When we think about the skills needed to eat or self-feed, the first things that come to mind are usually related to our mouth and tongue. We might even think about our hands for holding a utensil or bringing food to our mouth. But what we don’t often realize is that eating is founded in the ability to maintain an upright position at the table during meal times. Postural control and is the foundation for all feeding skills!
Being able to maintain a strong, stable, upright position at the table gives a child a solid foundation for all the small, complex movements of the mouth, jaw, and tongue required for eating. Proper alignment of the pelvis, trunk, and neck allows for the safest management of food while eating, and reduces the risk of aspiration by allowing optimal position for a safe swallow. Regardless of the type of chair they are sitting in, a child should have the following seated position at the table: hips, knees, and ankles at 90 degrees and trunk at midline. This may require modifications to the seating environment, such as changing the table or chair height, using side supports, or using a footrest.
How can you improve your child’s postural control to help support their progress toward feeding goals? Here are a few simple options to try at home:
1. Tummy time – at any age! Playing while lying on your stomach allows for the development of postural control and a chin tuck, the safest position to swallow. Do puzzles, read a book, or color – any activity can be done from your stomach! Other positions, such as tall kneeling (on knees without bottom resting on heels), one-sided kneel, or low kneel, are also great variations to work in a little extra postural demand.
2. Swinging! We often warm up for our feeding sessions by swinging, because it is a great postural challenge for children to try to maintain balance in response to the constant movement. The longer they can swing for, the more endurance they will have to sit at the table!
3. Animal walks and yoga poses that put weight into the arms! Animal walks (ex: bear walks and crab walks) and yoga poses (ex: downward dog and cat/cow) help a child learn to bear weight through their arms and contribute to the development of a solid core to support movement of the mouth and tongue. For an added postural challenge, have your child try to hold the pose on top of a pillow or couch cushion!
4. Add in some dynamic movement! Sitting on top of a yoga ball or wiggle cushion during mealtimes will challenge your child to activate their postural muscles to keep their body stable. It can also help to get them a little extra organizing vestibular and proprioceptive input to help regulate during mealtimes!