A lot of simple habits started right from the beginning can help to prevent so many problems later on.
This is not a page to make you feel guilty or a reason to get mad at your own parents. Most of us either didn't know about this information, or for reasons due to health, convenience, or extenuating circumstances could not adhere to these habits for ourselves or for our children.
My hope is this information can help parents and caregivers make educated decisions regarding their child's health and development going forward.
Breastfeed your Baby
Nursing is best. We know that breast milk contains all sorts of ingredients that are perfect for infant development, but did you know that the way the muscles are used during nursing also contributes to healthy face and mouth development? The muscles and amounts of pressure used during bottle-feeding differ from breastfeeding. Research has shown that individuals who were bottle-fed have a higher incidence of orthodontic problems than those that were exclusively breastfed. If you are wanting to breastfeed, but are experiencing difficulties, please read about tongue or lip restriction and contact a local lactation consultant.
Close their Mouth
Close their lips after they are finished feeding. George Catlin, an American lawyer, artist, and author from the 1800's, was fascinated with the Native American culture. In particular, he noticed a vast difference in their infant mortality rates and longevity of life, as well as their wide and well developed facial features (attributes common in a functional airway), versus those communities influenced by western lifestyle. Over the span of 30 years, he visited more than 150 Native American tribes in North, Central, and South America. He observed that the women always closed their babies lips together as soon as they were done nursing. He was told by the Medicine Men and the women that this ensured their good looks and prolonged their lives. George Catlin went on to write the book, Shut Your Mouth, Save Your Life. In his opinion, it was the Native Americans' emphasis on nasal breathing day and night that was the primary factor for these differences in health and appearance. If your baby is having difficulty keeping their mouth closed after you have closed it, this could indicate an airway issue (see mouth breathing) or a tongue restriction.
Don't Prolong Pacifier Use
According to Diane Bahr, MS. CCC-SLP, author of Nobody Ever Told Me (or my Mother) That, babies have an innate need to suckle for the first few months of life, even when not feeding. Between birth and 6 months, she recommends giving your baby a pacifier for calming purposes. There is no need to give your baby a pacifier if they are already calm. She recommends beginning to wean baby from the pacifier at 6 months, only providing it when your baby is most cranky and needs to sleep. Around this same time, an important oral exploration stage begins, called discriminative mouthing. It provides valuable skills needed in feeding and speech development. This doesn't occur if your baby routinely has a pacifier in their mouth. They need to regularly be exploring different shapes and textures with their mouth. Providing appropriate toys that your baby can chew and use in their mouth to explore will help mature their oral skills.
Research shows that babies who use a pacifier beyond 10-months of age are at a higher risk of developing ear infections and middle ear difficulties. Prolonged use can also lead to the child becoming emotionally attached to their pacifier (making the habit even more difficult to break), negatively altering jaw and teeth development, increasing oral candida, and preventing the development of mature food manipulation and swallowing patterns.
Some tips to eliminate pacifier use:
Around 6 months of age, when they are calmly sucking, take out the pacifier and exchange it for an object they can use for chewing or mouthing. If the habit persists, poke or cut a small hole at the end of the nipple. This prevents a good suck, and they will often wane in their interest. If deciding to cut or poke holes in a pacifier nipple, it is very important to boil after each use or only use it once, since this increases the risk for trapped saliva, bacteria, dirt, etc. inside the nipple. Also, ensure there are no rough ends after cutting, prior to allowing your child to have the pacifier.
*Research has not shown a significant correlation between a certain style/type of pacifier with negative jaw/teeth development.
*Research does show a correlation between pacifier use (high frequency/prolonged use) with the incidence of orthodontic problems.
Thumb-sucking (or finger-sucking, in some cases) begins in the womb by all babies. It is an important skill necessary to help in learning how to suck and swallow properly. Some babies continue this habit after birth, some do not. If your baby is one of these that do, it is important to try to wean them from the habit ideally around 6-10 months of age (for the same reasons as prolonged pacifier use - see above). Research shows thumb-sucking past 24-months can negatively alter the development of the jaws and teeth. It can be a difficult habit to break, as the pressure applied by the thumb produces a neurotransmitter, Serotonin, which helps to relax, sleep deeply, think rationally, and provide us with a feeling of well-being and calmness. If you are continuing to have difficulties helping your child to phase-out of thumb-sucking, orofacial myologists provide a habit elimination program to eradicate the problem using positive reinforcement strategies. The program is effective because orofacial myologists use the science behind the problem to eliminate the habit for good!
Avoid Frequent Soft/Processed Foods
Skulls from several hundred years ago rarely had orthodontic problems. They had enough room for all their teeth, including their wisdom teeth. They had large airways and broad palates. This began to change around the time of the industrial revolution. There was a shift in how people prepared food; it became more processed, often breaking down tough and fibrous food to make it easier to eat. The act of applying strong forces to bone is one of the precursors for bone formation. When less force is applied, less bone is produced. Harvard Scientist, Lieberman, and Stanford Paleoanthropologist, Ehrlich, both believe society's shift to softer and easier-to-eat diets has contributed significantly to our smaller palates, crowded teeth, and decreased airway sizes.
Choose foods more frequently that are fibrous and difficult to chew, which apply additional forces to the eating process. Think about how people used to eat - they definitely didn't have an immersion blender. When we think about most kids' favourite foods today, it's often things like macaroni and cheese or chicken nuggets, highly processed and easy-to-eat. An increasingly common lunch/snack companion is pureed vitamin-packed fruits or vegetables in a squeezable-tube. Albeit, that nutrient intake is an important aspect of eating, consideration for the "whole picture" of why we eat needs greater emphasis. Some excellent choices are lots of nuts and raw vegetables, like celery and carrots.
Dentist, Dr. Kevin Bourke, back in the 1960's, created a "chewer" appliance. He originally made it to see what effect it would have with people who had gum disease. He noticed an improvement in their oral health and began further research on the appliance in a diverse population, which yielded unexpected results. Children using the chewing appliance consistently developed straighter teeth than the normal population! The appliance now goes by the name of MyoMunchee* and it can be started on children as young as 18 months. These can be ordered straight from their MyoMunchee website.
Limiting Sippy-Cup Use
Sippy-cups. The original sippy-cup was created by an engineer who was tired of his children's spilled cups. Unfortunately, no thought was put into how the muscles are used while drinking from the cup and how their extended or frequent use can change the development of the mouth and face. Most sippy-cups tend to delay or prevent the natural progression of a functional and mature swallow pattern. Sippy cups with a valve are especially problematic because the encourage a tongue thrusting and suckling swallow. An open cup is the very best. Period. To help in this transition, the following sequencing is valuable: 1. getting them to drink liquid from a spoon, #2. a firm short straw, where the tongue does not touch the straw during the drinking process (Take & Toss Cups - with straw), #3. an open cup (nosey cup is useful in the beginning). If absolutely necessary, only when needed, and not to be used past 18 months is the 360˚ cup. This tends to encourage a better swallow, while still helping to prevent spills. But as mentioned above - open cup is the very best!
Children & Adults
Cleaning your Nose
There are two main entrances that we allow elements around us to enter our body - the mouth and the nose. We regularly clean the mouth, yet rarely if ever, think to clean the nose. It isn't until we have a stuffed or runny nose that we pull out the box of tissue. There are a couple of ways to achieve a good cleaning of your nasal filter.
The most thorough method is to wash the nose with a saline solution. This can be done once a day to prevent illness, runny nose, congestion, sinus issues, sore throat, allergy symptoms, etc..., or it can be done more often when symptoms are present. There are a variety of products on the market, including the traditional neti pot. Since our bodies have a slight saline concentration, it is important to use a concentration of saline that is higher than our body, if we want the symptoms to be alleviated. Unfortunately, this can cause a stinging sensation. Sodium bicarbonate (baking soda) is added to help decrease this discomfort.
In my personal experience, the first few times I tried nasal washing, I didn't fully understand the significance of using a higher saline concentration. I couldn't figure out why my symptoms were getting worse. Around this time I happened to read the book, Clearing the Air One Nose at a Time - Caring for Your Personal Filter, by Dr. Hana R. Solomon, a pediatric doctor who specialized in children's airways. I learned that it's not solely the water washing over the area that is beneficial, but the process of osmosis from the differing saline concentrations. A higher salt concentration is needed to provide full benefit.
Although any nasal wash system is great, as long as it does the job; I personally use Dr. Hana Solomon's Nasopure*. She has also created a mini version which can be used by children as young as 2-years old (on their own). You can make your own solution, or buy packets from various providers (including Nasopure).
Sometimes nasal washing can seem strange (at first), inconvenient, or uncomfortable (although this usually diminishes with regular use). So even though nasal washing is the best method, if you cannot or will not fit it into your daily routine, the next best thing is regularly blowing your nose. An easy way to remember is 4X4. Four blows on each nostril, four times a day. This helps to clear out some of the "stuff" that we don't necessarily want in there.
A brief personal story: My 10-year old daughter woke up one night so congested that she could hardly breathe. Even breathing through her mouth was laboured. I don't normally ever rush off to the ER, but as she was struggling to just get shallow breaths inside of her, I thought it might be my only option. After her attempts at trying to blow her nose proved unsuccessful, I remembered about nasal washing. Just a few days prior, I had ordered my Nasopure, but my package hadn't arrived yet. I had read about the benefits and the specific instructions* on how to do it properly. I really didn't want to go to the ER for congestion, if we didn't need to. So we decided to try to use what we had in the house to create our own nasal washer. We sanitized a make-shift squeegee bottle that we happened to have and boiled some water, cooling it to body temperature in an ice-water bath. We made our own home-made solution and attempted our first nasal washing. Within minutes, my daughter was taking long deep breaths through her nose. A huge smile spread over her face, "I can breathe!" It was one of those rewarding mother moments, literally having provided her with the gift of breath.
*Note: If done incorrectly, nasal washing can be dangerous. Always read ALL the instructions prior to attempting to nasal wash.
Goals of Myofunctional Therapy
Some of the basic goals of myofunctional therapy are:
- Lips should be sealed at rest
- Breathing through the nose - all the time
- Tongue on the roof of the mouth - not touching teeth. The only time your tongue should touch your teeth is when you say "th" sounds.
- Proper amount of space between your upper and lower teeth (2-3mm in the molars). If they are too close or too far apart, it can cause problems.
Sometimes, just making someone aware of these goals is all that is required to make a change. If these goals are not easily met, all of the time, it usually means some of the muscles in the face and mouth need help, or there may be other underlying issues causing the difficulty. Orofacial Myofunctional Therapy is an individualized exercise-based program, working on your specific problem muscles to achieve the goals. Once achieving these basic goals, myofunctional therapy progresses to more complex functions, like chewing and swallowing properly. Prior to starting orofacial myofunctional therapy, a complete assessment is necessary by an orofacial myologist.
*NOTE: I am not affiliated with any company that I recommend and do not receive anything for mentioning their products.
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