Do Infants Need a Speech Language Pathologist?
Speech therapy is understood, first and foremost, as a pedagogical discipline concerned with speech development disorders and as a specialized system of education and training aimed at correcting and preventing these disorders. However, in the modern era, speech therapy has evolved from a purely pedagogical discipline into the field of medicine and developed into a broader scientific domain known as speech and language pathology. A Speech Language Pathologist is the correct professional title for specialists working in this field. However, our country still incorrectly refers to these professionals as speech therapists. This misunderstanding hinders parents’ ability to grasp the essence of professional speech-language support for a child who is not yet able to speak.
In fact, the role of a speech-language pathologist (SLP) in infant development is highly significant. The role of a speech-language pathologist (SLP) includes assessing, treating, and preventing communication disorders such as expressive and mixed receptive-expressive language disorders, voice disorders, articulation disorders, speech fluency disorders, pragmatic language impairments, difficulties in social communication, and swallowing disorders throughout a person’s lifespan.
Speech-language pathologists can demonstrate excellent outcomes by employing a range of methods to support the breastfeeding process and to address difficulties in the coordination of sucking, swallowing, and breathing.
1. Assessment and management of oral–motor difficulties:
- Assessment of tongue movement, sucking patterns, and oral coordination
- Identification of potential oral–motor difficulties that may affect breastfeeding
- Development of exercises and strategies to improve oral-motor skills
2. Support for infants with lingual and labial frenula:
- Assessment of the impact of the lingual or labial frenulum on feeding
- Training in management strategies, including exercises and stretches
- Collaboration with breastfeeding and lactation consultants
3. Addressing feeding difficulties:
- Assessment of feeding
- Adjustment of positioning and latch techniques
- Education and support for parents
A speech-language pathologist can make breastfeeding easier and more effective for both mother and child, especially in cases of swallowing, oral–motor, or structural difficulties. Consequently, an infant’s feeding development is not limited to nutrition alone—this process is closely linked to oral-motor skills and the coordination of breathing and swallowing, as well as sensory and cognitive development. In the early stages, the infant’s only means of interacting with the environment is sucking; thus, the baby’s sucking serves as a fundamental indicator for obtaining comprehensive information about their overall health. A properly trained breastfeeding and lactation specialist who detects any difficulties at an early stage can, without a doubt, refer the infant to specialists in other fields in a timely manner. As a result, through collaborative work and adequate support, it is possible to prevent problems that may arise in early childhood and to promote the healthy development of the child.
Why is sucking activity vital?
For healthy sucking, at least 3–5 of the infant’s reflexes are involved in the process. Furthermore, the act of sucking, particularly breastfeeding, being a complex and intricate mechanism, requires the proper functioning and participation of the muscles of the face, mouth, throat, and even the neck. Thus, the correct development of at least seven types of muscles, which actively participate in the infant’s sucking, is crucial. One must also not forget the importance of the nervous system: at least five cranial nerves are involved in the infant’s sucking process. By emphasizing breast sucking specifically, our goal is to highlight its significant difference from bottle sucking. In conclusion, dysfunction of any of the nerves, reflexes, or muscles involved in the infant’s sucking process will, in most cases, manifest as difficulties with breastfeeding or partial (and in most cases, complete) refusal of the breast.
Speech–language pathologist Dr. Pouran Bagherpour notes that innate reflexes such as sucking and swallowing are present in infants from birth. These reflexes ensure safe feeding and the intake of nutrition necessary for growth. If a child experiences feeding difficulties, it is important to consult a specialist, such as a speech–language pathologist, to identify the problem in a timely manner and receive appropriate support. As infants grow, motor skills develop, including movements of the lips, tongue, and jaw. Visual and perceptual skills also emerge, helping infants distinguish between edible and non-edible objects. At approximately six months of age, infants are introduced to soft foods. The transition from liquid to solid foods requires new skills and coordination. At this stage, infants are exposed to different textures, temperatures, and tastes. They begin to grasp food with their hands and make attempts to eat and drink using a spoon and a cup. Occasional episodes of choking, coughing, or spitting out food are normal and represent part of the learning process. During this stage, parents should offer safe foods and support the child’s attempts to “explore the world.” Feeding development is closely linked to motor, sensory, and cognitive skills, which together contribute to the formation of healthy eating habits.
Dr. Pouran Bagherpour also reports on the coordination of Sucking, Swallowing, and Breathing, which is essential for healthy and effective breastfeeding in infants:
“It has been observed that in infants aged 0–2 months, a simple sequence is typically present: one suck, one swallow, one breath. Between 2 and 4 months of age, the oral muscles strengthen and coordination improves. During this period, infants may sometimes perform several, or even up to 20, sucking movements without breathing. This coordination is crucial for safe and efficient feeding. Disruption of this sequence can lead to feeding difficulties and may negatively affect the child’s development. The importance of coordination between breathing and swallowing is closely linked. The typical pattern is as follows: inhale–swallow–exhale. During swallowing, breathing briefly stops—this is known as swallowing apnea. Resumption of breathing after swallowing protects the airway. If this sequence is disrupted, the risk of aspiration (entry of food into the airway) increases. Monitoring this coordination can assist in the early identification of swallowing disorders.”
In conclusion, we would like to emphasize that if infants experience feeding difficulties, the selected specialist should not be merely a speech therapist but specifically a speech-language pathologist. Not every speech therapist is necessarily a speech-language pathologist. As noted at the beginning of this article, a speech therapist with a pedagogical background is competent in addressing speech-related disorders, whereas feeding issues require consultation with specialists in a medical profile.
Authors: Saltanat Zulfugarova
