Sippy, straw, bottle, cup

[6 months +]  A cup is a cup is a cup! Not! You can almost expect to spend a bit of money just finding the right cup for your little one.  It is frustrating as even if someone gives you a recommendation for a good one, it’s likely you won’t be able to find that exact cup in the stores.  And if you do, maybe it won’t suit your child.

moving to an open cup

moving to an open cup

First, let’s look at the basics of cup drinking.

When? Any time from 6 months on, even if it’s just providing exposure.  At about 7-9 months, your baby should be more interested and able to take some water.  That means if you are still breastfeeding, your baby need not ever drink from a bottle.  And there is NO reason why your baby can’t drink formula or cow’s milk (after 12 months), or any other milk from a cup, instead of a bottle (you can have a particular one for water and another for milk).

Why? Drinking from a cup gives your child’s jaw a mini-workout.  It moves from the more ‘immature’ action of suckling, with the tongue and jaw forward (as your baby would do on the breast or bottle) to the jaw having to grade and hold itself in place with tongue back in the mouth.  Go on, pretend you are drinking from a bottle and notice where your tongue and jaw are and then change to a position for cup drinking.

This workout for your baby’s jaw and tongue position leads to stronger muscles for later chewing and holding itself in place for the different vowel sounds (try ‘ae’ vs ‘oh’ vs ‘eh’ vs ‘ih’).

But before open cup drinking stage, your child will most likely use a sippy or straw cup and even a pop-top.

Which one?

You will most likely need to start with a sippy cup with a silicone mouth piece but even a young baby can learn to drink straight from an open cup (it’s just the spill factor that makes most turn to a closed cup).  Give it a try!  Don’t believe marketing – you do not need to buy a cup for 6 months, 9 months, 12 months, 18 months, 2 years etc.  Some babies can hold on quite fine without handles and others can go straight from a silicone mouthpiece to an ’18 month old cup’ without the need for the ones in between.  Once your child is used to a soft mouth piece, you can move towards a harder mouth piece and then possibly to training more on an open cup.  There are also cups that transition through several stages, with different attachments (more info below in ‘product review’).

The other thing is, cups bring a whole lot of plastic into your child’s mouth.  Since BPA-free plastic is now being found to still be not-so-desirable (take a look at ‘Even BPA-free Plastics Leach Endocrine-Disrupting Chemicals’), don’t forget to be on the watch for plastic alternatives, such as stainless steel or even protected glass.  The plastic-free sippy cups can be pricey, but why not look out for stainless steel drink bottles as soon as your little one is ready (even at supermarkets).

Sippy vs straw? And then what?

Sippy:

  • It is generally easier to teach your baby to drink from at first (silicone mouthpiece moving to harder mouthpiece). Note: the sooner you move to a harder mouthpiece, the less you will have to replace silicone tops that are easily chewn
  • The sippy cup with a silicone mouth piece can actually still promote the jaw/tongue forward position, but is good practice for open cup drinking, allowing your child to practice tipping the cup, with hand to mouth action
  • As your little one gets better at drinking, you can change to a sippy cup with a harder mouth piece which promotes keeping the tongue in the mouth (and thus jaw in a better position)
hard mouthpiece

hard mouthpiece

hard mouthpiece

hard mouthpiece

Straw:

straw_cup

  • Promote jaw/tongue back position – good for later speech
  • Can be tricky to teach but some kids just get it, easier than a sippy cup
  • Can be tricky to wash but may last longer than the silicone topped sippy cups
  • Can be easier to keep leak-free than the silicone mouth pieces that can split and allow ‘spill-proof’ to pour out
  • No plastic-free version (that I have seen), until your child can drink from an open cup…and then there are stainless steel cups and straws available

IMG_8028[1]

Pop top/sports top/drink bottle:

  • These are generally the step after sippy or straw cup, but if you are struggling with the above, feel free to give them a go!
  • Stainless steel varieties are readily available which prevent plastic chemicals from leaching into the water

    say 'no' to plastic

    say ‘no’ to plastic

Making it easier

Firstly, if your little one is struggling to drink from a cup, give it some time.  Once they are really needing to take in more liquid (ie less milk feeds, eating more or hot weather), you might need to try some tips below to help them:

  • start with a silicone top (you can even widen the hole if necessary) OR use a harder mouth piece and take out the valve
  • use a very small cup, such as a medicine cup to introduce a tiny bit of liquid to your baby’s mouth
  • some have claimed ‘take and toss’ cheap varieties have been the only way..
  • when introducing a straw cup, use a short straw in a cup, a ‘lickety-sip iceblock straw’ or even cut the straw in the cup (your little one will then have to tip the cup but only suck a tiny bit to draw the liquid up)

    a short straw to practice! and a novelty..

    a short straw to practice! and a novelty..

Moving to open cup

Once your child has the hang of a sippy or straw cup (probably some time after 12 months), you can try them occasionally on an open cup.  Think any small ‘cup’ like a medicine cup or round container.  A smoothie can be easier for a child to manage as it approaches their mouth more slowly than water and they will ‘feel’ it on their top lip better too.

Here is a variety of ‘cups’ that I have used over the years with the boys.  And sometimes the more novelty the cup, the more likely they are to try something new too (for example, fresh orange juice with all the pulp + barley grass & ginger!!).

they're all cups

they’re all cups

Product Review

Weego BPA free Glass sippy cup – I wish we had known about these when we bought all of our plastic cups (now knowing that any plastic can leach undesirable chemicals from them).  However, most babies generally need to start with a softer mouthpiece before moving to a harder one that this sippy cup has.  And you will have to trust that it will be easy enough for your little one to sip from without being able to test.

http://www.shopnaturally.com.au/lifefactory-weego-bpa-free-glass-sippy-cup-bottle-9oz-250ml-with-ocean-blue-silicone-cover.html

glass_cup

There is also a stainless steel variety that converts from a bottle to a sippy cup.   More plastic-free varieties at baby-bottles.com.au http://www.baby-bottles.com.au/p/8231028/earthlust-birds-bees-stainless-steel-baby-bottle-sippy-cup-birds-207ml.html

getting away from plastic

getting away from plastic

Mag mag – 4.8 stars (from productreview.com.au) goes from teat towards straw cup with varying teats in between + handles, can easily buy replacement valves and keep the cup (a plus over others where you have to buy another whole cup)

Nuby No Spill Flip-It – 4.8 stars. no spill, easy to sip from, babies have mastered as their first cup (say 7 months old), straw and cup not so easy to clean

Take and Toss – 4.7 stars cheap, removable handles, no valve, will leak, will need to replace often as children can chew on the plastic

TommeeTippee Discovera two-stage drinker – I can’t remember where I bought this (maybe Target or Woolworths).  It is the perfect step from hard mouthpiece sippy cup to open cup.  The rim of the open cup has a good ‘lip’ on it for the child to feel their mouth on it.  We have combined open cup drinking with this cup and stainless steel drink bottle (pictured above) for out and about for Master 20 months.

sippy to open cup

sippy to open cup

Of course, there are MANY other varieties I haven’t mentioned.  I’ve stuck with the popular and the non-plastic varieties.  Please leave feedback if you have found another brilliant cup that is worth sharing with others (and where you got it)!  Thanks, Heidi 🙂

We’re off to a speechie – finding a brilliant one

Be it speech or language or many other issues such as stuttering, feeding or autism, you might be in search of a speech pathologist for your child.  Where do you start? How do you find a good one?

Here is a list of things to consider:

  • First of all, we are supposed to be ‘communication experts’, so expect extremely good communication with your speech pathologist!
  • Like any professional, there are the good ones and the ‘not-so-good’ ones.  Always keep that in mind
  • Before forking out, consider government services, generally through a community health centre or maybe a hospital.  These are free but might have a long waiting list so don’t delay.  The government provides funding for professional development and good conditions, so it does not mean that you are getting less of a service because it is free!  I prefer to work in a government service than privately because of the conditions!
  • But! Many very passionate speech pathologists choose to work in private practice to do it their own way (and avoid government issues!), so you can certainly find some fantastic ones there too
  • If looking into a private speech pathologist, have you looked into an Enhanced Primary Care (EPC) plan? (this entitles you to a maximum of five rebated sessions – you’ll surely have some gap fee, per calendar year).  Ask your GP about this or the speech pathologist that you have chosen
  • If you sign up to a private speech pathologist, do you know roughly how long you’ll need to be going for?  I used to have families thinking they would solve their child’s speech delays using their five EPC sessions when in fact, it would probably take years of therapy
  • If a speech pathologist has the letters CPSP after their name, this means ‘certified practicing speech pathologist’ and they have chosen to sign up to seeking out professional development each year
  • Consider the difference between those that offer 30 minute sessions versus 45 minute (or even 1 hour sessions).  Sometimes short and regular sessions are good, but other times the child will only just get into the 30 minute session right when it is finishing
  • Another thing to think about (if you get a choice), is to do ‘chunks’ of therapy.  You might go for a term, then have a term off.  Sometimes kids do have ‘spontaneous recovery’, so at least you can assess this while you have a break.  Regular, ongoing therapy can also be draining and monotonous for some kids (even though we do make it pretty fun!) and also the parents/siblings.
  • Ask around for recommendations.  Every second person know someone who has needed speech therapy before.

And once you have started seeing a speech pathologist:

  • Do they encourage you to sit in on the sessions? (this allows you to see if your child is truly progressing and to take ideas for home) – I don’t feel there is any good reason for a parent to be asked to sit outside of the session.  This just makes it easier for a speech pathologist to be a bit ‘lazy’
  • Do they listen to you?  Do they encourage you to make goals with them?  If not, do they tell you of their goals?  Do they explain what and exactly why they are doing it? Are they well-prepared?
  • Do they give you ideas for home?  A take-home scrapbook might be fine for a school-aged child, but generally ‘real life’ situations are better practice for pre-school children which will encourage more generalisation
  • Remember to constantly assess if you are making progress and if not, move onto a different speech pathologist.  I am constantly surprised to talk with families who have been seeing other speech pathologists that can barely tell me what they are working on and when questioned they sit back and realise their child has made NO progress after continued therapy.  Of course there are the good stories too though! 🙂
  • Always ask questions if you are unsure of anything.

When in doubt, please ask a question through this blog.  🙂 Heidi

Getting the sounds out

Learning to talk has so many aspects, including a very tricky one…  Getting the brain to coordinate the ‘articulators’ (tongue, lips, teeth) along with voice and the jaw and even cheeks to make a sound.  Let alone stringing a few sounds together to make a word!

Babbling

It all begins with babbling, getting the jaw and lips/tongue moving.  It might be /bababa/ or /mamama/ or /dadada/ or /papapa/.  These might sound like what we say, but they are actually ‘immature’ versions of the sounds we produce later as adults.  For example, a baby moves their jaw and if their tongue happens to go with it, it might come out as a ‘dada’, but they cannot actually hold their jaw still and move their tongue to produce a ‘d’ by itself.  And even a ‘b’ or ‘m’ actually happens more by the fact that their lips happen to be closed before they open their jaw, rather than actually choosing to press their lips together, as we would.

Babbling is a great sign that your baby is practicing to talk!

First sounds

Children can make many different speech ‘errors’ as they learn to talk clearly.  Their brain has a lot of work in organising a string of sounds to make a word… and then sentences.  By two (anything goes before that!), the first sounds your child should be able to physically make are: p, b, m, d, n, t, h, w.  For all the other sounds, your little one may either use a different sound or leave it out altogether.

At two years of age, can other people understand half of what your child says?  A parent will always understand more, so get someone like a family member or a daycare leader to judge.

At three years of age, can others understand most of what your child is saying?  Then your child is probably going along okay!

Between 12 months and 3 years of age, your child will gain literally hundreds and thousands of words and have a lot of time to practice talking.  If your child is an early talker, their speech will tend to be clearer before the later talkers, just through more practice!

By three years of age, your child should also be able to use these sounds in words: k, g, f, ng.

By four years of age, your child should be using all sounds accurately except the following: s, v, r, th and consonant clusters (eg. green, pink).  Your child may still have a ‘lisp‘ when starting school (eg. ‘thilly’ for ‘silly’), which may need attention from a speech pathologist to correct.  They may also have difficulty with ‘r’, ‘v’ and ‘th’ up until 8 years of age.  This is the grey area where it is good to keep an eye on your child up until these ages (or think about speech pathologist waiting lists) but not necessarily be too concerned before this as it could certainly resolve itself.

If your child uses a dummy or sucks their thumb, keep in mind the longer they do it, the more possibility they could experience difficulty with a lisp and incorrect mouth position.   This is more likely for children who suck a dummy or thumb well past three years of age.

If your child is having difficulty making certain sounds, here are a few pointers:

  • don’t make fun of your child’s speech! For the young ones, it is likely they aren’t aware they are making errors
  • emphasise the correct way to pronounce the sound in the word (eg. ‘ohh the carrot’ for a child saying ‘tarrot’) but don’t make a big deal of it 
  • try not to exaggerate the sound too much or you risk your child learning to say the word with the sound exaggerated
  • be wary of children who may become upset with a lot of attention drawn to their speech errors (particularly the older children).  It is probably better to look into a speech pathologist if this becomes a problem before they really get put off focussing on changing speech errors
  • notice if your child changes the speech error over time – your child might start by saying ‘crown’ as ‘wown’, but then they might start calling it a ‘fwown’ which is getting closer as they are now putting a sound (‘f’) in place of the ‘c’ instead of no sound.  This is a sign your child is developing their speech skills and might resolve the speech errors on their own!

Remember!  The more you reinforce your child’s shortened versions of words, such as ‘nana/narny’ for ‘banana’, ‘bik bik’ for ‘biscuit’ or ‘puter’ for ‘computer’, the less of a model they get to eventually say the word correctly.  Model how to say words for your child!

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Related post – ‘We’re off to a speechie – finding a brilliant one’.

It’s not all lisps and stuttering!!!!

So what does a paediatric Speech Pathologist actually do?

Well, definitely more than just speech!  Having worked in a bar whilst I was at uni, I got my fair share of people pretending to have a ‘speech impediment’ or just thinking that I’d help them to ‘talk better’ (picture ridiculous lisps and the like!).  I think that’s how my uni friends and I started pretending to do anything other than Speech Pathology whilst we were out with drunken ones!

Anyway!  Sometimes we are called Speech Language Pathologists, as we also work with language difficulties.  A coming post on the actual difference between speech and language.  But we do much more than that….!

We can help children with delayed pretend play skills, those with attention difficulties, help teach cognitive skills, or help students who are struggling with literacy skills at school.  We teach social skills to children from pre-school to high school.  We can also help children with voice difficulties such as vocal nodules.  We work in hospitals with little newborns who have difficulties breastfeeding and those who have been born with a disability right through to supporting teachers at school.  We also work in community health centres.  Other Speech Pathologists work in private practice and cover some or all of the issues above.  We educate parents and other people involved with the child such as daycare leaders, teachers and even siblings.

Speaking for myself, I work with children with disabilities from birth to six years old.  We see children with autism, Down syndrome, many other syndromes, hearing impairments, intellectual impairments, Cerebral Palsy, medical complications, brain injuries and children with no diagnosis but whom are globally delayed.  Not only do I teach the children language skills, clearer speech, preliteracy skills, play and social skills but I also educate their parents so that they can continue ‘therapy’ for the rest of the time they are not with me.  Working closely beside physiotherapists, occupational therapists and psychologists, I also gain many skills off them which I can also pass onto the kids and families.  This job is where I draw my inspiration from in being an enthusiastic parent with my own children!

Speech pathology is now becoming quite a popular course at university as it is a rewarding career and is being sought out more.

Did you know Paul Jennings, author of some great books and the old TV series ‘Round the Twist’ is a speech pathologist?

So now you know a bit more about us Speech Pathologists!

Oh and of course we do lisps and stuttering!! 🙂

The future of a little sucker

dummy, pacifier, soother, comforter

dummy, pacifier, soother, comforter

Let’s look at the dummy from a Speech Pathologist’s viewpoint.

Did you know sucking (well any stimulation to that joint where your jaw hinges from, the temporo-mandibular joint, which often includes chewing gum or biting nails as an adult) promotes calmness and body awareness?  It’s no wonder many babies are ‘sucky’ babies!  And besides calming your baby, maybe promoting body awareness is also a positive out of sucking.

I’m in no place to comment as to the thumb/finger sucking vs dummy debate.  Here is a good link to the Raising Children Network about the pros/cons about dummies.  http://raisingchildren.net.au/articles/should_you_use_a_dummy.html

But yes, sometimes dummy sucking can be difficult to stop (as can thumb sucking).  http://raisingchildren.net.au/ditching_the_dummy.html

When should you get rid of the dummy?

Basically, the sooner the better but there is obviously a ‘safe’ time as far as speech and dental development.  Some say it should be gone by six months, to avoid a habit forming, but I’m fairly sure you’ll still face difficulties getting rid of it then!  The next thing to consider is when and how often is your baby using the dummy?  The more they use it, the less chance for babbling and speech development.  I have seen toddlers who manage to talk with a dummy in their mouth or those that are choosing not to say anything because they are quite comfortable sucking…and I have to restrain myself from taking it out of their mouths!

How does it affect speech development?

First, you’ll need to experience the sucking for yourself.  So go and grab a dummy or just stick a thumb in your mouth and suck!  Feel where your tongue is and how your jaw feels.  Now take it out and let your mouth go back to a resting position with your lips together.  Feel the difference!  Try a suck again and you’ll notice how your jaw sits forward, along with your tongue.  The longer your child’s jaw and tongue sit in this position, the more the brain gets used to this feeling as ‘normal’.  It is certainly not a ‘normal’ resting position to achieve normal speech development.

And looking into the future, this abnormal resting position with the tongue and jaw sitting forward can promote a lisp.  Have a go at saying any sentence with your jaw resting forward, even just slightly forward, and you can see how some people end up with speech errors.  I have no data to say exactly when dummy sucking equates to a lisp but this is the time to use common sense.  Aim for dummy sucking only at ‘non speech times‘ such as in the cot, car or pram but not in social scenarios or times you have noted your baby babbling or attempting words.  It is good to think this through very early when you introduce a dummy – will you only allow it in the cot/make them put it into a cup at the end of sleep time or will you just plan to cut it off altogether by around 12 months?  Soon after 12 months, your baby learns to communicate more, say ‘no’ and tries to take more control of their life (!!), so you will certainly have a harder time telling them when/where they can use it if firm rules have not been set up since before they can remember!

A little bit more on speech development

Babbling starts on average at six months of age and words come around 12 months, so this is about the time you will need to think about where the dummy fits into your baby’s life.  Of course you can’t take a thumb away either, but I have noticed babies tend to automatically take a thumb out when they have something to say, but maybe it is harder with a dummy as they know they will then have to hold onto it..

What many people don’t know is that a certain percentage of lisps are not just a speech error but caused by a ‘tongue thrust’ or ‘reverse swallow‘.  This relates to the child retaining that early swallow pattern (with the tongue pushing forward to swallow), which can certainly come about from excess sucking on a dummy or thumb as a baby.  A tongue thrust involves the tongue pushing forward against the front teeth in order to be able to swallow, instead of pushing against the roof of our mouth and backwards.  This constant pushing of the tongue against the teeth can cause dental issues and ‘interdentalized’ sounds (/s/, /t/, /d/, /n/), where the tongue sits in between the teeth to produce them, instead of behind.  Braces and speech therapy will not be able to repair the dental or speech issues until this swallow pattern has been corrected.  A speech pathologist can help with this.

So by all means, give the dummy a go, but be prepared and advocate for your baby’s speech development – they certainly don’t know to!

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