Oral Stimulation

While a child’s nutritional needs are being met with tube feedings, it is important to establish an ongoing oral stimulation program. Oral sensory input (touch, taste and deep pressure) may easily be ignored for children who are tube fed. It is important to maintain oral motor skills and a normal ability to register oral sensory input for the following reasons: 

• For possible return to oral feeding 
• For later speech development 
• For minimizing development of oral aversion 

The following oral stimulation activities can be done at home, school or in therapy, etc. 

1. Include the child in the family meal time so family socialization at meals and smells of food can be experienced. Whenever possible, give the tube feeding during the family meal time or snack time. Have the child sit up at the table. If the child is an infant or a toddler, he/she can be held while being tube fed in the dining room or kitchen dining area where bottle and spoon feedings would normally take place.
2. Encourage oral exploration of hands to mouth and toys to mouth. This is a normal activity of infants and young toddlers. You can dunk the toy in juice or dab a little strained baby food on the toy to provide a variety of tastes. Try putting juice or strained or blended foods on the highchair tray or placemat, and then encourage finger painting and hands to mouth.
3. Place a pacifier or your finger in the child’s mouth to suck to calm or while the feeding is taking place. When this is done during a tube feeding, the child will experience their stomach getting full with sucking.
4. Give lots of loving touches around the child’s mouth at times of closeness, such as kissing their cheeks and lips. Wipe the child’s lips and cheeks using a warm, wet, soft washcloth and slowly and firmly press against the lips and cheeks.
5. Encourage the child to make sounds such as blowing raspberries (making a motor boat sound). Imitate sounds the child makes. Brushing teeth twice a day can be a great time to provide touch input inside the mouth. If the child is fine with brushing, a regular soft toothbrush would work well. Try to continue brushing the child’s teeth and tongue as long as tolerated and you have time for. If the child is more sensitive, try using a warm, soft washcloth and toothpaste. Some children will tolerate an electric toothbrush better. The “Infa” toothbrush, which is a soft rubber tip that fits to an adult’s finger, may be easier. The “Infa” toothbrush can be obtained from Kapable Kids (1-800-356-1564). The dentist toothbrush found at drugstores may also be easy for those children who do not tolerate tooth brushing. Lastly, Kapable Kids carries a natural apple/ banana flavored toothpaste called “First Teeth Toothpaste.” This is a mild flavored toothpaste for children who do not like the taste of regular toothpaste.