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Category: Feeding

  • Top Tips for ‘Fussy Eating’

    Top Tips for ‘Fussy Eating’

    Between 25% and 45% of typically developing children struggle with feeding at some point during childhood.1 For children who find mealtimes challenging, there are universal strategies that can support positive mealtime skills. Try these top tips if you have a ‘fussy eater’ at your table.

    1. Pair New Foods with Familiar Foods

    If your child loves ketchup but isn’t sure about broccoli, serve broccoli with a side of ketchup so your child can dip their broccoli.

    2. Always Serve One Food Your Child Likes

    You don’t want your child to dread coming to the table, so serve at least one food item at each meal that you know your child likes. Make sure they have the other foods being served as a part of the meal on their plate as well.

    3. No Pressure, Except Positive Peer Pressure

    Meal times should be relaxed, pressure free, and include mealtime role-models. Research shows that children are more likely to eat non-preferred and new foods if they see their parents and other children eat them. 2 3

    4. Value Self-Feeding (Mess is Good!)

    Most people prefer to be in control over what goes in their mouth; let your child feed themselves, and save clean-up for when the meal has ended.

    5. Give Non-Preferred Foods Fun Names

    A study tested whether fun names (like ‘Power Punch Broccoli’) made vegetables more appealing to primary school students. Answer: Yes.4

    6. Repeat, Repeat, Repeat

    It can take a child 15 to 20 separate meals seeing a new food before being ready to eat the new food; so keep offering non-preferred foods without pressure.

    7. Don’t Measure Nutrition by the Meal

    Look at what your child eats across a week to help decide if they are eating a balanced diet.

    8. Food Play is Important (Mess is Good!)

    Children need to play with and explore their food to learn how to eat; messy food play is a vital part of the learning process, encourage it!

    9. Food Prep is Fun – Give Children a Way to Help

    The more your child touches and helps prepare foods, the more likely they are to eat the food later.

    10. Make Mealtimes a Positive, Social Experience

    Eat as a family and turn off screens and other distractions.

    Many children are able to move beyond fussy eating through supportive family meals involving the above strategies. However, some children’s fussy or selective eating is underpinned by a specific difficulty or developmental difference, and these children need specialist support with feeding and mealtimes. If your child’s fussy eating is not improving with the implementation of universal strategies, please get in touch. Feeding therapy helps support children to develop positive mealtime skills and decreases mealtime stress for both parents and children.

    Please sign up for South Lakes Speech & Language Therapy’s newsletter if you would like future posts sent directly to your inbox.

    1. Royal College of Speech & Language Therapists ↩︎
    2. Haire-Joshu D, Elliott MB, Caito NM, Hessler K, Nanney MS, Hale N, Boehmer TK, Kreuter M, Brownson RC. High 5 for Kids: the impact of a home visiting program on fruit and vegetable intake of parents and their preschool children. Prev Med. 2008 Jul;47(1):77-82. doi: 10.1016/j.ypmed.2008.03.016. Epub 2008 Apr 9. PMID: 18486203; PMCID: PMC3607447. ↩︎
    3. Influence of Screen-Based Peer Modeling on Preschool Children’s Vegetable Consumption and Preferences Staiano, Amanda E. et al. Journal of Nutrition Education and Behavior, Volume 48, Issue 5, 331 – 335.e1 ↩︎
    4. Musher-Eizenman DR, Oehlhof MW, Young KM, Hauser JC, Galliger C, Sommer A. Emerald dragon bites vs veggie beans: Fun food names increase children’s consumption of novel healthy foods. J Early Child Res. 2011 Oct 1;9(3):191-195. doi: 10.1177/1476718X10366729. PMID: 26257583; PMCID: PMC4527653. ↩︎
  • Big Chef, Little Chef: Cooking Together to Support Communication and Mealtime Skills

    Big Chef, Little Chef: Cooking Together to Support Communication and Mealtime Skills

    As the nights draw in and the trees lose their leaves, the distinct feeling of autumn is here. In my household, the excitement starts to build as the 31st of October approaches… what will the Halloween costume be this year, what sweets will be given out, and when are we making the cupcakes? Yes, Halloween cupcakes!

    We started the tradition when my son was three and it has evolved over the years. Early creations involved smiling ghosts and Oreo cookie spiders. More recent versions have included bats, mummies and other creatures emerging from a chocolate grave. The joy I get as parent spending time with my child is immeasurable, as is the joy I have as a speech, language and feeding therapist thinking about all the language and mealtime learning that occurs as a part of parents and children spending time together in the kitchen.

    Speech and Language Learning through Cooking

    Learning becomes more meaningful when it happens in the real world, and the kitchen is a fantastic place to build on your child’s speech and language skills. You might be surprised at all the communication skills you can target while cooking together.

    • Vocabulary – Cooking together naturally exposes your child to new words such as recipe, boil, measure, slice, chop, etc.
    • Basic Concepts – Time in the kitchen together provides opportunities to introduce basic concepts including: hot/cold; full/empty; dirty/clean; wet/dry; big/little; heavy/light; shiny/dull; first/next/last; and more.
    • Verbs – Cooking action words such as stir, whisk, pour, cut, heat, etc. can be practiced throughout your cooking activity in present, past and future tense forms.
    • Following Directions – Cooking is a multi-step activity and you can use time in the kitchen to support your child’s ability to follow one-, two- and multi-step directions.
      • Let’s get a spoon.
      • Get a spoon and put it in the bowl.
      • Get a spoon and put it in the bowl, then pour the milk in the bowl.
    • Understanding and Answering Questions
      • Who baked the cookies?
      • Where is the cookbook?
      • What did you use to mix?
      • When do we turn on the oven?
      • How many cupcakes did we make?
      • How did we open the tin?
    • Speech Sounds – Practice sounds your child has not yet mastered while cooking.
      • /s/ – salt, soup, sauté
      • /s/ blends – slice, steam, stir
      • /l/ – liquid, lettuce, ladle
      • ‘sh’ – sugar, chef, mash
      • /r/ – roast, rice, ravioli
    • Narrative Skills – Using narrative refers to a child’s ability to tell about a sequence of events in the correct order with a clear beginning, middle and end. When you finish cooking, have your child re-tell you the story of what you did in the kitchen together.

    Mealtime Learning through Cooking

    For children who enjoy eating as well as for those who struggle with eating or are ‘picky eaters,’ time around food in a no pressure environment, such as cooking, supports the development of skills needed to manage food at the table.

    To help your child build positive food connections, when cooking together focus on:

    • Sensory Exploration – Encourage your child to smell, touch, and look at the food without pressure to it eat. Use vocabulary such as soft, crunchy, firm, and colour words to describe what you feel and see.
    • Being Okay with Food Mess – Cooking and eating are messy at times. Practice with food on hands and clothes while cooking helps children to be comfortable with food mess while eating.
    • Food Choices – ask your child to decide what vegetable to serve with the evening meal and let your child wash, cut and boil or bake the vegetable in an age-appropriate way. You may even want to let your child plan the entire meal!
    • Enjoying Time Together around Food – Part of building positive food connections is enjoying time around food. When your child has fun cooking with you, that supports their development of a positive association with food. Be silly, smile and laugh together while you create your tasty treat.

    Happy Halloween and Happy Cooking with your Child!

    If you would like more information about children’s communication or feeding, please get in touch. Follow us on Facebook for more speech, language and feeding tips, and sign up for South Lakes Speech & Language Therapy’s newsletter if you would like new posts sent directly to your inbox.

  • Tongue-Tie: A Controversial Band of Tissue

    Tongue-Tie: A Controversial Band of Tissue

    As a speech and feeding therapist, I regularly am asked whether a tongue-tie may be a factor in a child’s speech or feeding difficulties. Over the course of my career, I have completed additional training in tongue-tie and have worked alongside colleagues who sit on both sides of the tongue-tie debate. Increasingly, I find myself squarely in the middle which got me thinking; why are tongue-ties controversial and why do we not have a definitive, universally agreed upon way to diagnose and manage tongue-ties in children?1

    A Brief History of the Tethered Tongue

    If you are wondering whether tongue-tie is a fad or a condition with historical roots, wonder no longer! Almost 2000 years ago, Cornelius Celsus, a Roman encyclopaedist, described ankyloglossia or what we more commonly refer to as ‘tongue-tie’. A reference to tongue-tie can also be found in the bible, where it is noted that speech was improved when “the string of his tongue was loosened”.2 As early as the 1600s tongue-ties were regularly treated in newborns with midwives keeping one fingernail longer and sharper to cut a tethered tongue.2 3 However in the 1900s, as formula milk grew in popularity, this practice fell out of favour.2

    The diagnosis and medical management of tongue-tie has ebbed and flowed with many linking it to the rise and fall of breastfeeding rates; in other words, when breastfeeding is more common, so is the diagnosis and treatment of tongue-tie.4 So, where does that leave ankyloglossia today, at a time where The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life?5 You guessed it, diagnosis and treatment of tongue-tie has sky rocketed in the developed world. It is estimated that between 4% and 11% of babies are born with tongue-tie.6 With one study finding an almost 10-fold increase in the diagnosis of ankyloglossia between 1997 and 2012 and a further doubling between 2012 and 2016.7 As the diagnosis of tongue-tie increases, so do the number of tongue-tie surgeries with rates of tongue-tie surgeries more than quadrupling in high-income countries over the past ten years.6 This increase in tongue-tie diagnoses and surgical procedures however, is not without controversy.8

    An Agreed Upon Definition and Response?

    Surprisingly (or perhaps not so surprisingly) the controversy over tongue-tie starts with the definition. Most professionals agree that a tongue-tie involves an abnormally tight lingual frenulum, the band of tissue that connects the tongue to the floor of the mouth; but that is where the agreement ends. Some tongue-ties are attached close to the front of a person’s mouth with a visible short and tight lingual frenulum (resulting in a heart shaped tip of the tongue); while others are attached toward the back of the mouth where the lingual frenulum may not be visible but there is restricted tongue movement (a ‘posterior tongue-tie’).9 So, the question becomes, ‘Should we diagnose a tongue-tie when we see the ‘tie’, or should we diagnose a tongue-tie when we ‘see’ decreased tongue function?’ (Professionals have yet to agree on an answer to this.) And, ‘What do we do when we diagnose a tongue-tie?’

    The most common and immediate fix for a tongue-tie is a lingual frenectomy which involves cutting or lasering the lingual frenulum. For babies under 6 months, this generally can be done as a part of an office visit with a skilled practitioner, but older babies and children will need an anaesthetic.10 Following a lingual frenectomy, most practitioners recommend specific aftercare to prevent re-attachment.11

    But, does every tongue-tie warrant a lingual frenectomy or are there some tongue-ties that can be managed with specialist input and a ‘wait and see’ approach? And how do we know which is which? (Professionals have yet to agree on an answer to this as well.)

    Commonly Agreed Upon Symptoms

    Despite not agreeing on a definition or response, there are a generally agreed upon set of symptoms of a tongue-tie (although not every person has every symptom). These include:12 13

    • Difficulty with breastfeeding for both baby and mother.
    • Difficulty managing solid foods, especially as a part of early weaning.
    • Poor oral hygiene for older children and adults (due to an inability to use the tongue to clear food from between the teeth and cheek).
    • Difficulty producing speech sounds that involve the tongue tip making contact with the roof of the mouth such as ‘t, d, l, and n’.
    • Difficulty with other activities involving specific tongue movements such as licking an ice cream cone, licking one’s lips, and playing a wind instrument.
    • A change in oral structures such as the palate, jaw, and teeth (due to an altered resting position of the tongue).

    Given this list of clear symptoms, you may wonder why diagnoses and treatment is controversial; can’t we simply agree that a person with the above symptoms has a tongue-tie (and ‘fix’ it)? Unfortunately no, we can’t. Many of the above symptoms can have causes other than tongue-tie, and delaying investigation of other causes in favour of immediately defaulting to tongue-tie as the cause can delay the individual receiving the appropriate treatment (and may put the person through an unnecessary medical procedure).

    What Does this Mean for My Child?

    The answer to this question is not simple and depends on what medical professional your child sees (much like the answer to the questions of how we identify and treat a tongue-tie). I have met parents whose child had a lingual frenectomy and they found that following the procedure their child’s symptoms improved or resolved; other parents I have met whose child had the procedure reported little or no difference in symptoms. Some families I have worked with who have been offered the procedure and declined, have found that their child’s symptoms improved with therapy and time.

    As I finish writing this, I find that I am no closer to shifting my ‘middle of the road’ position when it comes to tongue-ties. Children who have difficulty with feeding or speech need a thorough assessment, including an oral motor examination. If a tongue-tie is identified or suspected, parents should be given the opportunity to discuss their child’s symptoms with a practitioner who specializes in tongue-ties and performs lingual frenectomies to determine whether this is an appropriate consideration for their child. Equally, their child needs quality feeding or speech therapy to directly address their symptoms and improve outcomes whether or not a lingual frenectomy is performed.

    If you have concerns for a tongue-tie in your child and would like information about feeding or speech therapy with South Lakes Speech & Language Therapy, please get in touch. Follow us on Facebook for speech, language and feeding tips and sign up for South Lakes Speech & Language Therapy’s newsletter if you would like new posts sent directly to your inbox.

    1. Becker S, Brizuela M, Mendez MD. Ankyloglossia (Tongue-Tie) [Updated 2023 Jun 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482295/ ↩︎
    2. K. Ganesan, S. Girgis, S. Mitchell,
      Lingual frenotomy in neonates: past, present, and future,
      British Journal of Oral and Maxillofacial Surgery,
      Volume 57, Issue 3,
      2019,
      Pages 207-213,
      ISSN 0266-4356,
      https://doi.org/10.1016/j.bjoms.2019.03.004.       ↩︎
    3. Johns Hopkins Medicine: A Clinical Consensus on Tongue-Tie ↩︎
    4. ENT Today ↩︎
    5. WHO ↩︎
    6. Evans L, Lawson H, Oakeshott P, Knights F, Chadha K. Tongue-tie and breastfeeding problems. Br J Gen Pract. 2023 Jun 29;73(732):297-298. doi: 10.3399/bjgp23X733221. PMID: 37385756; PMCID: PMC10325602. Download .nbib Format: ↩︎
    7. HealthyChildren.Org ↩︎
    8. Obladen M. Much ado about nothing: two millenia of controversy on tongue-tie. Neonatology. 2010;97(2):83-9. doi: 10.1159/000235682. Epub 2009 Aug 25. PMID: 19707023. Format: ↩︎
    9. Infant Journal ↩︎
    10. NHS: Tongue Tie ↩︎
    11. Alabama Tongue-Tie Center ↩︎
    12. Mayo Clinic: Tongue-Tie ↩︎
    13. Guy’s and St Thomas’: Tongue-Tie in Children ↩︎
  • Ready to Wean – Top Tips

    Ready to Wean – Top Tips

    Top Tips from South Lakes Speech & Language Therapy to make weaning easier for you and your baby.

    1. Set Your Baby Up for Success

    Make sure your baby has a comfortable and supportive seat for feeding; and start by offering food at a time of day when your baby is well-rested and has a content belly. No one likes to try something new when they are uncomfortable, tired or overly hungry; and that includes your baby.

    2. No Pressure

    Early weaning is a time for babies to learn about food through play. Between 6 and 12 months breastmilk or infant formula will continue to be your baby’s primary source of nutrition as they learn about solid foods. Don’t worry if they don’t swallow much food when you start weaning; the most important thing is that they enjoy weaning and feel happy exploring a variety of solid foods.

    3. Mess is Good

    Babies need to explore and play with food in order to learn about it. This will be messy. To make clean up easier, put a plastic sheet under your baby’s chair and dress your baby in old (or no) clothing. Try offering food immediately before bath time.

    4. Calm is Key

    Your baby looks to you to help them regulate their emotions and know whether a new situation is safe. If you are calm around food, that lets your baby know that they can be calm around food too. If you feel anxious about weaning, your baby will too.

    5. Gagging will Happen

    Gagging is a normal part of weaning. It is the body’s way of preventing choking, and new feeders will gag while their body learns how to respond to and manage different food textures and sizes. Remember Top Tip number 4, ‘Calm is Key’.

    6. Be a Role Model

    Family meals are an important part of your baby learning to eat solid foods. Include your baby in family mealtimes so they can see you eat and learn about family foods and mealtimes. When possible, give your baby the same foods as the rest of the family so they start to develop a taste for family foods early on in their weaning journey.

    7. ‘No’ Doesn’t Always Mean No

    Babies and young children need multiple exposures to a food before developing a like or dislike for that food. So, if your baby makes an unhappy face the first time they taste broccoli, offer it again (and again) at different meals.

    8. Baby-Led vs Traditional Weaning

    Both weaning styles can lead to happy, healthy eaters; so do what works best for you and your baby, and don’t feel pressure to choose one method over the other.

    9. Store-Bought vs Homemade Baby Foods

    Store-bought baby foods are great for when you are out and about or short on time, but if you want your baby to eat family foods when they have transitioned to table foods, use
    predominantly family foods during weaning.

    10. Batch Cook and Freeze

    If you are making your own baby food, freeze it in ice cube trays so you have a variety of foods and flavours in small portion sizes ready to defrost and serve to your baby when you need it.

    For more information about weaning and children’s feeding, see South Lakes Speech & Language Therapy’s Information and Resources page and follow us on Facebook. Sign up to our newsletter if you would like new posts sent directly to your inbox. If you would like support with feeding your child, please get in touch.

  • Back to School

    Back to School

    For children with speech, language, and/or feeding needs, a new school year can bring unique opportunities and challenges. There are some things you can do to help your child feel confident, prepared and supported as they return to school.

    Supporting Children with Speech and Language Needs

    1. Establish a Routine

    Children thrive on predictability. Establish a school day routine with consistent wake-up and go to bed times and structure school mornings so your child can predict what and when things happen before leaving for school (e.g., getting dressed, eating breakfast and brushing teeth). Some children may benefit from a wall calendar that shows the day of the week, and for children using Now / Next boards or other visual schedules, make it clear what days are school days so your child knows what is happening each day.

    2. Practice Self-Advocacy Phrases

    Practicing language such as “I need help”, “I am hungry / thirsty,” or “Where do I go?” can help your child feel more confident advocating for themselves at school. If your child’s speech is difficult to understand, help them communicate in other ways when needed such as describing or showing what they are trying to say; and if your child uses Makaton or other sign language system, make sure you show your child’s teacher the signs and their meaning. Whenever possible, provide pictures of your child’s sign vocabulary to be kept in the classroom. 

    For children who use pictures to communicate, be sure to provide the classroom teacher and teaching assistant with a copy of the pictures you use at home and explain how your child uses the pictures. There will be new picture vocabulary that you child will need at school, so talk to your child’s teacher about what pictures they think may be relevant in school that you have not yet used at home.

    3. Expand School-Related Vocabulary and Activities

    Introduce words your child might hear at school such as, “schedule,” “assembly,” “school hall,” “recess,” etc. and model how to use this new vocabulary in real-life. Looking at books together that tell stories about children at school and have pictures of classrooms and school settings is a good way to support your child to learn school-related vocabulary.

    4. Practice Social Communication and Play

    Practice social situations like asking for help, taking turns, or joining a group during free play or at recess. If your child is shy or has difficulty navigating social scenarios, simple scripts like “Can I play?” or “My turn” can help your child build confidence when meeting new friends. For children who use pictures and/or sign language to communicate, introduce social pictures and signs at home and practice using them in situations your child may encounter at school.

    Supporting Children with Feeding Challenges

    1. School Dinner and Lunchbox ‘Dress Rehearsals’

    Borrow a dinner tray and/or plate from school and let your child practice eating some meals from it at home. If your child will be bringing a packed lunch to school, let them practice eating from their actual lunchbox at home. This includes using the same containers they will bring to school. This way your child gets used to a new mealtime routine and you can see which containers, if any, are difficult for your child to open or close.

    2. Stick to Familiar Foods

    Avoid experimenting with new foods at the start of the school year; the sight, smell and sound of having a mealtime with peers can be overwhelming for some children. Pack safe, preferred foods your child is most likely to eat in a busy, sometimes overstimulating environment.

    3. Involve Your Child in Meal Preparation

    Let your child help pack their lunch and choose containers so they know what to expect when they sit down to eat. 

    4. Talk about Lunchtime Expectations

    Explain school mealtime rules: sitting in one spot, limited time to eat, and not always having an adult to help immediately. Practice these at home, so your child knows what to expect when they sit down to eat at school. 

    5. Help School Understand Your Child’s Mealtime Challenges

    Talk with the school’s mealtime supervisors to make sure they understand your child’s feeding challenges and how to support your child at mealtimes. It is important that mealtimes be pressure free and that your child find mealtimes at school enjoyable which may mean they don’t always make a healthy choice or finish what is on their plate.


    For more information about supporting children with communication and/or feeding difficulties, please see South Lakes Speech & Language Therapy’s Information & Resources page or get in touch; and sign up to our newsletter if you would like new posts sent directly to your inbox.