The Essential Guide to the Tongue Thrust Reflex

By Hannah Whittaker RD, PGDip | Aug 14, 2023

The Essential Guide to the Tongue Thrust Reflex! As parents, we are constantly in awe of the developmental milestones our babies achieve. One such intriguing behaviour that often captures our attention is the tongue-thrust reflex.

If you’ve ever noticed your little one instinctively pushing their tongue forward (tongue thrusting) when you introduce food, milk, or when giving them little kiss, you might have wondered what this is and why it happens. I know I remember it well with my two daughters.

The Essential Guide to the Tongue Thrust Reflex will help to shed light on this topic. Demystifying its purpose and advising you on its significance in newborn babies.

 So, let’s dive in!

What is the Tongue Thrust Reflex?

The tongue thrust reflex (also known as the extrusion reflex) is an involuntary action in babies.

It is where a babies tongue pushes forward when something touches or comes near to their lips. This natural reflex is a normal part of development and essential during breastfeeding or bottle feeding, as it helps to direct the milk toward the back of the mouth and allows your baby to swallow efficiently.

It’s an important for efficient feeding, but also for safety as it helps to prevent your baby from swallowing foreign objects. 

The Development

The tongue thrust reflex is present from birth but typically becomes more visible during the first few months of life. At around four months of age, the reflex starts to decrease, as your baby develops more controlled tongue movement. By around six months of age, the tongue thrust reflex has generally started to phase out as your baby’s facial muscles strengthen and their coordination develops.

Factors such as the shape and size of your baby’s mouth, the strength of the muscles in their mouth, and the frequency of feeding can all influence development. 

Tongue Thrust Reflex

The Significance when weaning

Over time, as your baby’s tongue movements become more coordinated, it’s vital to encourage them to develop and learn how to chew. I always recommend introducing solid foods as early as possible. For example when starting with puree, always give a finger-sized piece of soft cooked vegetables alongside. You can find more information on when to start weaning via my blog.

How to check Tongue Thrust Reflex

Identifying the tongue thrust reflex is easy in young babies between 4-6 months of age. You can check if it is still present by placing a small amount of pureed food on their tongue and watching the response. If your baby’s tongue pushes the food away then the reflex is still present. 

Reasons why the reflex may be present after 6 months

Understanding the extrusion is crucial. Below are some tips on what is normal development and also when to seek medical advice.

Delayed weaning and introduction of solid foods

Delaying the introduction of baby-led weaning and continuing with puree for too long can affect your baby’s oral development. When a new food is introduced in the early days I always advise giving a small amount of soft-cooked finger foods alongside puree.

If your baby is over 6 months and you still feel they have a strong reflex present this doesn’t mean that you have to delay weaning. Check out my blog for more advice – When to start weaning – Expert Dietitian Guide.

Speech Development

The tongue thrust plays a huge role in the development of your baby’s speech. 

A strong and persistent tongue thrust reflex in older babies may affect their speech development. The tongue plays an important role in your baby forming of sounds and words. For sounds like “t”, “d”, “n”, “s”, “z”, “l”, and “sh”, the position of the tongue is important. It has to make contact with the roof of the mouth or the alveolar ridge (just behind the front teeth). If your baby continues with a strong tongue thrust reflex as they start to form early words, their tongue may push forward against or between their teeth instead of lifting. 

Over time, this can lead to sounds changing. For example, they might pronounce the “s” sound more like a “th”, leading to “thumb” sounding like “sum” because of the tongue pushing forward.

If you are concerned speech therapy can help to support you. 

Development Variations

Every baby develops at their own pace, and some babies may experience a slower maturation of their oral motor skills. If your baby’s development is delayed slightly, the reflex may last a little longer. This may occur in babies who are born prematurely (before 37 weeks gestation) and is generally nothing to worry about.

Mouth Breathing

Mouth breathing can contribute to or make worse a tongue-thrusting habit. If in early childhood your little one predominantly breathes through their mouth, the tongue tends to rest lower in the wrong position, pushing against their front upper and lower teeth. This position of their tongue may mean the tongue thrust reflex continues as they get older. This may be caused by nasal congestion and could also be a sign of a food allergy

Over time, this can lead to dental issues, like pushing the front teeth outward and the habit of open mouth breathing may also affect speech or chewing.

For babies and young children showing signs of prolonged mouth breathing or persistent tongue thrusting, it’s important to speak with your paediatrician, dentists, or speech therapist. Early intervention can make a big different.  

Structural Abnormalities

This includes things such as a high palate, lip or tongue tie and can impact on a baby’s tongue position and movement. 

Habitual Sucking Patterns

Babies who rely heavily on dummies or thumb sucking may have habitual sucking patterns. The repetitive sucking reflex can reinforce the forward tongue movement, making it more challenging for the reflex to fade naturally.

Tummy issues

Certain gastrointestinal conditions, such as reflux or cows milk protein allergy can cause discomfort or pain during feeding. This can lead to a strong gag reflex and babies may use the tongue thrust reflex as a way of protection and alleviating discomfort. If you need support then contact me for more information.  

Neurological Factors

In some cases, neurological factors may affect development. Conditions that affect the central nervous system or motor control, such as cerebral palsy, trisomy 21 (down’s syndrome) or genetic abnormalities, may impact a baby’s ability to control their tongue movements.

If you have concerns about your baby’s tongue thrust reflex persisting it is important to consult with a qualified healthcare professional. They can assess your babies development and provide guidance on appropriate support.

Remember – It doesn’t have to stop you from starting weaning if your baby is around 6 months old.

So I hope The Essential Guide to the Tongue Thrust Reflex has helped you to understand that it is an essential part of helping your babies development and also in their transition from formula or breast milk to more solid foods. Remember, you don’t have to wait until the reflex has gone until you start weaning. Just make sure your baby is showing other signs that they are ready for weaning. Always speak to your doctor if you have any concerns with your babies development. 

Hannah 

Hannah is a respected figure in the field of nutrition. Renowned as an expert dietitian, captivating speaker and sought after media spokesperson being featured in esteemed publications including the Sunday Times, Independent and Huffington Post. 

Explore Hannah’s inspiring journey as a mum of two, overcoming her own nutritional struggles. Discover how she empowers fellow mums with valuable nutritional knowledge, ensuring balance and offering support on their personal journey. 

Get in contact if you need support

Hannah Whittaker Dietitian Bump2baby Nutrition
Expert Pregnancy & Paediatric Dietitian at | info@bump2babynutrition.com | Website | + posts

Hannah is an Expert Registered Dietitian specialising in Vegan Family Nutrition and Cows Milk Protein Allergy. 

She is a respected figure in the field of nutrition and a captivating speaker and sought after media spokesperson being featured in esteemed publications including the Sunday Times, Independent and Huffington Post.

Credentials

  • Registered Dietitian
  • First Class Degree in Nutrition

Experience

  • Over 15 years experience working in the field of nutrition
  • Respected Media Spokesperson both in the UK & USA; quoted online, TV and in local and international news
  • Writer & Researcher, supporting the BDA and PEN Nutrition

 

 

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