Tuesday, November 3, 2009

The Stage One Oral Toolkit

In a way, speech therapy begins naturally for all babies on day one with eating, crying, yawning, rooting, burping... As those instinctual actions occur, a baby’s brain receives information and mouth muscle coordination beings. A baby’s brain also receives information about its mouth through stimulation, texture, and pressure (as well as taste... but stage one babies are usually getting only one yummy taste via bottle or breast.) Our babies need a little bit more information and more practice as the mouth masters its jobs.

Enter the oral toolkit, a treasure chest of goodies you can use to orally stimulate and train your baby. Most items can be purchased in a department store or baby store, some must be ordered online, and for those on a tight budget... your fingers are free :-)

The Nuk Brush

The Nuk brush is great for oral stimulation inside and outside of a baby’s mouth. On the outside, you can roll it down from just under your baby’s nose to her upper lip. You can do this same movement all the way around her mouth, rolling toward the mouth with each stroke. This stimulates lip closure. Used inside the mouth, the textures expose your baby to new sensations. Later on it can be used to introduce trace amounts of food to a beginning eater. $3.70

Red Cross Infant Oral Care Kit

This kit has a couple very useful tools in it. The finger infant toothbrush is used for gum tracing exercises and applying pressure to the lower jaw to encourage and strengthen the bite reflex. The gum stimulator is perfect for tongue walking and for gently pressing the center of the tongue to encourage your baby to make the bowl shape with her tongue. You can use the infant toothbrush on occasion in place of the Nuk to expose your baby to different textures. $7.99

The First Years Massaging Action Teether

The First Year's "Star" teether has different textures on each star tip. When baby puts pressure on a tip, the teether vibrates and wakes up the mouth muscles. This is also a great tool for demonstrating cause and effect. Though it is slightly big for a newborn, it can be used by a parent in small doses to stimulate the baby’s lips and cheeks. This teether is easier to trigger than other brands. 7.99

The Grabber

Easy to hold, your baby will love to mouth and bite on the Grabber teether thereby strengthening jaw muscles and control. It is a smooth teether and great for babies with who are showing signs of texture aversion. $6.50

Soothie Pacifier

A pacifier is good for letting your baby practice sucking and keeping his tongue down. I had some unused orthodontically correct pacifiers (my boys wouldn’t take them) and I tried to use them but was quickly corrected by our speech therapist who said the shape is not good for babies with Ds. Who knew? The hospital style Soothie is a good paci to use and luckily most hospitals will give you a handful on your way out the door but if not, you can get them online. Two for $4.79.

Your Finger
Nice clean fingers can be used to tongue tap, press the jaws to stimulate the bite reflex, rub the gums, gently pinch-pull the lips and cheeks, and trace lines on baby’s cheek skin. Your speech therapist, or a lactation consultant who has experience with children who have Ds, can show you many exercises you can use. You can also find detailed oral stimulation techniques in the books, Early Communication Skills for Children with Down Syndrome and The Down Syndrome Nutrition Handbook: A Guide to Promoting Healthy Lifestyles.


The Z-Vibe is a great tool for babies who have moved on to stage two but it is too powerful for newborns. I will do a post on this tool in the future.

Your Turn
Do you have a tip or trick you used for your baby's oral aerobics? Do you love/hate any of the tools in the toolkit? Share your thoughts with us.


  1. Thanks for sharing these! I use the nuk brush with Bennett and I'm thinking of getting some of the others you mentioned. I just started solids with him and while he does okay I'm wondering if I should get him one of those spoons that has grooves on the bottom to add more texture- have you used these?

  2. I tried a bunch of different spoons and then settled on the Maroon spoons (search maroon spoons at beyondplay.com) They work very well and encourage correct eating techniques. I also have the Z-Vibe spoon tip which I use once in a while when she is in a very good mood and will let me. It isn't the best for feeding but it really gets things working while she eats.

  3. LOVE the maroon spoons! I'm also a huge fan of the straw hierarchy but that comes a bit later for babies but it's never too early to try the honey bear :)

  4. We love the maroon spoons here too! We use an Arc Probe instead of the nuk brush though--Miss B hated the nuk but happily goes along with the tongue rolling w/ the arc probe.

  5. Lots of new ideas! I use the Nuk brush to encourage lateral movement of Sylas' tongue. After hearing this suggestion from a blogger mom, I tried introducing food to Sylas with the Nuk brush, it worked great! We use the Maroon spoons with success and also a green flat spoon(EZ spoon by Beckman) that allows him take the food off easier.

  6. we use the nuk brush and the maroon spoons at therapy and at home, another "thumbs up" here!

  7. We've used just about all of that stuff. Nothing really works better for him. I need to remember to brush his little teeth more though. I forget when he doesn't eat by mouth to brush those teeth.

  8. Our speech therapist brought sugar free lollipops a few times to "wake up" Kayla's mouth. Also flavored tongue depressors and gloves. You can find lots of oral motor ideas at Super Duper Publications, http://www.superduperinc.com/, click on products, then Oral-Motor.

  9. I have used or use all of the above. Great post.

  10. Why are orthodontic pacifiers not recommended? We used to use Soothies and Gum Drop brand, but were told that the NUK orthodontic pacifiers would work better to help flatten out the roof of her mouth.

  11. Anon, that is a good question and I will follow up on it. Oddly, the NICU nurse who was also a lactation consultant experienced with babies with Ds had also told me not to use the hospital bottle nipple shaped like that as well... something to do with it being harder for her to manipulate and get closure around.

  12. Do you know anything about seizures linked to Ds? My 5 week old is in PICU with possible seizures and I know I read about someone else who's little one had them, I just can't remember who or where I read it. Any help is appreciated, along with prayers! Thanks, Christina Schye

  13. Christina,

    email me at ds.mama at yahoo dot com and I will connect you to a mom who has some experience with this.

  14. GREAT info...huge thanks...Maddie is starting to get very oral...off to find some of these goodies..

  15. Ok- instead of narrowing my email to you Sandra I divided and enhanced it in my last weeks posts on my blog. The sum up version is this though- and I don't know if it is true for all babies that have Ds or not- I'd be interested to know if anyone has been successful nursing w/out guidance-- but if you need guidance an OT or an SLP trained in feeding issues will work and are better trained in jaw strengthening. For us they were more help then Lac Cons. The LC's just told us to find an OT or SLP. I tried both and prefer my OT due to her Sara Rosenfeld Johnson Training/protocol on oral-motor strengthening. I actually have both right now but the OT does feeding/nursing for us and the SLP just does speech. She doesn't have the feeding experience. My other thought is to use these tools with the advice of an SLP or OT- you can't know what you don't know until you know it! You know? Off to order a star teether!

  16. Thanks for sharing all of these oral tools with us! As a new mom I find these resources to be extremely valuable. I am 9 months into my journey and new to the blogging world. I am so happy to have found a community of people so willing to share their personal experiences to help others in similar situations. Thank you all!

  17. How do you go about introducing food using the NUK brush?? We have been using this on her gums to get her tongue moving around, but not so much on her palette because it seems to make her thrust more. Any tips would be great.. Thanks!


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