My daughter started sticking her tongue out under the sippy cup. She also does this with a straw cup. We switched her to an open cup and now she is doing it with that as well. What should I do?

I spoke with our licensed speech pathologist and feeding specialist, regarding your question. She said that she would not call this tongue thrusting but rather, tongue protrusion. Tongue thrusting is what we see with a diagnosis of cerebral palsy. Tongue protrusion is when the tongue is just “hanging out” at times. It could just be something developmentally she is doing since she was able to drink with it in her mouth before and hopefully it will return to normal. It could also be somewhat behavioral at this age, if she is constantly getting attention for it, she may be apt to do it more frequently.  But, if it is not developmental/behavioral it could be low tone in her face/tongue or her tongue and postural instability. Be sure her posture is 90/90/90 degrees when sitting to provide the accurate positioning. In other words, make sure her back is flat against the highchair or booster chair and that her feet touch the foot rest of the chair so she is stable while drinking. Use an electric toothbrush on her teeth, tongue and all around her mouth if she will tolerate it.  This helps to alert her mouth and help strengthen muscles via vibration.

Also also you can incorporate tongue movement into play. Look into a mirror and have her imitate sticking her tongue out, moving it side to side, up/down etc. Also while the she is drinking you can help place the cup horizontally on the lower lip while providing some support to the jaw with your opposite hand. This will help keep the tongue inside her mouth. The straw cup and open cup you are using are usually preferable to the sippy cup for more mature oral motor practice.  If she continues to stick out her tongue while drinking from the various cups and you continue to have concerns, you may wish to seek an evaluation from a licensed speech pathologist or occupational therapist with feeding experience who can offer you additional guidance.