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Tongue Protrusion in an Infant

Robert Mason Dmd, Ph.D

June 22, 2009

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Question

My daughter is now 9 months old, and since birth she came out sucking her tongue with a little of it sticking out. At first I wasn't concerned and thought it was cute. But now at 9 months old she still does it; occasionally she'll completely close he

Answer

While this is a somewhat unusual habit that your daughter has developed and maintained, protrusion of the tongue is a universal finding in newborns that can persist in infancy as a habit. At age 9 months, it may be related to some delay in the oral maturation process, or may possibly suggest an issue with the size of her nasal cavity or posterior airway (the pharynx). Tonsils and adenoids can be observed shortly after birth and may enlarge faster than surrounding structures of the pharynx. If the developing tonsils or adenoids are enlarged in a small pharynx, this could account for the tongue being positioned forward to maintain the airway. Your pediatrician can evaluate for this. At this point, there is no tongue brace or any appliance that would be suggested. Whether or not your daughter outgrows the tongue protrusion pattern remains to be seen. If the protrusion does not resolve spontaneously over time as the oral cavity and pharynx enlarge and as oral functions mature further, therapy can be provided for retraining the rest posture of the tongue many years in the future; most likely around age 5 at the earliest. For the present, I would not worry about your daughter ending up with a deformity of her dental arches or lips. I do suggest that you express your concerns to your pediatrician who can monitor this situation and provide continuing advice.

Robert M. Mason, DMD, Ph.D. is a speech-language pathologist (CCC-ASHA Fellow), a dentist, and orthodontist. He is a Past President of the American Cleft Palate-Craniofacial Association, a professional, interdisciplinary organization specializing in problems associated with facial and oral deformities. Dr. Mason has studied and written extensively about orofacial examination, developmental problems related to the tongue, and the anatomy and physiology of the speech and hearing mechanisms. His reports have appeared in speech, dental, medical, and plastic surgical journals and texts. He is considered to be an expert in tongue thrusting, tongue tie, and other problems related to tongue functions and speech.

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