X posted:Nursing and speech

[Moonchild77]

I am the the mother of two boys, ages 4.5 y and 1.5 y,
My oldest son still nurses, our start was bumpy and rough, thrush, bad latch, so on so on..
We overcame all of this and when I got pregnant, he still nursed and now together with his brother.
The oldest nurses at waking and when he goes to bed and maybe 1 or 2 times during the day.
The youghest, well, I do not know, maybe 100 times?

Anyway, the oldest has Verbal dyspraxia of speech and a light form of Sensoric integration disorder.
We saw a speech therapist when he was 11 month old, because he always vomitted and choked when trying solids.
He had a strong gag-reflex, very in the front of his mouth.

When he was 2 he spoke no more than 3 words. We saw again a ST and it helped a bit.
He still talked not much when he was 3 and very bad (his speech was very bad ) so again a ST but this one thought he was autistic and we left, because I could not imagine such a diagnosis.
Finally, we found aSpeech therapist / Sensoric Integration therapist (occupational therapist) and she said Verbal dyspraxia and it fits!!

He speaks better when in movement, esp when we are there, once a week.

I never told her about the BF, I just asumed, she knew, because the previoust therapist knew.
But I found out she did not, so I told her (via mail) and the very nex session, she said it would be better to stop nursing him.

She said:
- the nursing, continued and daily, puts him back in a bad movement with his tongue (lazy, low in the mouth)
he has difficulty raising and moving his tongue around on demand.
(letters like L, R, N, M, etc etc)

- she said, she did not really think it caused his bad speech abillity, but most likely contributed to it and it would be wise to make him experience more, better and more stimulating impulses, than nursing at the breast, that is she said a low tongue mechanism and not good for him
He never used a bottle or a pacifier, only 1 week in his live and he never used a sippy cup, he drank from a regular cup at 9 mo old. he now uses regular cups and straws.
-

I really want to help him, really, but is she really right? Because my son is nowwhere near weaning, he just started kindergarten and is such a sensitive boy, he really needs his nursingtime with me.
He and his brother are bonding so good now!
And I am fearfull, he will turn to other - bad - mouth things, I was a very sensitive bottlefed girl and I thumbsucked untill my 10the year, only stopped after a bicylce accident, forcing me to stop because of the braces I got.
I also snore ..

I sometimes think, me nursing him for so long (and in a babycarrier a lot when he was a baby) made him cope with his sensitiviy better and that is made him come out better then if he had been on the bottle or pacifier?..

I really hope you can answer my questions, or if you know someone who can?

[PatioGardener]

I would say she is wrong.

breastfeeding helps with oral development.

dr brian palmer has lots of info on this. http://brianpalmerdds.com/

if i were you i would challenge her to give you research publications that prove what she says, or i would ignore her. breastfeeding is too important to give up based on a whim of a non-expert.

nak

[MaryMarg]

I'm wondering if you are currently seeing an OT or a speech therapist or both. OTs do diagnose sensory integration disorders and are integral in their treatment. An OT could also diagnose an oral dyspraxia, meaning the movement of the mouth is atypical/uncoordinated. However, verbal or speech dyspraxia (also known as childhood apraxia of speech, etc.) is diagnosed by a licensed speech therapist/pathologist and oral and verbal dyspraxia are different diagnoses. First just wanted you to have that tidbit of info in case the diagnosis didn't come from the right place!

Now, many people feel the structural (including muscular) and neurological pathways for feeding and speech are not as intertwined as previously believed. That is, a child with a feeding disorder could have normal speech or a child with a speech disorder could have normal feeding. Thus, the action of the tongue for breastfeeding did not, in my opinion, have a likely effect on the speech problem. Yes, the tongue may be in a "low" position and may stick out during bf'ing to extract the milk from the breast, but if your child can drink from an open cup and a straw and his tongue stays in his mouth during cup-drinking, it suggests he has adopted a mature swallowing pattern. Watch when he's drinking and see if his tongue slips past his lips under the straw or slips into an open cup while drinking or if you just see his lips drinking. If his tongue slips out, he may not have fully adopted a mature pattern of sucking or exhibit another related need. Again, there are many people out there who don't have great feeding/sucking patterns but have normal speech!

The previous oral feeding problems and the speech problems suggest both sensory integration needs and speech needs, although one did not necessarily cause another. The OT treats sensory needs and the SLP treats speech concerns. It IS very important to receive the sensory integration (SI) therapy as such therapy can improve overall functioning in the world, including speech (and feeding, if issues still remain). Then also important to follow the SI therapy with speech therapy targeting coordination of movement of the mouth across syllables for functional speech. A licensed SLP can let you know if you child's oral structures seem to have decreased muscle tone or aren't working well for his speech, then target these concerns with speech-based practice (i.e. working on sounds and words to improve the need). Movement can be incorporated into the speech therapy sessions and your home practice sessions as well!

Note also, that when you and/or your son decide to wean, if he begins other "bad-mouth" things as you mentioned, an OT or SLP can help you come up with alternatives to undesired mouthing, such as eating crunchy foods, chewing gum, chewing on a tubing designed for such needs, and so many more.

As a speech pathologist (and a breastfeeding mom!), it's my opinion your child's speech issues were NOT caused by his extended breastfeeding. I hope you will release this weight off your shoulders. Instead, continue to follow the wonderful path you are on right now of seeking consistent, weekly OT for SI needs and speech therapy for the speech needs. Practice both daily at home and stick with it until he's better (although you don't have to stay with the same therapists)! And don't forget your local school can test your son and provide additional therapy if you'd like and if he qualifies. Best wishes to you, mama!

[Moonchild77]

Hi, both very much thanks for the answers!

I am feeling really torn, I do not want to stop and he neither, but I want good info, to give to the ST.

It is a speech therapist who also is trained and has a diploma of Sensory integration specialist, how it is called in HOlland.

And a OT comes with her 2 out of 3 times, almost every week though, working together with him, doing exercises, like running or crawling a course/route, meanwhile speaking or shouting, trying to help him with planning, proprio, etc etc.

So you do think I can keep the nursing going?
Is she thinking about that a pacifier and bottle are not so good to be doing to long, after the first year?

A tongue is not that pacive while nursing, right??

TIA

(feeling sick in the stomache even, first a ST that thought he did it on purpose, not talking when he was 1 and then a ST that thought he was autistic, when he was 2, and now finally a sound diagnosis and it fits soo good and now the nursing thing...
:-(

[MaryMarg]

Very great to have a speech therapist with sensory integration training! That's wonderful! And the OT sessions sound good, too. I think you can keep the nursing going. Typically in the U.S., docs and specialists recommend discontinuing bottles and pacifiers around age one. However, I work almost exclusively with a minority population whose children continue to use a bottle long past age two or more. Although some of these children have speech disorders (unrelated to the bottle), many do not. It is more of a cultural choice/difference. It is true that extended pacifier and bottle use can modify the shape of the hard palate and cause dental problems if they are used too long, same as thumb sucking (my DD was an example of this with thumb-sucking!). I would guess, and this is simply a guess, that the softness and extension of the nipple during breastfeeding decreases the concern of palate problems. Think of all the children who have EB'd and had no problems! Extended passy use may decrease speech just because it's plugging the "speech port," if you will. All that to say, I think the need to suck for calming etc. may last for different lengths of time for different children, i.e. some children may need the pacifier or breast longer for soothing, integration, etc.

The tongue is active while nursing and strips the milk from the breast in a pumping motion. As a child ages, this motion changes to a more mature suck pattern that still involves movement of the tongue (up/down, as in an adult suck).

Consider that speech/feeding pathways may be completely different as previously mentioned, thus you can continue bf'ing. If you are truly concerned that the bf'ing may be causing the speech problems, continue nursing AND getting regular speech therapy for a set time period (e.g. four-six months). If the speech doesn't improve at all and you want to re-consider the issue, reconsider it then. My opinion is consistent speech therapy and home practice should make a difference in your son's speech whether you are breastfeeding or not! You're doing great!

[Moonchild77]

Thank you for your helpful words en warm tone

I am trying to make the exercises at home more and more, but my son is very consious and will become shy or angry when we push him ..
Am trying to find more integrated exercises, so he won't really mind or even notice we are practicing

Again, thank you Marymarg xxxxx

[prothyraia]

Even *if* nursing is affecting his speech somehow (and I'm not convinced that it is), you have to weigh the potential negatives of stopping. It sounds like nursing is still a big help for him emotionally and helps his relationship with his brother- that's important, and not something the speech therapist is really thinking about when she gives you advice.

You don't need to convince the therapist that the nursing is unrelated; it's perfectly fine to say "We're not interested in weaning at this time, so we're just going to have to work around it".

[PatioGardener]

Originally Posted by prothyraia

it's perfectly fine to say "We're not interested in weaning at this time, so we're just going to have to work around it".

great advice!

[miss_nikki]

I don't have any scientific evidence or anything for you to hand to the OT or ST. However, my DS (2 and a half), also is receiving speech therapy. He was basically not talking at 2 years old. They evaluated him as having the speech level of a 9 - 12 month old. He is also still breastfeeding about as often as your DS. He has no problems with saying the letter M or N. Our speech therapist has not mentioned breastfeeding as being an issue with his ability to speak. Although we have seen a lot of improvement in the last 6 months, with his speech. I'm not saying that it couldn't be a factor in your situation. I really don't know if it could or not. I just wanted to give you some encouragement that maybe it isn't.