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While much of the guidance out there is regarding how to teach toddlers how to spit out toothpaste after brushing their teeth, there’s no need to wait until a child is 2 or 3 years old to start practicing this skill. As soon as you start brushing a baby’s gums and teeth, you can also start teaching baby how to spit.
Spitting has many meanings around the world, with positive or negative associations depending on your culture, but consider this:
Learning how to spit can be a life-saving skill for babies and toddlers.
Infants are naturally driven to explore by putting things in the mouth. Their fingertips, lips, and tongue are highly sensitive and provide the curious brain with information to help babies make sense of the world. While we want to encourage baby to explore, we know that infants do not discriminate. Spitting can protect baby from choking on food and other objects that they put in their mouth. It also help minimize the likelihood that baby will unintentionally swallow an unsafe object, like batteries, water beads, or magnets. This is why it is a good idea to teach baby how to spit and create plenty of opportunities to practice.
Around 6 months of age, baby is ready to explore solid food and build complex new skills, like taking bites and chewing. As they practice, there will be many instances where they aren’t quite able to thoroughly chew food. In these moments, spitting is an important safety move and reinforces the trial-and-error effort that baby needs to make in order to learn how to chew.
Around 9 months of age, babies typically develop the pincer grasp—the ability to use the tips of the thumb and pointer finger to pick up small objects. This developmental milestone has many benefits at mealtime and in life, but it can get baby into trouble when they encounter choking hazards or dangerous items on the ground.
As the pincer grasp develops, baby is likely to pick up and put in the mouth non-food choking hazards that spark their curiosity, including batteries, coins, pebbles.
Don’t think this is likely to happen? In our many years of clinical experience as a multidisciplinary team of licensed pediatric professionals, we have surgically removed pennies, batteries, paper clips, and more from many a child’s esophagus—and helped rebuild their eating skills after the traumatic experience.
In fact, it happens to nearly everyone: baby is curious about an object, grabs the object, and puts the object in the mouth. This will happen when you least expect it, and in that moment, baby needs to know how to spit. Although an adult’s natural instinct might be to get the object out of baby’s mouth themselves, putting your finger in baby’s mouth may actually make the situation worse, pushing the item further back in the mouth. Encouraging spitting is the safest way to get something out of a baby’s mouth.
Good news: most babies around 6 months of age are primed to learn how to spit out as they explore solid food that needs to be chewed.
At this age, babies begin to spit by using their tongue. Babies are born with a reflex (the tongue thrust) that makes the tongue stick out whenever something touches the tongue or front of the gums. Baby’s tongue thrust reflex tends to fade between 4 and 6 months of age, and by this point the movement has become so familiar that the muscle memory tends to stick. This is why, as babies are introduced to solid food, they reflexively push out food with the tongue. This is also how a baby begins to learn how to spit out food and other objects. And this is why we encourage a feeding approach that introduces finger food as soon as baby is showing signs that they are ready to start solids.
Positive reinforcement and practice are key. When you see baby moving a large piece of food around the mouth, try this: Hold your cupped hand under baby’s chin and then say, “Spit out.” Baby may not understand the words, but inevitably the tongue thrust reflex will cause them to spit. When this happens, praise them with a smile and say, “Thank you!” when the item falls into your hand. If you do this consistently, they will begin to connect the dots and learn that when you say, “Spit out” and hold your hand under their chin, they need to spit out whatever is in the mouth.
Occasionally babies between 5 and 7 months of age have a very weak tongue thrust as they start solids. This is normal and not a cause for concern. Usually these babies tend to learn very quickly how to chew and swallow foods, and they do not naturally practice spitting out food.
For babies who are spoon fed, or who only eat mashes and purees from 5 to 6 months of age, the tongue thrust reflex may also no longer be present when finger foods are introduced. When you start with purees and mashes, baby practices over-riding the tongue thrust pattern by moving the puree back to be swallowed.
In these instances, baby may not naturally spit out food at first. After a few weeks, if baby is not naturally spitting out food, you may need to actively teach baby to spit.
Model how it’s done. While away from the table, stick out your tongue, pause, and wait for baby to imitate you. They may not do it at first, but the more opportunities for mimicking, the better. If baby does not imitate you at first, you can also try gently tapping their lower lip as you stick out your tongue.
Be dramatic. Exaggerate putting something in your mouth and spitting it into your hand dramatically by opening your mouth, leaning forward, and allowing the food to fall out as you also push it out of your mouth with your tongue.
Make it a game. Get a clean washcloth or lovey, then put a corner of it in your mouth, bite down, and shake the cloth in front of baby. Wait for them to reach out to touch or grab it. When they do, let go and laugh. Try again, making a game out of the activity. Each time they pull on the cloth, dramatically say, “Blah!” and stick out your tongue to mimic spitting. Try to play this game in reverse: let baby put the cloth in their mouth and as you gently pull on it, say, “Spit out!” to encourage the mouth to open and release the cloth.
It can take months of practice for baby to become an expert spitter. Do not give up. With consistent modeling and practice, the child will figure it out.
Even with lots of modeling and practice, there will likely be a time when baby takes a too-big bite of food or puts an object in the mouth that shouldn’t be there. When this happens, follow the steps below
Stay calm. Take a deep breath and be patient. You don’t want to scare baby and, while it may feel like an emergency, it is not. Babies can manipulate even big pieces of food in their mouth. And they can safely swallow them whole. If they don’t spit, try not to assume the worst.
Clear the food from the tray. Make sure baby does not continue to put more food in their mouth.
Kneel down in front of baby. As they look down at you, their head tilts forward. This movement puts gravity on your side.
Use gravity if needed. If baby doesn’t lean forward to look down at you, help them by placing a hand on their back and gently pushing them forward so gravity can help them spit out the food. If baby pushes back against you, stop trying and kneel down in front of them again to encourage them to look down.
Talk to baby. Calmly tell them, “Too big. Spit out.” Even if baby doesn’t have the language to fully understand or respond to your words, talking both helps baby associate the word “spit” with the action that you’re practicing, and your calm tone helps reassure baby if they’re uncomfortable or upset.
Place your hand under baby’s chin. This simple tactile cue, especially when baby is looking down at you, can encourage them to open their mouth and stick out their tongue.
Stick out your own tongue. Encourage baby to spit by sticking your own tongue out in an exaggerated way. You can even add a sound effect: “Ahhhh.” You can also spit out a small bit of your own food with your tongue to demonstrate. As you model how to spit, keep your hand under baby’s chin as a tactile cue. If baby laughs as you are modeling, read our "What if baby laughs at me when I model spitting?" section below.
Do not try to remove the food. When done improperly, trying to manually remove the food from baby’s mouth yourself can actually greatly increase the risk of choking. Let your baby work it out. If over-stuffing turns to pocketing (when baby stores the food somewhere in their mouth), try our strategies to get the food out of their mouth before leaving the table.
Practicing the cup-under-chin spitting technique with Maeve (7 months)
If baby has a piece of food or object in their mouth that concerns you, your first instinct may be to force baby’s mouth open and try to pull it out. Don’t do this. Putting your fingers in the child’s mouth in this scenario can dramatically increase the risk of choking, as it can not only scare the child, but can also unintentionally push the object or food further back in the mouth. However, if you are certain the child needs help (and if you are sure that the child is not gagging or choking), you can perform a finger sweep.
If a child is incapable of spitting out a dangerous object or piece of food and is in distress, there may be a need to perform a finger sweep. It is important to understand that if finger sweeps are not performed correctly, they can actually increase the risk of choking by inadvertently pushing food further back in the mouth, so read the following steps carefully.
How to do a finger sweep safely:
Track your finger along the inside of the cheek toward the back of the mouth.
Hook your finger, and sweep the finger forward and out of the mouth.
NEVER put your finger directly (straight) into a baby’s mouth—this significantly increases the risk of choking, as you will likely push the item backwards.
The same recommendations for babies apply for toddlers: model how it is done and create lots of opportunities for practice. A big difference: toddlers may have more ability to understand and follow directions, so you can give more nuanced coaching like demonstrating how food naturally falls out of your mouth if you just open it and tilt your head forwards.
Unfortunately, toddlers are also more likely to find dramatic spitting demonstrations funny and may try to do everything they can to continue to pocket the item in order to keep the “game” going. Remain calm and be direct, especially if the item in the mouth is unsafe: “Open mouth. Not safe.”
The first step is to model spitting yourself. Young toddlers naturally try to imitate what they see others do around them. It may be logistically tricky to set the child up in a safe position to watch you brush your teeth, but it can be done. Try holding them on your hip as you brush your own teeth, for example. Let them watch you as you brush and then spit out the foam. Make the spitting dramatic by smiling at the child with an open mouth full of toothpaste foam, then lean toward the sink and make a silly noise like “pitooy” as you spit into the sink. Interestingly, the “p” and “t” sounds are quite similar to the mouth movements for spitting. Alternatively, you can lean your head forward and open your mouth wide to show that all it takes is gravity and an open mouth to pull the saliva and toothpaste out and into the sink.
Many young toddlers will naturally follow your lead and begin to wrap up their own toothbrushing routine with a dramatic “pitooy!” and pretending to spit. Once they start to do this, or once they have seen you model this many times, see if they can imitate you by spitting a small bit of water. Take a tiny sip from a cup and then lean forward, open your mouth and let the water dribble out into the sink, then let the child try. As they get older, you can use phrases like, “Spit it out” and “Spit into the sink, please” to coach, but at first, your actions will help guide them more clearly than words.
Around 6 months of age, babies often push food out of the mouth with their tongue. This is called the tongue protrusion reflex or tongue thrust.
The tongue thrust is a reflex that causes baby to stick their tongue out when the tongue is touched in certain ways. While this reflex begins to disappear around 4 to 6 months of age, muscle memory is strong, and baby has minimal experience moving the tongue in any other way. This is why many babies will naturally push food out of their mouth, even without you teaching them how to do so. You can take advantage of this motor pattern to establish spitting as a purposeful, functional skill.
The challenge, however, is that many babies first experience chewable food after the tongue thrust naturally disappears, which occurs around 4 to 7 months of age. This is why teaching baby how to spit is so important.
Baby may find it funny when you stick out your own tongue to demonstrate spitting. If baby just laughs at your coaching, stop modeling the behavior and just keep your hand in front of their chin and wait for them to stick their tongue out. In this moment, there’s not much else you can do but be patient. Know that if you continue to calmly coach them and refrain from giving big reactions, baby is likely to practice and learn the skill eventually.
There are actually many benefits to letting baby inspect and eat the food they just spit out. Baby is learning how their mouth works and how to manipulate food, and since they can’t look inside their own mouth, observing food they’ve chewed and spit out can be a valuable part of the learning process.
Looking at a piece of spit-out food can show baby how broken down the piece is, and baby’s brain connects that visual information with the feeling of the food in their mouth. Putting food back in the mouth to try chewing it again allows them to further connect the dots: what does this food feel like in their mouth now? Is it broken down enough to swallow yet?
Some babies do this repeatedly, while others do it only occasionally. Both are normal. And many toddlers as old as 2 or even 3 years of age use this clever strategy with more challenging-to-chew foods.
If you know that a child has a problematic object or piece of food in their mouth and they refuse to even open their mouth, the first thing to do is stay calm. If you continue to insist the child opens their mouth, they will likely refuse even more adamantly. Offering an empty spoon to baby may encourage them to open their mouth to put the spoon inside, thereby giving you an opportunity to see where the object is. Alternatively, you can try gently tapping on their chin while kneeling next to them. You can also try leaning them forward, so gravity is helping to keep the item forward in the mouth.
While you may have heard that pinching or plugging a child’s nose can get them to open their mouth in a situation like this, doing so also increases the risk that they will forcefully inhale through their mouth, moving the item closer to their airway, or worse, causing the child to choke. If any of the child’s caregivers or family members do this, tell them to stop immediately.
This is a common behavior in babies and toddlers. See our strategies for what to do when a child holds or pockets food in their cheeks, the roof of their mouth, or anywhere else in their mouth.
The first thing to try is offering a dry, empty spoon for baby to suck on. The sucking motion can help dislodge the food and allow baby to either try to chew and swallow the food again or spit it out. You can also offer a small sip of water from a straw to see if that helps. If baby is not interested or not willing to take the spoon, you may need to do a finger sweep. See how to safely performing a finger sweep, but focus your finger on the palate area rather than the inside of the cheek.
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