"Have you ever noticed that newborns, usually under 4 to 6 months of age, thrust their tongue or extrude it if any foreign object, like a spoon, touches or presses against it? This is a normal phenomenon known as extrusion reflex and it protects babies from ingesting any foreign objects inside, and it also helps them latch onto a nipple. To put it simply, it is a way babies of this age selectively choose only the nipple or bottle for feeding." Since the muscles are not yet developed enough to handle solid foods, babies rely on this reflex to avoid solids and only accept liquids.
After 4-6 months of age, the extrusion reflex disappears, and that is how babies learn to wean from the nipple or bottle and start trying solid foods like purees, softened table foods, etc. Problems arise when they continue to display this reflex for a longer period, leading to issues with solid food intake and other problems such as teeth misalignment, delayed speech, and in some cases, lisping.
"When should we start introducing solid food? Experts recommend starting when the child weighs approximately 6 kilograms or when they can hold their head up and sit in a high chair, usually around 6 months of age. Additionally, when attempting to feed, the child should open their mouth, and when the spoon is withdrawn, their lips should close inward. If the child struggles with solid foods even after achieving this milestone, wait a week before trying again. Extrusion reflex typically fades after 6 months of age. It's also important to consider premature babies; solid foods should be introduced based on their corrected age. For instance, if a child is born 3 weeks prematurely, this reflex is expected to disappear around 6 months and 3 weeks."
Dr. Madhavi Bharadwaj, MD, a pediatrician, took to Instagram and shared her opinion in a video about the extrusion reflex from her Instagram handle, @bacchon_ki_doctor.
In the video, she describes that recently, a grandmother from the outskirts of Kolkata contacted her regarding her 3.5-year-old granddaughter, who consumes everything in puree or liquid form, including ground rice resembling a liquid and biscuits in milk. They have modified the bottle's nipple to accommodate this feeding method. The child is habituated with this feeding habit that even small solid foods trigger vomiting in the child.
Dr. Madhavi explains that infants typically exhibit an extrusion reflex from birth to 6 months, causing a gag reflex when solid foods reach the pharynx, serving as a protective mechanism. However, as babies begin mouthing objects, this reflex gradually diminishes, allowing for the proper swallowing of solid foods around 6 months of age. In some cases, infants may have an extended extrusion reflex, as seen here, where the child has been exclusively fed liquids such as pulses and rice in water, reinforcing this feeding pattern. This habituation to liquid feeding poses challenges when introducing solid or textured foods, often resulting in vomiting.
Dr. Madhavi suggests not reverting to liquid consistency but rather progressing forward. Despite food rejection, offering both purees and denser foods, along with finger foods, encourages self-exploration and aids in overcoming the fear of solid foods, ultimately facilitating their consumption. Conversely, perpetuating liquid feeding inhibits the development of proper swallowing techniques. If unsure, seek guidance under a doctor's supervision, but avoid feeding porridge or biscuits in milk through a bottle.
References:
1. https://www.healthline.com/health/parenting/extrusion-reflex
