You sit down to a meal with your baby and lovingly place a picture-perfect plate on the table with two or three different types of foods, camera ready. Next thing you know you’re tossing the camera; your heart has stopped, and you’re prepared for some hands-on support because your baby has filled their mouth to the brim with too much food. You’re sure they’ll choke.
Or maybe you are getting your baby ready for a bath and you notice your baby still has food in their mouth…from the dinner, which was 45 minutes ago.
If this sounds at all familiar, you are not alone! When babies keep the food in their cheeks or put too much in to begin with it’s called food pocketing, food packing, over-stuffing, or shoving. So why do babies do it and what can you do about it?
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What is over-stuffing?
Over-stuffing is just like it sounds — your baby or child puts too much food in their mouth and it interferes with their ability to successfully chew and swallow.
What is food pocketing?
Pocketing food or food packing is when your child holds food in their mouth for an extended amount of time without swallowing. Usually babies and children pocket food in one of a few places:
- Inside either cheek
- In the very front of their mouth
- Against the roof of their mouth
Why do babies and toddlers shove too much food in their mouths?
Babies overstuff their mouth for a variety of reasons:
- They are still learning how much food is too much.
- They enjoy playing and tasting the foods.
- They just don’t know how to take it slow…yet.
Food stuffing is common in infancy and even in toddlerhood. Our feeding specialists report seeing lots of over-stuffing in baby-led weaning infants from 6-12 months, while non-baby-led weaning babies tend to over-stuff from 9-18 months.
Food stuffing seems to be a phase most babies go through and there’s good reason for it! Your baby is learning where everything is inside their mouth. Since they can’t look at the inside of their mouth, they rely on touch sensation and feedback from the muscles in the tongue, jaw, and cheeks. This helps create what’s known as a “map” of the mouth.
Imagine you are chewing a bite of omelet and suddenly crunch into a small bit of eggshell. A number of things happen at that moment.
- You pause and immediately “picture” where that eggshell is located in your mouth.
- You sift around the food in your mouth until you isolate the tiny eggshell.
- You scoop it up and move it back to the front of your mouth with your tongue.
- You spit it out.
- You proceed to finish chewing and swallowing the bite of omelet in your mouth.
This level of sensory awareness within your mouth takes years to hone and is incredibly important to safely chew and swallow all textures of food.
So, how does your baby build a map of the mouth? Biting down against a piece of food which touches multiple points in your baby’s mouth at once (i.e., the tongue, gums, roof of the mouth and the lips) helps your baby relate each of these areas to one another. In fact, the bigger, firmer, and more flavorful the piece of food, the more input it gives your baby. So, when your baby stuffs too much food in their mouth, they tend to get a really clear “picture” of what’s going on inside their mouth. Yes, it can be scary and risky, but it has a purpose!
What should I do when my baby puts too much food in their mouth?
There are two elements to consider when baby stuffs their mouth with too much food: helping in the moment and helping long-term.
How to address over-stuffing in the moment:
- Stay calm. Take a deep breath and be patient. You don’t want to scare your baby and, while it may feel like an emergency, it is not.
- Talk to your baby. Calmly tell them, “That’s a little too much in your mouth, let’s spit some out.”
- Coach to spit. Encourage your baby to spit out the food. In an exaggerated manner, spit out a small bit of your own food with your tongue, and hold your hand in front of your baby’s mouth, ready to catch their food.
- Clear the food from the tray. Make sure your baby does not continue to put more food in their mouth.
- Use gravity if needed. Lean your baby forward gently so gravity can help them spit out the food. If your baby pushes back against you, kneel down in front of them to encourage looking down, which again allows gravity to help them spit out the food.
- Do not finger sweep or try to remove the food. Let your baby work it out. If over-stuffing turns to pocketing (where your baby isn’t moving the food around at all and instead storing it in their mouth somewhere) use the strategies described below to get that food out of their mouth before leaving the table.
How to address over-stuffing long-term:
With all things feeding, you want to keep the long game in mind. The long-term goal is to raise an independent, healthy, happy, confident eater.
- Eat with your baby. Babies love to watch and learn. Help them quickly get past the over-stuffing phase by sitting down and eating together. They will watch and learn from you!
- Talk to your baby. Every time you see your baby starting to over-stuff, tell them: “That looks like a lot of food in your mouth. Finish that bite first.” Or: “Slow down, you have too much in your mouth.”
- Let them investigate. Once your baby spits out the wad of food, don’t take it away! It may seem gross, but looking at it, touching it, and even allowing your baby to pick it back up and try again can be extremely valuable learning. You can point to the mass of food and say: “See, that was too much. Take a smaller bite.”
- Go big! Around 9-12 months old, your baby is likely chewing better and knows how to spit out food, if needed. Start coaching them to take bites off larger pieces of foods. Babies around 9-12 months old love to pick up small pieces of food and practice their pincer grasp but dicing foods into small pieces at every meal for 9-24-month-old babies denies them the chance to practice the important skill of taking a small bite from a large piece. As always, show them how it’s done. If your baby needs support, hold softer foods at the front of their mouth for front teeth to bite through, or teach them to use their molars with more resistive foods, like meat, where they will learn to bite, hold, and pull.
It can be tempting to try to prevent over-stuffing by only putting one bite at a time on your baby’s tray. However, we don’t recommend this since there are some benefits to over-stuffing and it’s not a long-term solution. Regardless, your baby will likely go through a phase of over-stuffing once you stop limiting the amount of food on the tray.
Why do babies and toddlers pocket food in their cheeks or mouth?
There are a few reasons why a baby or toddler might pocket food or hold food in their mouth without swallowing. The most common reason is simply lacking the sensory awareness and/or tongue coordination to fully chew and swallow certain foods. Instead, they chew or suck on the food, and pocket it.
Some babies may accidentally pocket food, or the food moves to a place in the mouth where the baby can’t quite get it back out. Other babies are purposeful in their pocketing — holding the food in the same spot every time because they don’t feel confident about safely swallowing.
Just like over-stuffing, food pocketing is often totally normal in 6-12-month-old babies as they map and learn the boundaries and spaces of their mouth. Pocketing should happen less as your baby builds the “map” of their mouth and develops the tongue coordination and jaw strength to successfully chew and swallow foods. It’s very possible to see pocketing beyond 12 months, particularly with challenging-to-chew textures.
Is food pocketing dangerous?
Well, sort of. Any time food is held in the mouth for an extended period of time or the mouth is so full of food that it can’t be fully chewed, there is increased risk of choking.
Over-stuffing the mouth may look more dangerous and scarier to a parent because you can see it. Pocketing can seem less dangerous possibly because it’s not as obvious and easy to miss. However, food pocketing may be more concerning than over-stuffing. The longer the food sits in your baby’s mouth, the more likely your baby or child will have moved on to something else, potentially unsupervised and forget all about the food, which is a serious choking risk. Pocketing also carries a significant risk for tooth decay and cavities as food sits for an extended period of time against your child’s teeth.
What should I do if my baby or child pockets food?
If your baby or toddler is frequently pocketing food and storing it in their cheeks like a chipmunk, you will need to address this in the moment to get the food out of their mouth and help them break the habit over time.
How to address food pocketing in the moment:
- Watch your baby closely. If, after a minute or so of chewing, they have not swallowed, remind your baby to swallow the food. You can show “swallow” by swallowing a bit of your own food (or drink) while running your hand from your lips, along your throat, and down to your stomach.
- Coach your baby. If demonstrating swallowing doesn’t work, tell your baby, “You can spit that out,” and show how it’s done in an exaggerated manner. Spit out a small bit of food with your tongue while holding your hand in front of your baby’s mouth to catch the food.
- Offer a drink. If coaching doesn’t work, offer a small sip of water, breastmilk, or formula to drink. You are trying to help wash down the food and clear the mouth. Ideally, offer an open cup rather than a straw cup. An open cup allows liquid to enter your child’s mouth right at the front to clear all areas. When we sip from a straw, the liquid enters the mouth further back and may miss the food if it’s sitting towards the front of the mouth.
- Carefully remove the food. As a last resort, if the above steps do not work, you will need to help your baby get the food out of their mouth. This should be done with extreme care, as any time you put your fingers or an object in your baby’s mouth you increase the risk of pushing that food back into their throat, which is a significant choking risk. However, leaving food to sit in your baby’s mouth after a meal also increases the risk of choking. You can clear the food with your finger or with a toothbrush. Either way, you want to first know where the food is sitting in your baby’s mouth, so try to look by asking them to open up. Carefully go into your baby’s mouth along the side (the inner cheek), not in the center of their mouth, and sweep the food out.
How to address pocketing to break or prevent the habit:
- Build awareness. You want to help your baby or toddler build sensory awareness within the mouth, as well as develop tongue coordination and jaw strength to chew food and move it back to swallow. This comes with lots of practice eating both easy and challenging-to-chew foods. Long, unbreakable stick-shaped foods are ideal for this: 1) Beef or pork ribs with most of the meat cut off and all gristly or loose bits removed; 2) mango pits with most of the fruit cut off; 3) Corn on the cob with most of the kernels cut off. All of these are extremely difficult, if not impossible for a baby or young toddler to bite through. However, gnawing or sucking on these foods build strength and coordination in your baby’s jaw and tongue muscles, while also giving lots of sensory input to the jaw, gums, tongue, and roof of the mouth. This helps build that mental “map” of the mouth! Your baby won’t get much nutrition from these foods, so consider them exercises for your baby’s mouth.
- Keep it easy. When it comes to actually chewing and swallowing foods, your baby may pocket less with soft, well-cooked foods. Dry textures (like bread or chicken without sauce) may be challenging. Avoiding dry foods for a few weeks can help your baby practice chewing and moving food back to swallow, rather than develop a habit of pocketing challenging-to-chew or dry foods. In a few weeks, try again with more challenging foods.
- Pump up the flavor! Offer your baby lots of foods with slightly tart or sour bright flavors: oranges or lemons, mashed blackberries, marinara sauce, and tangy yogurt are all examples. These types of foods “wake up” the muscles of mouth and lead to increased saliva flow, which prepare your baby to swallow.
- Regular tooth brushing. Brushing your baby’s gums, teeth, and tongue twice a day also “wakes up” and helps to “map” the mouth.
- Talk to your baby. Share what you see: “That bite is really chewy. There is still food in your mouth. You need to keep chewing and then swallow.” Or, “You need to keep chewing that bite and then swallow it.”
When should I seek support for pocketing or over-stuffing? Who can help me with this?
It may be time to seek support if:
- You are regularly finding food in your baby or toddler’s mouth half an hour or more after meals.
- You have tried the strategies above for a month or so and are seeing no progress.
- Your baby is over-stuffing and pocketing at every meal with all types of foods.
Discuss options with your pediatrician. You can find support with an occupational therapist or speech therapist who has expertise in pediatric feeding, eating, and swallowing.
Kary Rappaport, OTR/L, MS, SCFES, IBCLC