When it comes to newborn reflexes, there are a few that you should be aware of. The extrusion reflex is one such reflex and can be worrying for some parents when they first see it. But what is the extrusion reflex and what should you do if your baby exhibits it? Keep reading to find out!
In this article we will discuss:
What is the extrusion reflex?
Extrusion reflex is a lesser-known reflex, but one that you may come across in the early days and weeks with your baby. It is also known as the tongue thrust reflex and is often one of the first reflexes parents will notice. The extrusion reflex is a primitive reflex that is exhibited by newborn babies. It is characterized by the tongue moving forward and protruding from the mouth. The extrusion reflex usually disappears after around 4 months old but can occasionally persist into early childhood.
When should you worry about the extrusion reflex?
In most cases, there is no need to worry about the extrusion reflex. It is a normal, primitive reflex that helps babies to feed in the early days and weeks. However, if the reflex persists beyond 4 months old, it may be indicative of a condition known as tongue thrust.
Some children may appear to have excessive drooling. In some cases, this may be a sign of an underlying medical condition. If your child has excessive drooling, it is important to consult your doctor.
What is tongue thrusting?
Tongue thrust is a condition where the tongue protrudes from the mouth during swallowing. This can cause problems with feeding, and may also lead to speech difficulties later on in life. If you are concerned that your child may have tongue thrust, it is important to speak to your doctor or health visitor. They will be able to assess your child and provide you with guidance on the best course of treatment.
Eliminate extrusion reflex through speech therapy
What are some of the causes of the extrusion reflex?
There are a number of different factors that can contribute to the extrusion reflex. These include:
Anatomical factors such as:
Ankyloglossia or tongue-tie: tongue-tie is a condition where the tongue is tethered to the floor of the mouth by a band of tissue (lingual frenulum), which limits tongue movement. This can make it difficult for children to correctly place their tongues when speaking or swallowing.
Structural deviation to the jaw: An overbite, underbite, or open bite When the teeth and jaws are not properly aligned, it can cause tongue-thrusting habits as the tongue tries to compensate for the misalignment.
Cleft lip or palate: A cleft lip or palate is an abnormal opening in the lip or palate (roof of the mouth). This can cause a tongue thrust because the tongue may try to fill in the opening. Tongue thrust can often be seen in children who have had surgery to repair a cleft lip or palate.
Upper Airway obstruction: people with enlarged tonsils or adenoids can show signs of tongue thrust by partially obstructing the airway and the tongue falling back into the throat.
Missing teeth: When teeth are missing especially in the front of the mouth, the tongue can fill in that space. This can cause tongue thrusting.
Macroglossia: this is a condition where the tongue is larger than average. This can make it difficult to correctly place the tongue when speaking or swallowing.
Neurological conditions such as:
Cerebral palsy: Cerebral palsy is a neurological condition that can cause tongue thrust by affecting the muscles used for speech and swallowing. They may or may not show signs of tongue thrust.
Down syndrome: tongue muscle tone can be affected in people with Down syndrome, which may lead to tongue thrusting.
Autism Spectrum Disorder: Autism spectrum disorder is a neurodevelopmental disorder and tongue thrusting is a common symptom of autism.
Habits such as:
Thumb-sucking or extensive use of pacifier: sucking on a pacifier or thumb beyond the age of 4 may develop the habit of pushing the tongue against teeth as it gets used to the sensation.
Nail-biting: like thumb sucking, nail-biting may also show signs of tongue thrust as it can also change tongue muscle tone and movement.
What are some of the consequences of the extrusion reflex?
The extrusion reflex is generally considered to be a harmless primitive reflex. However, if it persists beyond 4 months old, it may be indicative of a condition what is tongue thrusting. Tongue thrust can cause problems with feeding and may also lead to speech difficulties later on in life.
Speech Difficulties include:
Fronting: This is when a child says /t/ or /d/ as if they were saying /k/ or /g/. For example, the word “dog” would be pronounced as “gog.”
Lisp: A lisp is when a child has difficulty making the “s” sound and may substitute it with a “th” sound. This can make words like “sun” sound like “thun.”
Feeding Difficulties include:
Crowding of teeth: When the tongue thrusts forward during a swallow, it can push the teeth apart and cause them to become crowded.
Difficulty chewing: If the tongue is not correctly positioned when swallowing, food may escape from the side of the mouth instead of going down the throat. This can make chewing and digesting food more difficult.
Aspiration: This is when food or liquid goes down the wrong pipe and enters the lungs. This can cause choking and coughing. It can also lead to pneumonia if aspiration occurs on a regular basis.
Excessive drooling: When the tongue is thrusting forward, saliva can’t be properly swallowed. This can cause excessive drooling.
Who can diagnose a persistent extrusion reflex?
If you are concerned that your child may have a tongue thrust, you should consult your pediatrician or family doctor. They will be able to refer you to a speech-language pathologist or ENT (ear, nose, and throat specialist) for further evaluation.
How is a tongue thrust diagnosed?
A tongue thrust is diagnosed through a combination of medical history and a physical examination.
The speech-language pathologist will ask you questions about your child’s development, feeding history, and any concerns you may have. They will also observe your child’s mouth while they are eating and drinking to know more about what is tongue thrusting and what causes it.
The ENT will examine your child’s airway and check for any abnormal growths or blockages. They will also assess your child’s swallow function.In some cases, additional tests may be required such as a barium swallow study or an upper endoscopy. These tests can help to rule out other conditions that may be causing similar symptoms.
What are some of the treatments for the extrusion reflex?
If the extrusion reflex persists beyond 4 months old, it may be indicative of a condition known as tongue thrust. Tongue thrust can be treated with a variety of different methods, depending on the severity of the condition. Treatment for tongue thrust typically involves speech therapy and/or myofunctional therapy exercises to help retrain the muscles used for swallowing and speaking.
Tongue Thrust exercises include:
Isolating the tongue: This tongue thrust exercise involves holding the tongue in a specific position for a period of time. This helps to retrain the muscles used for swallowing and speaking.
Tapping: Tapping the tongue on different surfaces helps to increase awareness of where the tongue is in relation to the teeth. This can help with the correct placement of the tongue during speech and swallowing.
Elevating the soft palate: This helps to prevent food or liquid from entering the nose when swallowing.
These are just a few of the many different tongue thrust exercises that can be used to treat tongue thrust. It is important to consult with a speech therapist or myofunctional therapist to find tongue thrust exercises that are right for you.
If you are concerned that your child may have tongue thrust, it is best to consult with a speech therapist or myofunctional therapist to learn more about what is tongue thrusting. They will be able to recommend the best course of treatment for your child. That’s why we are here! At Better Speech, we offer online speech therapy services convenient for you and tailored to your child's individual needs. Our services are affordable and effective - get Better Speech now.
Frequently Asked Questions about extrusion reflex
How do I know if my baby has the extrusion reflex?
For most babies, the extrusion reflex can be observed when something solid is pressed to the mouth and the baby's tongue pushes outward to remove it from the oral cavity. It is a natural reflex that is believed to protect a baby from choking. It can also be observed when something like puree food is introduced and the baby is seen pushing the food forward and out of the mouth with their tongue. Some might assume this is done because the baby finds the taste displeasing, but in most cases, it is just this reflex at work.
What can I do to help my baby with the extrusion reflex?
Typically nothing needs to be done about an extrusion reflex, as it will most often disappear on its own when solid food is introduced. However, if a parent/caregiver is concerned that the reflex is lingering longer than it should and it is impeding their baby's ability to get nutrients, feeding therapy might be considered. Often a referral can be obtained from a pediatrician, or a parent/caregiver can seek out an evaluation from a speech-language pathologist that specializes in feeding.
How long does the extrusion reflex last?
As a baby develops and gains more control of their oral motor skills, the extrusion reflex begins to lessen. Extrusion reflex typically lasts until around 6 months of age in many infants. In many cases, it will most rapidly begin to disappear when solid foods are introduced to the baby, and the baby learns how to manipulate these foods without the reflex protecting them from choking. The stronger the oral mechanisms become, the less the reflex will be relied upon until it disappears completely.
About the Author
I am a Speech-Language Pathologist with 14 years of experience working with children and adults who have communication difficulties. I completed my Bachelor of Science degree in Health Science at Cebu Doctors' University and have been helping people overcome their communication challenges ever since.
I have worked with individuals of different ages, including toddlers, preschoolers, school-aged children, adults and seniors. I'm passionate about speech therapy and take great satisfaction in helping people overcome their communication challenges and improve their lives through better communication skills. In my spare time I like reading books, going hiking in nature and taking care of my dog Locas.