The Second steps to overcoming Oral Aversion: Massaging lips, and front gums

After you have read the post: First steps into overcoming oral aversions: Touching the head, ears, and face, AND you have followed the exercises in the first post for a few days, you are ready for this post.  Please do not skip the steps in the first blog, they are so important to connect your baby or child to your touch and your interactions.  When your child is connected to you emotionally and they feel safe with your touch always, then and only then are you ready to move toward the mouth.

If you start these next few steps and your child shows no interest in your fingers close to their mouth, don't be discouraged.  You may need to show them gently they are safe by backing off to the sides of the mouth but always returning within ten seconds.  You do not want them to continue the behavior that they simply need to show displeasure and they get away from oral stimulation.  Therefore, if they show displeasure (not pain) continue with the exercises for at least three seconds to start.  Then move back to massaging their head or ears, anything they like.  Also, make sure you are talking and interacting through all this for comfort and fun.

Remember, we are the parents, and although there may be very good reasons our children have developed an oral aversion, we need to teach them to cope and develop in that area.  We make our children sit in car seats, do their homework, and take medicine when needed.  As parents we need to make sure we help children develop the skills needed to eat, even if they don't like it.

Step 1

After you do the usual head, ears, and face touching, and you feel the child is engaged and comfortable, softly rub the inside of your pointer finger across your child's lips.  Tell the child what you are doing.  Name the body parts.  Sing songs about the baby's body parts.  For example, you could softly and happily say, "These are your good lips, they are soft and red.  You have nice lips."  If the child is receptive move your finger around their lips, as if your finger is lip gloss you are applying. Do this all while talking and engaging the child.  Move then away from the lips to a familiar place on their head or cheeks.  You may want to do this three to five times before moving on.  You may need to do this for a few days until the child is used to you putting your finger on their lips.  But if you are persistent with calmness and fun, the child will eventually allow you to touch their lips willingly.

Step 2

Only when the child is very comfortable with you massaging and touching their lips, AND the child's lips are naturally open and relaxed with your touch, gently take the soft, inside tip of your finger and briefly touch the wet inside of their lip.  Just do this quickly, then draw back to something comfortable.  Do this at least three times.

Step 3.

Take your pointer finger again and slide your finger gently but quickly into the inside of your child's lips, with your pointer finger pad touching the front gums.  You will need to play with the pressure, but always start softly at first.  Your nails should be clipped so as not to scratch in inside lip.  Feel the top gums first, then the bottom.  Then, and only then, move back to another part of the body.  You may need to stop there for the day, but always go back the next day.  Be persistent with happiness and calmness.

Step 4

After touching the front gums, you can do a circle in a clockwise rotation all around the inside of the lips.  Baby's love this when they are calm and engaged.

Step 5

Take the child's hand and allow them to touch their lips, the inside of their lips, and inside front gums.  You may need to guide them hand over hand, finger over finger, but help them connect their hands to their mouths if they are not doing it yet.  Also, make sure you don't fight them, but be determined to always come back to the mouth.


Please don't hesitate to leave comments, suggestions, or questions.  Good luck, stay calm and persistent.   Next blog will be about putting your baby's fingers and hands inside your own mouth with intent. 

First steps into overcoming oral aversions: Touching the head, ears, and face.

If your child has developed an oral aversion, it is usually because they don't feel safe with food or other items in their mouth.  Their fear can be based in a real safety concerns because the child has aspirated or has pain from reflux. It can also be based on sensory integration issues where there is not a true threat to life but the fear of something unknown and very uncomfortable.  No matter the reason for oral aversion, their fear, pain and sensory problems are real and need to be addressed sooner than later.

Many therapists will tell you not to put food or items in the child's mouth until they "show" they are ready for anything in their mouths.  I disagree.  The more the child gets accustomed to oral stimulation and various sensory stimulation, the more the child will overcome their aversions.

The first way to overcome oral aversions is to use your loving, caring, clean fingers near your child's mouth.  Many children with oral aversions have already had stress from pain and doctors in and around their mouths.  They very well may already have an NG-Tube causing them to feel uncomfortable.  These kids will be nervous and possibly combative.  That is why you need to be calm, patient, and playful while doing these exercises.

This first blog will only focus on the outside of the mouth, but if done daily you will be prepping the child for stimulation inside the mouth. 

1. Rub the baby or child's head softly.

Simply sing and talk to your child while rubbing their head.  Be nurturing and look the child in
the eyes.  Get the child's attention to what you are doing by slowly and patiently relaxing the
child and engaging the child.   Be patient and don't allow the child leave by finding other
engaging  songs to draw the child's attention to you. This works especially with children ages
three and under.

2. Move from the head to the ears.
       
Gently run your fingers over the outer edges of the child's ears.  Talk to the baby about the ears.
Keeps talking engagingly.  Move the child's  own hands to his or her ears to rub them as well
and connect the idea that their hands can make this good feeling on the ears as well. Gently pull
on the bottom of the ears in many different directions.  This will help open up the ears through
the Eustation tubes and allow them to feel sensations run from ears all the way into the back
of the throat, or pharynx.

3.  Touch the jaw and cheeks.
     
After the ears move your fingers softly to the child's jaw.  Massage the back of the jaw in gently
circular motions.  Then run your fingers along the outside of the jaw bone down to the chin.
Keeping the child calm and engaged in your activities through songs are important.  Finally,
without any pressure, run a long finger along the outsides of the cheeks up to the corners of the
mouth.  Continue doing this gently until the child is relaxed and feels the movement.

4. Nose down to corners of mouth.
       
Put your thumb and pointer finger at the bridge of the nose.  Keeping constant contact with th
child's skin, and with a bit more pressure than the other massages, slide the thumb and finger off
the nose to the outsides of the nostrils, then out and around to the corners of the child's mouth.
Do this at least three times.

5.  Jaw to mouth
       
While still keeping the child engaged through soft songs and talk, take your thumb on one side
of the jaw and middle finger to the other side of jaw.  Start on the large chewing muscle on the
jaw, putting a bit of pressure on the jaw.  Then gently but with a little pressure, slide your fingers
forward making the cheeks move forward with your fingers.  Stop at the edges of the mouth. The
lips should be bunched up loosely between your spaced thumb and middle finger.

Do these exercises every day, perhaps even twice a day, until you feel like the child is comfortable and you are ready to move into the mouth.

Next blog will be about moving your fingers into the child's mouth.