This week in ASHA Leader Live, a brief article entitled "Clarifying Social Media Information about Pediatric Feeding Disorders" warrants even more clarifying! In other words, today's blog could have been titled "Clarifying Social Media Information about 'Clarifying Social Media Information about Pediatric Feeding Disorders'." This is not because the article's authors are not skilled and knowledgeable therapists who may disagree with me on some therapeutic points. They are both skilled and knowledgeable, and clearly if it was a back and forth discussion instead of an article it would continue on and on. Rather, the information presented is in my opinion problematic for therapists and parents as it's brief, not individualized, and over-simplified.
You can read the original article here. (I hope you'll re-visit this blog for my clarifying comments below):
Clarifications:)
-I usually do not recommend sippy cups, except when saving yourselves a mess is the highest priority (and admittedly sometimes it is the highest priority!). My recommendation is not because sippy cups directly cause poor oral motor development as the authors argue against. Rather, they do little to promote positive oral motor development in the way that straw and open cup drinking does. Most sippy cups have a non-spill valve that may encourage biting in some children, and the spouts are often hard and large—thus displacing the tongue to a low position and encouraging a less than optimal suck-swallow position.
-Oral motor exercises with actual foods are usually optimal as noted in this article, agreed. However, sometimes as with all therapy, we may need to take a couple steps back which may even mean doing an exercise that is “non-nutritive” to start. Oral motor "tools" have their place in the therapy process with some children.
-As a Certified Lactation Counselor, I agree that there is a plethora of ways to solve most breastfeeding issues outside of surgery to release a tongue tie. I agree, conservative management first! However, what about the other 10-30% mentioned in the article who are not served by these other means? The New York Times article referred to, which was replete with misinformation, has harmed some of those children --those who do in fact have a tongue tie and would benefit from what is actually a low risk surgical procedure.
-Newsflash: Lips should flange outward at least a bit to establish an effective seal on the breast. Truth is I rarely see a lip tie that is impeding a child's progress in therapy, however, stating that a lip flange is not needed is misleading.
In actuality, there is no such thing as "clarifying" much of anything on social media when it comes to pediatric feeding challenges. Every child presents differently, warrants an individualized plan, and we ALL have to get comfortable with a bit of gray (something that is not represented well when surfing the web). There should be no "always," no "never," etc. and there is no alternative to seeing a professional when attempting to find out which pediatric feeding strategies are right for your child.
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