Close the Lip
Bring the upper lip down to meet the spoon when it is resting on the lower lip. This should be done gently with one or two fingers. Be careful not to poke your child in the process.

Sideways Spoon
Present the spoon sideways rather than tip first. First, rest as much of the side of the spoon as possible along the lower lip, and pause to see if the child responds by bringing the upper lip down. If not, tip the spoon upwards to touch the upper lip while still staying in contact with the lower lip. Lower the spoon back to its resting position on the lower lip Repeat tins touch of the upper lip in a teasing fashion as if to say to the upper lip, "See, this is where I want you to be. Come down and touch this spoon." Gradually you should see more and more action of the upper lip toward the teasing spoon.

Many of these techniques can be used together, depending on the needs of your child. Be sure to check with your child's feeding therapist before starting any of these techniques. Working closely with a dietitian is important in determining what foods to prepare, to maximize nutrition while your child is improving eating abilities. Cood luck!