Tongue Extrusion Reflex | Important Things You Need To Know

Newborn babies are born with involuntary reflexes.

One of these reflexes is the tongue extrusion reflex.

This extrusion reflex is also known as the tongue thrust reflex, or gag reflex.

A baby’s extrusion reflex prevents him from aspirating breast milk or formula, or choking on solid foods or other foreign objects.

What causes tongue extrusion reflex in babies?

Tongue thrust is a involuntary action in babies.

Involuntary actions, or infant reflexes, are a part of normal development and are crucial to a baby’s survival.

The extrusion reflex protects your baby’s airways. If a foreign object enters your baby’s mouth, the tongue thrusts forward to push the object out of the mouth and away from the airways.

In breastfed babies, the tongue thrust works together with the sucking reflex to help a baby latch effectively to the breast.

You can read more about this in BellyBelly’s article Breastfeeding 5 Months.

Does tongue thrust reflex go away?

As part of your baby’s development, newborn reflexes gradually disappear.

The tongue thrust reflex fades from around 4 months of age. Most babies lose the extrusion reflex by around 6 months of age.

This coincides with the time you begin to introduce solid foods to your baby.

It might take a little longer in premature babies.

You can read more about feeding your baby in BellyBelly’s article Feeding Your Baby From Birth to 12 Months.

Tongue thrust reflex and starting solid foods

The World Health Organisation recommends starting solids foods at around 6 months of age, when your baby is ready for solids.

Your baby is not developmentally ready for solids until the tongue thrust reflex disappears. The extrusion reflex prevents babies taking solid foods into their mouth.

Your baby should also have good head and neck control and be able to sit upright unaided.

Introducing solid foods before your baby is ready, when the tongue thrust reflex is still present, will cause him to push food out of his mouth with his tongue.

Some parents might mistake this for picky eating.

Baby led weaning can help you recognize when your baby is ready to eat solids.

Baby led weaning is when babies are offered soft finger foods so they can feed themselves, rather than fed purees from a spoon.

You can read more about this in BellyBelly’s article Baby Led Weaning | What Is It?

You might worry about your baby’s ability to prevent himself from choking on solid foods after the extrusion reflex disappears. At this stage of development, your baby’s gag reflex will become more apparent. Although gagging can be frightening to some parents, it’s usually not frightening for babies.

A sensitive gag reflex, with the introduction of solids foods, shows that babies are continuing to develop their oral motor skills.

Can a tongue tie affect the tongue thrust reflex?

Underneath your baby’s tongue is a piece of connective tissue called a frenulum.

If the frenulum is very short, thick or tight, it can restrict the full range of movement of the tongue.

Some experts believe that a tongue tie can lead to a prolonged tongue thrust.

A tongue tie can reduce the lateral (side-to-side) movement of the tongue. Tongue thrust is apparent when there is more forward movement of the tongue during swallowing.

Some parents might also worry a tongue tie might affect their child’s speech development.

Interestingly, a 2021 prospective cohort study examining the effect of tongue-tie release on speech articulation and intelligibility found that tongue tie was not associated with isolated tongue mobility related speech articulation errors in a consistent manner, and there was no benefit of tongue-tie release in improving speech articulation or intelligibility.

You can read more about tongue tie in BellyBelly’s article What is Tongue Tie – 8 Facts To Be Aware Of.

At what age is tongue thrust a problem?

If your child’s tongue thrust reflex persists past infancy, seek advice from your healthcare provider.

A persistent extrusion reflex past the age of 4 can sometimes warrant treatment.

Symptoms of a tongue thrust past an appropriate age can include:

• Mouth breathing
• The tongue protrudes between the teeth when in a resting position
• There is a gap between the front top and bottom teeth
• A lisp is apparent on the sounds ‘s’ and ‘z’.

Problems that can occur from a tongue thrust reflex that persists past infancy can include:

• Crowded or crooked teeth
• Difficulty biting, chewing or swallowing
• Elongated face shape
• Breathing and sleep disorders
• TMJ disorders.

Can tongue thrusting be corrected?

In most cases, tongue thrusting that persists past infancy can be corrected.

Orofacial myology is a therapy that helps to correct the placement of the oral structures. Regardless of the age of your child, the treatment is similar.

With regular therapy, a tongue thrust can be corrected over time.

Talk to your healthcare provider if you are concerned about your child’s extrusion reflex.