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.