If your child’s mouth is open, no big deal, right? Think again… An open mouth can cause a domino effect on your child’s development… Without the proper tongue placement in the mouth, the palate doesn’t form correctly… A smaller or higher palette can can cause the tongue to not fit into the mouth properly, which could cause the tongue to stay out of the mouth, be exposed to air even more and the tongue could become desensitized, which could interfere with proper speech development… Sleeping with improper tongue placement can carry over into sleep problems, with apnea and sleep obstruction as likely outcomes…
No fear, here are tips to help you tackle this issue in many ways including supplementing; oral motor therapy; “mouth dot” training; loosening, clearing and preventing congestion; and breathing exercises.
Our children with T21 usually have smaller nasal passages than a typical child. Coupled with their overproduction of GABA — which causes airway epithelium to produce mucous and decrease the tone of smooth muscle — and thyroid issues, which can cause a buildup of fluid and a swollen tongue — we have quite a problem to deal with. So, it’s very important to keep your child’s nasal passages clear, not only for the benefits that breathing through the nose gives, but also to avoid the problems associated with mouth breathing. We want to disrupt that domino effect!
How do you encourage a closed mouth?
- Jett has avoided a lot of problems because he was taking ginkgo to reduce the overexpression of GABA (see Ginkgo: The Hows and Whys for Down Syndrome). Now he takes EGCG (green tea extract) to balance GABA.
- I also was obsessed with keeping his mouth closed as much as possible.
- Here’s a great blog post from Bill and Ria on how to keep your child’s mouth closed and tongue in using oral motor therapy.
- There are ‘spots’ to stick on the roof of your child’s mouth, starting at 3 months old, for proper tongue placement. The exact location to put the spot is where your tongue would touch the roof of your mouth when saying “N”. Slightly wet your finger and when your child opens his mouth, touch-dry the spot where you want to put the dot with a cloth. Then ask your child to put his tongue on it so he can secure it there. You stick it on 3 times a day for a few weeks. The tongue immediately lifts to “explore” it and the tongue learns to stay/rest there. Interestingly, is an important spot in acupressure and closes meridians of happiness. That point allows the flow of serotonin and endorphins. You can get them here: http://myomadeeasy.com/product/sticky-spot/ Other places to buy are here, but most moms like the first product the best. This one, you cut off a dot of the product: http://www.parthenoninc.com/products/Brava-Ostomy-Strip-Paste.html or from http://www.brucemedical.com/stpapoandwa.html in which you would use a hole puncher to cut them into small circles.
- Visit an orthotropic specialist or an oral maxillary therapist such as http://www.sandracoulson.com/Home_Page.html
- Also look into this method: http://www.ergoenergie.com/en/padovan-method
Babies and children who mouth breathe experience the same negative effects as adults, which include abnormalities in blood gases, cell hypoxia (reduced body and brain oxygen content), reduced perfusion of all vital organs and suppressed immune system. Additionally, the effect on children’s development include:
- Malocclusion (misalignment of teeth)
- Malformation of palate
- Tongue enlargement and desensitivity
- Higher incidence of gingivitis (gum infection)
- Allergic rhinitis
- Enlarged adenoids and tonsils
- Obstructive deviation of the nasal septumPostural alterations
- Additional facial changes
- Bad breath
For more information, here are related abstracts:
Prevalence of oral malodor and the relationship with habitual mouth breathing in children (Kanehira et al, 2004)
Low Muscle Tone
Our children often have open mouths for many reasons, one is low muscle tone. Oral and deep muscle massage can help with low muscle tone.
In the meantime, be vigilant about keeping your child’s mouth closed. For Jett, right from the beginning, it was a non-stop job to close his mouth. When possible, I held him on my chest, tummy down as he slept. He was much less likely to have his mouth open in this position. Otherwise, I would put washcloths under his chin or the back of his head to make it so his mouth would be closed. When he was awake, I could usually just touch his tongue with my finger and he’d bring it in and close his mouth. Some parents put their finger under the chin and just close the mouth that way. (I didn’t know about the sticky dots when Jett was a baby.)
A product I understand is successful in helping to prevent congestion and colds is Xlear. It’s a saline nasal spray with xylitol in it.
One product I used successfully with Jett is Si Jin Bao brand of AIR tea. It’s a Traditional Chinese Medicine concentrated herbal tea blend that cleared Jett’s nasal passages. It takes a couple of months to fully clear the congestion and he took it twice a day from age 5-12 months old. It tastes great! My pediatrician recommended it. You take it before your child gets sick.
I used to be up a lot in the night with the nose drops and “mucus suckers,” but not at all anymore. I just clean out his nose quickly with a swab in the morning and give him saline nose drops twice a day. Before, Jett was completely congested back in his sinuses where I couldn’t get to it. After using AIR tea, I could finally feel the air coming from his nose, which I couldn’t do before. At 21 months old, Jett has never had a cold or sinus infection. I would give him 1/5 teaspoon (1 ml) in the morning and before bed with 2 ml of water. He loved it!
It’s blended by hand in small, organic batches.
You can get this from your local TCM practitioner ($45-65) or from sjbherbs.com. Go to the homepage, click on “Order Now” and scroll down on the left hand side of the page. You will see a pink bottle and it is labeled AIR. Click on it to order. You can also get it from Jett’s TCM at http://www.loiacupuncture.com/index-2a.html
I recommend Nose Frida with saline nose drops or xclear spray to get the mucus out. For the saline, you don’t have to squeeze the bottle, you just turn it upside down and gravity will release a couple of drops gently in his nose. The Nose Frida is a gross concept, but it works great. Once the AIR tea gets going and releases all the mucus that’s backed up, you won’t need to use it everyday any more. (I don’t have to use at all now.)
You can get it at amazon here: http://www.amazon.com/Nosefrida-The-Snotsucker-Nasal-Aspirator/dp/B00171WXII
I can’t say Jett liked it initially. But when I did use it, I told him what I was doing every time and told him when I was stopping, etc. (“1-2-3, stop!”) He seemed to understand that it was a necessary evil. (The battery powered ones didn’t work at all for us. He found them kind of relaxing though. He’d even hold it without batting it away.)
By the time Jett was 3 or so, he’d ask for the Nosefrida if he felt he needed it. I stopped using it when he was able to blow his nose with enough force. (Blowing your nose it’s really recommended, it’s actually better to just wipe, but, that’s not always practical!)
The Baby Vac
Another one that’s recommended is The Baby Vac: http://babyvacusa.com/
And if you google baby vac, there are some YouTube videos of babies using it on themselves. Be sure to put saline solution in his nose every time before you use this. I understand that it works great for getting the stuff way in the back of the nose that would be difficult to get out with the Nose Frida.
Neti Pot I have not used the neti pot for Jett. But many people swear by its use. The Neti pot looks like a miniature tea pot. It’s an ancient remedy that is filled with a saline solution and then used to irrigate the nose. It washes out all of the pollution, infection and allergens that may be causing trouble. It’s okay to use the neti pot as long as symptoms occur — from once a week to multiple times a day. If you don’t have a neti pot, a pop-top bottle (like those used by cyclists) can do the job, as the top is bigger enough to cover a nostril, with a small hole in the middle. I would definitely try this on yourself before you tried it on your child!
Here’s a great post on natural ways to clear congestion at the 3 of 21 Blog.
Opening Nasal Passages
As mentioned earlier, our children usually have smaller nasal passages because the bridge of the nose is not as defined. The midface can get extra support with proper nutrition to support bone growth and nutrient absorption and with Craniosacral therapy.
Electric humidifiers and natural humidifiers, like houseplants, can help increase the amount of moisture in the air so your child’s nasal passages will be less dry and irritated and more lubricated. I moved all the houseplants into the bedroom every night and moved them back out during the day. A a wheeled shelf would be ideal for this. I also put wet wash clothes near where he was breathing to increase the humidity. (Yes, I’m aware that I’m obsessive!)
Allergies, both through food and from the air, can be a main cause of congestion as well. You can help clear the air of many allergens by using a hepa air filter. Regular dusting and vacuuming, when the child is not in the room, helps as well. Replacing carpet with tile or wood flooring will also reduce the amount of allergens in your home.
I’ve recently discovered NAET which are energy treatments that help “clear” allergies. Jett and I went through this process and I’m really excited about the results.
Honey, purchased from a local beekeeper, can help your body build up immunity against allergens local to your home. Honey should not be given to babies and neither of my children muscle test well for any bee products.
Anti-Mouth Breathing Exercises
I haven’t had to try anything like this since Jett can keep his mouth closed himself now. If you have, or get, a neurodevelopmentalist, s/he can address the problem for you and create specific exercises to do. Otherwise, I found this article called “Using the Buteyko Breathing Method For Children” by Dr. Natalia Lapa, MD, Specialist in Remedial Gymnastics, Children Hospital No. 8, Novosibirsk, USSR, 1991. The paper was published in the book “Buteyko method. Its application in medical practice”, ed. by K. P. Buteyko, 2-nd ed., 1991, Titul, Odessa, USSR [in Russian]. You can find the method explained here: http://www.normalbreathing.com/index-nasal-children.php. If you or someone you know has tried this, I’d love to hear how it worked for you.