Mouthing Objects: What does this mean about my baby’s ability to start solid foods? with Marsha Dunn Klein, OTR/L, MEd, FAOTA

Katie Ferraro (0s):

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Marsha Dunn Klein (1m 1s):

You will not be able to self feed if you can't bring your hands to your mouth. Babies need to be able to bring things to their mouth to feed themselves.

Katie Ferraro (1m 10s):

Hey there, I'm Katie Ferraro, registered dietitian, college nutrition professor and mom of seven specializing in Baby-Led Weaning. Here on the Baby-Led Weaning with Katie Ferraro podcast. I help you strip out all of the noise and nonsense about feeding, giving you the confidence and knowledge you need to give your baby a safe start to solid foods using Baby-Led Weaning. Is your baby currently bringing objects to their mouth? You'll hear sometimes like, oh, babies have a tendency to put everything in their mouth and mouthing objects is among one of a number of signs of readiness to eat, but it's not an independent sign that your baby's ready to eat.

Katie Ferraro (1m 51s):

Meaning like just because your baby is bringing objects to their mouth doesn't indeed make them totally ready to eat. And then what about babies who aren't mouthing objects? From time to time I'll get concerned emails and letters and comments from parents like, oh my gosh, my baby's not doing this thing. So how is this action of mouthing related to a baby's readiness to eat? Well, there is nobody better on the planet to answer this question or teach about this topic than Marsha Dunn Klein. Marsha is an occupational and feeding therapist. She's the founder of the Get Permission Approach to feeding children. She literally wrote the book on Pre Feeding Skills and I love any opportunity to talk to Marsha. So I reached out to her to see if we could chat about mouthing.

Katie Ferraro (2m 33s):

So in this interview, she's gonna be teaching us about the role that mouthing plays on a baby's ability to feed themselves. So Marsha's gonna cover how old babies usually are when they start mouthing objects and what it means if your baby is not demonstrating this skill yet. Heads up, spoiler alert, it's not the end of the world. She's also gonna cover what motivates babies to mouth objects and then how does that determine ultimately their readiness to eat. And she kind of blew my mind telling the story about a seven month old baby who was hanging onto the sides of their highchair for dear life and explaining how that baby is very unlikely to succeed at self-feeding. So Marsha and her team create amazing resources for parents as well as feeding professionals on her website. Get Permission Institute, you can check them out at getpermissioninstitute.com.

Katie Ferraro (3m 15s):

They're on social media at Get Permission Institute. Be sure to subscribe to this podcast if you like learning about kind of the intricacies and the ins and outs of starting solid foods. I do a mini solo training every Monday. I do a longer interview with a feeding expert on Thursday. If you subscribe to the podcast, you'll get notified each week when both of those episodes go live. And if something you've heard on this podcast like change your mind or open your eyes or made something about feeding your baby easier, please share it with your friends who may also be going through the same stuff because your word of mouth recommendations mean the world to me. It's literally the only way that we grow this show and can get it in front of more parents who need this info and want this info.

Katie Ferraro (3m 56s):

So thank you so much for listening and for subscribing. And with no further ado, I want to welcome Marsha Dunn Klein who is here today to talk about mouthing objects. And what does this mean about your baby's ability to safely start solid foods?

Marsha Dunn Klein (4m 13s):

Katie, I met a baby that was 11 months old and the parents were concerned that she wasn't feeding herself, she wasn't mouthing, she was bringing nothing to her mouth, no food, no toys, nothing. And so then we wonder what's going on because we fully expect 11 month olds to be bringing lots of things to their mouth, including food. We expect that of 4, 5, 6, 7, 8 month olds mouthing is just what they do, right? So we have to wonder when we meet somebody who's not mouthing, I wonder what's going on. So we wonder how does she feel? Because some babies that don't feel good, that have a lot of reflux and gaginess, when they bring their hands to their mouth, it makes 'em gag more.

Marsha Dunn Klein (4m 57s):

It makes 'em uncomfortable. Some babies just don't like the feeling of the foods on their hands or the different textures at the mealtime and that's what's blocking them. Some children just don't have great motor planning systems so they can't quite figure out how to get that thing from the tray or that toy from my environment to my hands and to my mouth. That motor piece is a challenge for them. Some children just aren't motivated to eat because eating has been uncomfortable for them. Whether it's been the presentation of foods or how the foods feel in their mouth. So they're not motivated to do it more because it hasn't felt good. But when kids are not mouthing Katie, we need to pay attention because there's so many questions we could ask.

Marsha Dunn Klein (5m 43s):

And what we're wondering is, is there a way to present food in a different way that helps that child feel more comfortable and work towards self-feeding in a way that they can build confidence at their sensory and motor level

Katie Ferraro (5m 57s):

Marsha, I've heard you say in the past that you've never met a baby who does an adequate job of feeding themselves if they can't mouth objects and it makes sense, right? Eating and feeding is about bringing something to your mouth. Can you talk about the role that mouthing plays on being able to feed yourself.

Marsha Dunn Klein (6m 15s):

To feed yourself a baby must be able to reach out, touch food, grab it and bring it to their mouth, let go of it at some point and then repeat that process. Self-feeding is what we're aiming for with babies that we're teaching them how to eat 'em when we're giving them opportunities with food. So we're looking for their ability to be independent and self feed you will not be able to self feed well or really self feed if you can't bring your hands to your mouth. Certainly I've met some children in my lifetime that have cerebral palsy or big motor challenges where we need to make all kinds of adaptations for them to be successful. But for the most part for babies need to be able to bring things to their mouth to feed themselves.

Marsha Dunn Klein (6m 56s):

So when we're not seeing babies bring things to their mouth, we have to wonder, you and I have spoken about this before, that the first toy a baby has is their own body. So the beginning mouthing that we see with babies is usually bringing their own hand to their mouth, their own fist, one finger, two fingers back of the hand, front of the hand. So they're bringing what's close to their environment, close to their mouth. And so their own first toy is their own body. And usually babies get comfortable doing that first. Then they begin to figure out how to get something in their hand on purpose or accidentally at first and then bring that to their mouth.

Marsha Dunn Klein (7m 36s):

So we see lots of babies bringing their shirt to their mouth and whatever toy happened to be in their hand. And then gradually they learn they can reach for something. And I wanna bring that to my mouth 'cause mouth is that exploration place, that place, when they learn about their world, they learn about sensory, they learn about what feels good in my mouth, what doesn't. And they learn about how to figure out how to get that thing that I wanna put in my mouth, into my mouth. Katie, they're not good at, at first at it, you, you and I see so many babies that when they go to bring something to their mouth, they bump into their lip and they bump into their nose. And you know that first mouthing isn't, isn't so pretty. But what happens is the more kids do that over and over again, they begin to realize I have that toy in my hand, I wanna bring it to my mouth.

Marsha Dunn Klein (8m 24s):

And now I know open my mouth bigger. Aim a little differently. Differently and learn the perceptual skills of bringing something from your hand to your mouth in many more refined ways. It comes from practice, it comes from not therapizing them, it just comes from I want this in my mouth and I'm gonna get better at it 'cause I'm just gonna keep doing it. So that's kind of the progression of mouthing that happens is from my own body to things in my world. Which is why we are always saying to parents give them sweet little toys to mouth that give them all kinds of different shape and texture experiences in their mouth. So while they're learning hands to mouth, they're learning it with lots of different textures that help ready their mouth for food.

Katie Ferraro (9m 7s):

I give them your TeetherHeart Marsha, I absolutely love those.

Marsha Dunn Klein (9m 10s):

Yay. So do I.

Katie Ferraro (9m 12s):

Okay, so what about mouthing as a sign of readiness to eat? We, we know that when we're looking at a baby's ability to start solid foods and begin to feed themselves, and we're talking for the most part about typically developing children, which I know is always hard when I talk to a feeding therapist 'cause you guys tend to see the outliers. But for your typically developing full term child around six months of age, parents start looking up lists online, okay, signs of readiness to eat. And sometimes they'll see things like, oh, interest in food. Now you're three month old who's looking at you while eating food that some parents have been like, well that means they're ready to eat. Right? No, not at three months of age. What about mouthing? Like if a baby starts bringing stuff to their mouth at three or four months of age, does that mean they're ready to start solid foods prior to six months of age?

Marsha Dunn Klein (9m 50s):

You know, I'll tell you what that means to me and I'm hoping we're in agreement on this topic. But when children are bringing things to their mouth three months and on, so let's say 4, 5, 6 months, I don't think those babies are ready to sit at a high chair and feed themselves. I mean for lots of reasons, including they don't have the trunk skills to sit in a, in a high chair and be efficient with that. However, I love when I see babies that are curious about my food and they're four or five months old and they're sitting on your lap or they're watching you eat and they've got a mouthing toy in their hand. I love dipping it in cold water or dipping it in warm water or dipping it in a little of something that the family's having or rubbing it on a cucumber or rubbing it on a piece of corn on the cup or rubbing it on an apple.

Marsha Dunn Klein (10m 35s):

So that what the parents can do at that point is to say, wow sweetheart, you love bringing things to your mouth and you're getting so good at it, which we want them to have practice with. And you know what? I can start, I'm not gonna give you volumes of food at this point. You're not ready for that. But boy oh boy, could you explore taste? And I get to watch when I give you the opportunity to sort of rub these toys or your fingers on foods, right? What do you love about dipping it in spaghetti sauce or even purees at this point? I'm just so rubbing it on that apple, rubbing it on that carrot just saying to your child, wait, do do you love this flavor? What about this flavor? So what you are doing then as a parent is not pushing 'em to be feeding themselves a a volume or anything at this point, but just saying you're practicing, bringing your hands to mouth more practice is just gonna help you be better at this.

Marsha Dunn Klein (11m 26s):

And do you love flavors because you're helping them find their motivation. So by the time they're ready to sit up in a highchair and have their arm and hands available for mouthing, they have had some practice with that. They've had some practice with hand to mouth and practice with flavors.

Katie Ferraro (11m 41s):

Hey, we're gonna take a quick break but I'll be right back. You mentioned ages a little bit that you would fully expect 5, 6, 7 month old baby to be mouthing themselves. Is there an age in your world of infant feeding and occupational therapy where if a baby is not mouthing things you start to think like oh this is problematic. I know you told a story about an 11 month old. I recently was working with an friends 11 month old baby who not interested in food at all. And then when I was doing the observation, didn't touch the food. But also the mom mentioned, oh that baby's never brought anything to their mouth and doesn't mouth objects like 11 months.

Katie Ferraro (12m 23s):

Yeah that's problematic. Is it earlier than that? Like when would you start getting concerned or is is it that a hard question to answer 'cause every baby's different.

Marsha Dunn Klein (12m 28s):

Well I'm gonna have to say it's a hard question to answer because everybody's different. And you know, if a baby is 5, 6, 7 month old and and you're really looking at beginning the process of introduction to self-feeding and they're doing nothing about self-feeding, their hands are not coming to their mouth. It's time to be asking some questions. So for example, Katie, I met a seven month old who the parents really, really wanted to do Baby-Led Weaning and they really wanted to do self-feeding. And they had been introducing this baby to foods on her trave since she was five months old and then six months old and then seven month old. And when we saw that baby, I watched her sitting in the high chair hanging onto the high chair for dear life with both hands hanging on with her hands was what was helping her sit up in that high chair because she needed a little bit extra postural support.

Marsha Dunn Klein (13m 23s):

So this particular baby wasn't quite comfortable sitting up in that high chair yet to have her hands free from her trunk to bring her hands to her mouth or reach for things. So her hands were busy hanging on to the height chair for posture. So one of the things I would wanna do is if the child's not mouthing in the highchair, could she sit on your lap? Or if you're sitting on the couch and you're eating an apple and you hand it to her, will she kind of suck on it a little bit? Right? Will she show any interest in a different situation where you're giving her a lot of support in her body? Are there other positions that that child might have that skill? We see some children bringing their hands to their mouth when they're laying on their back on a blanket, right? They're bringing their hands to their mouth, they're bringing their knees up their feet to their mouth.

Marsha Dunn Klein (14m 6s):

They're doing lots of that kind of mouthing that position is really supportive of your shoulder girdle. And so it really does support better reaching so that same child when they're sitting up might not be as good at reaching just yet because sitting up your shoulder doesn't get quite as much support.

Katie Ferraro (14m 24s):

What about a baby? I can imagine that's being force fed by spoon. You've mentioned baby holding on for dear life in their highchair, but what if you have a baby that the parents are force feeding by spoon the babies realize I don't have to do anything here 'cause they're gonna do it for me. Do you see that sometimes as being associated with the baby not mouthing objects or foods?

Marsha Dunn Klein (14m 43s):

I do. I do. I mean that baby, you may see that baby mouthing in another situation other than mealtime. That's that's possible for sure. But I definitely meet babies who have had the, the experience of eating has been my grownup is trying to get food in me and I'm a little bit worried about it 'cause they're going a little faster than I'm ready for. And so I've seen babies kind of shut down. It's like I'm not touching it, I'm not reaching for it. You're pushing me into it. I don't like it. So that can be a problem, you know? So, so what I'm saying is if the baby's not mouthing, we have to wonder does the baby feel well enough in their system? Are they motivated? So the baby you just talked about isn't so motivated to do it themselves 'cause eating hasn't been that great of an experience.

Marsha Dunn Klein (15m 23s):

Right? Or they're not motivated if they've had discomfort and gagging when they get to their mouth. But also I have to wonder, do they like the touch of this food? Food is really sensory, Katie, you and I have talked about that before. It feels lots of different ways and some babies are on the more cautious side of Sensory exploration and some babies are more adventuresome. And so it's so hard for me to wanna do it must be by this age or stage. And then because I don't wanna ask your audience to be panicky about any of these topics.

Katie Ferraro (15m 55s):

Hundred percent I get it.

Marsha Dunn Klein (15m 56s):

But more that we can together be curious about. I wonder is the touch okay in another environment or is it just the highchair environment or does the child bring things to their mouth in a different environment like on the floor or when I'm holding them and just not the highchair. Or is it nowhere? You know? So we're, we're really looking at what can we do to help that baby feel comfortable and motivated to bring their hands to their mouth.

Katie Ferraro (16m 21s):

Sometimes parents will report that their baby is not mouthing anything. What are some situations or some conditions or some reasons why a baby might not be mouthing items, objects, foods.

Marsha Dunn Klein (16m 32s):

For sure. One of the reasons is because it was negative when they brought it to their mouth because of like reflux for example. One of the reasons could be the objects in their world and the food in their world hasn't got any meaning for them yet. They don't quite get that. This is something that could be interesting, right? One of the reasons could be that they don't like the feeling of things in their environment and they're, they're really sensitive and one reason could be they're just not so good at the motor planning of actually grabbing something and bringing it to their mouth. So those are the kind of questions that we need to tease out when kids just plain aren't mouthing. So my first go-to is gonna be helping that child feel comfortable and safe in their posture because you cannot bring your hands to your mouth if your posture and your body's not working.

Marsha Dunn Klein (17m 15s):

So can I just hold them so they're very supported? That's gonna be a first kind of a thing that any parent can do. What if I just hold them and we're sitting here and I give them a mouthing toy with a little flavor on it? Would, would it work better in my arms? Right? Would that work better when they're in that swing or they're in a little seat that's got a lot of support that doesn't require them to sit up yet, right? So I always wanna just figure out what is it that would help you sweetheart to feel better about this? The first baby we talked about Katie that was sitting in the highchair at 11 months and hanging onto the high chair and her eyes were wide and she just was saying, this isn't working for me. I, for what are you putting me in this high chair island for and expecting me to do something with this food?

Marsha Dunn Klein (17m 56s):

I can't, I don't know how I, this is confusing. My feeling is if we're putting a child in that situation and they aren't making change, we gotta change something, right? Don't keep putting them there expecting every day something's gonna get fixed. No, no, no.

Katie Ferraro (18m 12s):

That's the definition of insanity, right?

Marsha Dunn Klein (18m 14s):

Exactly. You and Einstein. And so if it's not working right now, could we just be curious and think about is there another way we could offer, this is another food we could offer this. Is there, could we dip the mouthing toy in a food? Could we dip a finger in a food? Could we dip a short baby spoon in some food and see if maybe if they just hold that thing, is that better? Do they like the texture better because they didn't have to touch the what stuff on their fingers maybe for that sensitive baby? That's a way to do it, right?

Katie Ferraro (18m 41s):

Marsha for parents and caregivers who are listening who want to learn more from you, where can they go to sign up for your courses and take your workshops and learn from you.

Marsha Dunn Klein (18m 49s):

As you and many of your audience know, I started the Get Permission Institute a couple years back with a couple colleagues, Karen Dilfer and Stephanie Cohen and we offer mealtime education kinds of talks. I would say that most of them are directly created for professionals. Parents are absolutely invited. There are beginning to be more and more offerings that are for parents. And I have one that I really, really like and it's called Dear Parent and it's free and it's really focusing on parents whose kids are kind of on the picky side of life. You know, kind of on the more worried pick your side of life. So it could be a place to begin to sort of have an overview of understanding of these kiddos and sort of questions you could ask as a parent.

Katie Ferraro (19m 32s):

But what if people have babies? Like I don't want them taking a picky eating class 'cause they think their baby's picky. Is that for older kids?

Marsha Dunn Klein (19m 40s):

That is for older kids, that is for older kiddos and not your tiny ones. On our Get permission Website, we have an infant and toddler class that's given by Karen Dilfer and Stephanie Cohen that is amazing. And really looks at infant feeding from the perspective of responsive feeding, which really is, it's our job as grownups to offer and adapt in any way we need to for baby success. And it's the baby's job to let us know, this is working for me, this is not working for me. And we get to respond and adapt according to each baby. Katie, you know, out there on Instagram and all over the world, there are rules, there is shaming, there are judgments, there is, you must do this or you're a terrible parent kind of stuff, you know?

Marsha Dunn Klein (20m 25s):

And so I, I feel badly for parents. There's so much noise out there and I think, you know, my whole goal when I think about feeding babies is it's our job to help them figure out what do you love and how can we build a foundation of a, of a great lifetime relationship with food? And if what we're doing as grownups is offering food in a way and the child is not enjoying it and is not successful, we need to try something different. You know? And that's the thing we need to be curious and make some changes.

Katie Ferraro (20m 55s):

Hey, we're gonna take a quick break, but I'll be right back.

Get Permission Institute (21m 7s):

So Marsha, earlier I mentioned your TeetherHeart, you brought me, you sent me like a massive box of them and every baby I meet I give a couple of 'em to them, but I'm running low so I'm gonna need a restock. Tell us about the heart teether. Why did you create this? What does this tool signify and how does it help babies who are starting or getting ready to learn how to start solid food. I created the TeetherHeart a couple years ago because I wanted to make sure that while I still have energy in the feeding world, I wanted to create a mouthing toy that I loved, that I thought babies would love. I love its texture and its softness. It has a little handle on the side that makes it so easy for, for little early mouthing babies to figure out how to hang onto this little thing and and keep hanging on until while it gets all the way to their mouth. It's got texture on it, it's got one side that can sort of, you can put more puree in it so when they bring it to their mouth they can get more puree or less puree. It's great for rubbing on foods as I mentioned earlier, but the most important thing, Katie, between you and me that I love about it is that it's a heart shape and it is my goal to make sure that that parents and therapists think of eating through the lens of love and connection through the lens of what do you love sweetheart? And not just through the lens of it's my job as a grownup to get this amount of food into my child, right? And so I love that it supports babies doing it themselves and that it supports that connection and that love at mealtime and it gives babies texture experiences, sort of pre chewing experiences. So thanks for asking about it. And if anybody in your group wants any, I know you put this in the link, but they can get 20% off either hearts by using the Marsha20 code with special supplies. And so I know you'll share that with people.

Katie Ferraro (22m 49s):

I certainly will. Marsha, I know once people hear this episode, if they haven't heard you before, they're gonna be like, where can I learn more? So I'm gonna go and link to all of the episodes you have been, I think the most prolific or frequent guest on the podcast, but I'm sorry I'm always asking for your time, but I'll think of something I'm like Marsha would know the answer to that and you are always so gracious to come on and share your expertise. So I'll put all of your other episodes in there. And then I've also interviewed Stephanie a couple of times and Karen as well. So I want you guys to be learning from the experts in this space, not from Instagram, with all of the arbitrary food rules that literally drive the algorithm and get you hooked and have you write comments. And it's not a good place to learn. And I just love your seminar format. Actually the other day was speaking to a colleague who took a course of yours like 20 years ago, somewhere in the western Virginia Mountains or something.

Katie Ferraro (23m 34s):

And she was like, and we just got to learn from Marsha for a day on end. And I think that model of learning from experts, which we as feeding experts learn from other experts, parents have the opportunity to learn from experts as well. And the Get Permission Institute is such a wonderful resource for parents. And I know you've gotta do the social media stuff to get the word out there, but hopefully you know from this podcast. And we promote these shows on, on our social media, but also in our email list to let parents know that there are more thoughtfully designed educational opportunities for you out there to learn about important things like feeding your baby. Like you don't have to learn about it from TikTok and Instagram. Definitely check out the other episodes that Marsha has been on with us. Her TeetherHeart, her courses from the Get Permission Institute and Marsha, thank you as always for sharing your time with us.

Katie Ferraro (24m 17s):

I just absolutely love learning from you. You brighten my day. I gotta make these episodes at the end of the day. So I go into like the second half of my day, which is my kid part of the day, like smiling.

Marsha Dunn Klein (24m 26s):

I love it. Thanks for having me.

Katie Ferraro (24m 28s):

Well I hope you guys enjoyed that interview with Marsha Dunn Klein. She puts a smile on my face. We actually had a follow-up call after that podcast interview 'cause I'm helping that her team with some stuff related to dietitian advanced training. And she said something really interesting. I was like, Marsha, you are so gracious. Like you always share. I mean, you would think like she's like, she is one of the busiest people that I know and yet she always has time to take a call to share something, to share a resource. And she just reminds me how important it is to share information openly and to share your talents. And she's like, I have had the great fortune to be teaching about infant feeding for a very long time and she just wants to share what she's known and she knows and she's learned and I'm so grateful for it.

Katie Ferraro (25m 9s):

And I'm so grateful that she's always willing to come on the podcast to cover like sometimes really odd topics like this, like mouthing, you know? But she's like definitely the perfect person. So if you were concerned about mouthing before, I hope you're not now, or I hope she answered some questions. And the other good thing about learning from feeding therapists is that in the event that something really is wrong with your kid, it's important to know and to get it checked out. A lot of times what we worry about never really manifests itself, but sometimes when you worry about stuff like you know your baby best and you know if something is not typical, and hopefully hearing from experts like Marsha can help you realize, oh wow, there's other experts out there that can help me get over this hump with my baby and get back on the track to success. So check Marsha and her team out at getpermissioninstitute.com.

Katie Ferraro (25m 50s):

They're on social media at Get Permission Institute. I will put all of her resources in the show notes for this episode, including that 20% off code. If you wanna check out her TeetherHeart. I was just using her

Get Permission Institute (21m 9s):

TeetherHeart for a baby

Katie Ferraro (25m 58s):

that an eight month old that I'm working with who's really not bringing anything well food to his mouth. He brings other stuff to his mouth, but he's just not digging the food. But doing some of the purees and sauces on a, on Marsha's teether has actually been really helpful to get this baby to try to start feeding himself. So all those resources on the show notes page for this episode, which you can find at blwpodcast.com/428. And thank you to our partners at AirWave Media. If you guys like podcasts that feature food and science and using your brain, check out some of the shows from AirWave Media. We are online@blwpodcast.com. Thanks so much for listening. I love hanging out with you guys and I'll see you next time.

Katie Ferraro (26m 44s):

Bye now

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