 Photo credit from top left, clockwise: @druckstarr, @shaysmomlife, @ccamila55, @lilmisskekeisen Chipmunk cheeks - is this normal?Has your baby or toddler ever filled their mouth with blueberries - one after the next - without chewing and swallowing? Perhaps they store them in their cheeks or at the roof of their 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 their 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 themself by placing their own hands into their mouth. By doing this, they learn the landscape of their 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 their mouth and learns to gum and teethe on these safe teething toys. This is a developmental milestone that should be encouraged. They first learn where their mouth is, and then they learn about the boundaries within their mouth, such as the tongue, the hard palate and the back of their mouth. Your baby will also learn to open and close their mouth around toys and their hands, and they soon learns that placing a toy straight back in their mouth may cause them to gag. They also learn when their 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, they may discover that they can put lots of food in their mouth. Their mouth is now bigger than it once was when they were a young baby, and they may get excited about eating new flavors and textures - so excited that they jam them all in their mouth at once. Perhaps they store them in their 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 their mouth safely. 1. Encourage your child to chew, but if they won't ask them to spit out the food, take a sip of water, and start over. 2. Offer her a small bite as their 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 that they won't spit out or chew. 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 their food and may not be feeling the food within their mouth. A lack of oral sensation can lead to stuffing because excess food helps your child understand the boundaries of their mouth better. They may seek out crunchy or chewy textures or may crave highly flavored foods (spicy, sour) to "wake up" the oral sensations within their 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 they leave the table, as this can be a safety and choking concern.  We hope this helps you keep your kiddo's mouth safe and keeps their cheeks available for sweet parent 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!  |
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