Why Is My Lactation OT Asking About Oral Motor and Positioning, Along With Sensory and Stress?

Feeding and eating is one of the most complex jobs we have as a human. Especially with all the constructs around feeding that society has put on food. We can only eat SOME foods with our fingers, we must be seated at a table or in a group, and we have to do all of this within a certain amount of time a certain number of times per day.

Let’s break down one of these skills. Using a utensil to bring food to our mouths.

First, it has to be the ‘correct’ utensil. We need to use a spoon for soup or cereal. We need to use a fork and knife to cut and eat meat or larger pieces of food in general. At the very base of this we need to have a solid foundation in postural stability (core strength), balance, and bilateral coordination (using the two sides of our body together). This helps us remain upright and use the utensils. Then we need fine motor skills and strength to load the utensils. Force discrimination and control to get the utensil to our mouth without missing, overshooting, dropping food items, or just giving up an using our hands. We need the oral motor control to do something with the food in our mouth chew thoroughly, taste, and coordinate a swallow with the suck, swallow, breathe synchrony and not choke. All of this doesn’t happen in a sensory-deprived environment, but instead a sensory-rich environment. So now we have to consider the processing of all of the sensory input to even get us to remain in this spot.

See how complicated it gets? OTs will focus in on all of these areas, often one at a time, but sometimes all together. Since each of these skills happen together all the time, that’s what our practice needs to imitate. As a lactation OT, chest and bottle feeding are slightly less complicated than table feeding, but not much. We still need to consider all the aforementioned areas, because the utensil for an infant is either a breast or a bottle.