 Photo credit from top left, clockwise: @druckstarr, @shaysmomlife, @ccamila55, @lilmisskekeisen Chipmunk cheeks - is this normal?Has your baby or toddler ever filled her mouth with blueberries - one after the next - without chewing and swallowing? Perhaps she stores them in her cheeks or at the roof of her mouth and you find food a few hours later! Is this normal? Is it behavioral? Is this a sensory processing issue? This question comes up almost daily in my practice as an Occupational Therapist specializing in feeding therapy. In short, food pocketing and stuffing can happen when children are eating too fast and haven't mastered chewing skills, but if pocketing becomes a persistent issue despite using the preventive measures listed in this post, it may be time to seek professional help. To understand why your child may pocket or overfill their mouth, let’s briefly discuss her oral development. Note: the images used in this post were provided by parents in our free Facebook Group and are used with permission. The children in these images aren't pocketing food but rather have adorable, squishy cheeks! Disclosure: some of the links below are affiliate links, which means (at no cost to you) we will make a small commission if you click through and make a purchase.  @rukiperez Mouth development and oral awarenessStarting at birth, we want your baby to learn to soothe herself by placing her own hands into her mouth. By doing this, she learns the landscape of her mouth. This type of self-soothing with hands is comforting to babies and is exactly what we want them to do! Your baby eventually learns how to bring toys further into her mouth and learns to gum and teethe on these safe teething toys. This is a developmental milestone that should be encouraged. She first learns where her mouth is, and then she learns about the boundaries within her mouth, such as the tongue, the hard palate and the back of her mouth. Your baby will also learn to open and close her mouth around toys and her hands, and she soon learns that placing a toy straight back in her mouth may cause her to gag. She also learns when her mouth is too small for a large toy. In the OT world, we call this mouthing and the development of oral play skills. This is exactly what we want to see babies doing before 6 months of age. Mouth stuffing and food Once your child starts feeding herself, which can happen around 6 months if you're doing Baby-led Weaning, she may discover that she can put lots of food in her mouth. Her mouth is now bigger than it once was when she was a young baby, and she may get excited about eating new flavors and textures - so excited that she jams them all in her mouth at once. Perhaps she stores them in her cheeks, chipmunk style. What do you do? In the case of pocketing and mouth stuffing, prevention is the best remedy. Preventing your child from stuffing in the first place is the safest and most effective way to manage chipmunking. How do you prevent mouth stuffing?
 Your child's mouth is already overstuffed with food - now what?While prevention is key with overstuffing, if stuffing happens it's critical to maneuver food out of her mouth safely. 1. Encourage your child to chew, but if she won't ask her to spit out the food, take a sip of water, and start over. 2. Offer her a small bite as her next bite and use the strategies listed above. 3. If your child won't spit out the food, won't chew and swallow, and won't drink any water, you may have to remove the food from her mouth. Be extremely careful, as you may push food further back in her mouth. Use your finger to slide food to the side and forward, not back. This may be a negative experience for your kiddo and should be only used as a last resort. This is not recommended when your baby is gagging while learning to eat and should only be used if you can clearly see the food. When should you seek help? @jennyslens If you regularly find food stored in your child's mouth minutes to hours after a meal, it may be time to seek professional help. While it can be behavioral, food stuffing may also be a red flag that your child is not chewing her food and may not be feeling the food within her mouth. A lack of oral sensation can lead to stuffing because excess food helps your child understand the boundaries of her mouth better. She may seek out crunchy or chewy textures or may crave highly flavored foods (spicy, sour) to "wake up" the oral sensations within her mouth. This behavior is concerning to feeding professionals and may require therapy. Speak with your pediatrician and seek professional help for your child if this is a persistent problem. We recommend scheduling an assessment with a Feeding Specialist (either an Occupational Therapist {OT} or a Speech Language Pathologist {SLP}) who has specialized training in oral/mouth development. If your child is regularly pocketing food, please always do a mouth check before she leaves the table, as this can be a safety and choking concern.  We hope this helps you keep your kiddo's mouth safe and keeps her cheeks available for sweet mama kisses, not food pocketing!   Let's talk about poop.OK, so it's not everyone's favorite topic, but as a dietitian I discuss it - oftentimes in great detail - with almost all of my clients. Constipation is a common problem for many young children, and when kids are constipated (which oftentimes makes them uncomfortable), finding a fix can be frustrating. We will go into more detail about what defines constipation, what can cause or affect it, and what we recommend our clients do with chronically constipated kiddos in a future post. For now, let's talk about one way to remedy it. Enter: the Sweet Berry Constipation Smoothie. You probably know that "p" fruits like prunes, pears, plums and peaches are helpful for constipation. Many of our clients use apple juice or prune juice (4 oz diluted with water) to help things move along. Sometimes, however, kids are sick of juice or won't eat "p" fruits. That's why offering a tasty smoothie - or putting it into a popsicle - can help. Changing your child's diet overall can help with constipation as well. Check out our toddler course for more info on transitioning to a more balanced diet. I'll be honest...it was really hard to create this recipe. I hate prunes. They taste like raisins to me...and you may know what I feel about raisins. I wanted to include prunes and apple juice - which make a very sweet, overwhelming flavor in my opinion - while keeping the smoothie tasty for kids who are resistant to consuming these foods. Enter blueberries and strawberries. Kids love them, they're full of nutrients, most parents have them on hand, and I notice that many of my clients find that blueberries help with constipation (bonus). Strawberries are just dang delicious, so let's throw those in there too. Aside from prunes and apple juice, we also included other ingredients that may help with constipation: Kefir: kefir is a cultured milk drink that contains more live and biodiverse bacteria than traditional yogurt. It also colonizes more effectively in the gastrointestinal tract than yogurt and may help rebalance gut flora if that's what is causing constipation.. It has a sour flavor like unsweetened yogurt. If your child is dairy-free, use an unsweetened Greek dairy-free yogurt like Kite Hill brand. Chia seeds: chia is high in soluble fiber, which helps soften stool. (Insoluble fiber, found in whole grains and vegetables, is important for bulking up stool, but if not consumed with enough soluble fiber a child may still be constipated.) Coconut oil: many parents notice that adding coconut oil to their tot's diet can help ease constipation. It's unclear if the medium-chain fatty acids in coconut oil help get things moving, or if the oil itself has another property that aids digestion. Dates and blueberries: I have noticed that many of my clients find relief from constipation when eating dates (like in the form of Lara bars) and blueberries. Kids also like how these foods taste, and they balance the flavor of the apple juice and prunes. We also added hemp hearts for extra nutrition and strawberries/cinnamon for flavor. Make sure to taste the smoothie as you create it and modify it per your taste. We like the addition of cinnamon in balancing out the apple flavor, but you can omit it if you want to. My kids and I tasted various iterations of this smoothie as we experimented, and let's just say this...even though we don't have "going" issues in our house, this smoothie was effective within a few hours for everyone :) Please note: this is one suggestion for occasional constipation. This recipe does not replace specific medical advice geared toward your individual child. If your child continues to struggle with constipation, please make an appointment with your pediatrician and a pediatric dietitian. Sweet Berry Constipation Smoothie  We hope that this recipe helps get things moving! Good luck!  |
AuthorsMegan and Judy, co-owners of Feeding Littles, bring you helpful info on food, nutrition, picky eating, and feeding young children. Megan McNamee MPH, RDN is a Registered Dietitian Nutritionist based in Scottsdale, Arizona. Judy Delaware, OTR/L is an Occupational Therapist specializing in feeding therapy with children 3 and under in Boulder, Colorado. Megan and Judy are both moms of two and love helping families develop a healthy appetite for all foods!
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