How can we support babbling and early speech development? SLT tricks and tips

ByLondon Speech and Feeding May 3, 2024May 3, 2024

My baby isn’t babbling and developing speech – what can I do to support?

While every baby develops at their own pace, if your child isn’t babbling by nine months, it’s worth seeking help from an Early Intervention Health Professional, such as a doctor and a speech therapist. Don’t panic! There are many reasons for delayed babbling, and early intervention is key.

In the meantime, it is highly recommended that we talk, sing, and read to our baby often. Exaggerate sounds and expressions, and respond to their coos and smiles. This playful interaction helps stimulate their communication skills.

Below are some tips and tricks from my experience of working with babies and toddlers who need a little bit of help and support to develop.

The benefits of imitating your baby

Copying your baby’s sounds and gestures isn’t just silly fun, it’s a powerful learning tool! By mimicking their babbles and actions, you activate “mirror neurons” in their brain that help them connect sounds with meaning. This playful back-and-forth teaches turn-taking, a foundation for conversation. Plus, it encourages them to copy you, building their own language skills and social interaction abilities.

This is a nice clip on youtube showing how copying/imitating your baby looks like:

Here are some fun ways to imitate your baby:

Matchmaker: Grab two of the same, or two similar toys your child loves, like rainmakers or shakers. Give one to your baby and keep the other for yourself. When your child plays with his/her toy, mirror his/her actions with yours! This creates a fun, interactive game.
Face Time: Get down to your baby’s level, sitting opposite him/her on the floor or kneeling. This makes eye contact easy and encourages him/her to look at you during your playful imitation.
Be the Funniest You: Go all out with silly faces, exaggerated sounds, and big gestures. The goal is to capture your baby’s attention and make you irresistible to watch. This playful energy encourages him/her to interact and potentially imitate you back!

By incorporating these tips, you can turn imitation into a fun and engaging way to boost your baby’s communication skills. I have seen this happen numerous times over the past decades. It is very powerful, go ahead and try it! You cannot be silly and goofy enough!

Great toy ideas:

Organza Veil Fabric good for hide and seek

Bubbles – always handy keep in every room

Antic Duck Peekaboo Knob Puzzle Suction Cup Spinner toys

Did you know that speech and language development starts with how we talk to our babies?

Adults naturally use a special way of speaking called motherese. It involves a higher pitch, slower pace, and exaggerated sounds compared to regular conversation. Sentences are simpler, with shorter words and repetition. This grabs babies’ attention, helps them distinguish sounds, and reinforces word meaning.

Imitation is a key part of motherese. We wait for our baby to make a sound or gesture, then playfully imitate it with exaggeration. Babies notice this right away and often respond with more vocalisations, creating a mini conversation. This back-and-forth teaches turn-taking, a foundation for future conversations.

By responding warmly and engaging in these playful interactions, we encourage our babies to keep exploring the world of communication. Talking, singing, reading and, of course, imitating, these simple actions can have a big impact on a baby’s language development.

Once your conversation is underway then try and keep it going for as long as possible. It’s a beautiful dance of turn-taking, even without words!

A last word on oxytocin

There’s evidence suggesting early non-verbal communication with your baby can increase a mother’s oxytocin levels, often called the ‘love hormone’. This hormone plays a key role in bonding and social connection. Positive interactions, touch, and stress reduction all contribute to oxytocin release, strengthening the mother–baby bond.

For parents of babies with extra needs

The stress of caring for a child with medical needs or developmental delays can be difficult. Stress can lower oxytocin levels, creating a cycle of sadness for both parent and child.

Breaking the cycle:

Knowledge is Power: Understanding the importance of communication can empower parents.
Seek Support: Speech therapists and other healthcare professionals can provide valuable guidance on communication strategies.
Start Small, Celebrate Big: Even small interactions can boost oxytocin. Focus on playful imitation and positive reinforcement. Remember, friends, family and healthcare professionals are there to encourage you.

This approach can help reverse the negative cycle and create a more positive and connected relationship between parent and child.

I hope this is helpful! Don’t hesitate to reach out with any questions.

Kind regards

Sonja McGeachie

Early Intervention Speech and Language Therapist

Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

The London Speech and Feeding Practice

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

Toys

Toy rotation – A good idea?
ByLondon Speech and Feeding April 26, 2022January 29, 2026
Here is a very commonquestion/request that I get from most parentsI see: ‘Help! My childhas lots of toys!In fact we have so many toys we couldopen a shop but , alas, he/shedoesn’t play with anything for longer than a minute, even less than that! What can I do?’

My short answer to this is always: consider tidying most of the toys away and ROTATE them! This is my top tip for helping your little one sustain interest, focus, curiosity and creativity. Let me explain…

First up, I am not suggesting you sell all his/her littlegems on E-Bay (although…. ☺ ok let’s not go

there for now). NO, I simply recommend that instead of having ALL the toys out in the living room and all across the home, you put them into categories and groups and you pack them into boxes or containers so that you can find whatever you are looking for easily. So, all the construction toys – Lego’s magnetix, blocks etc go together; all vehicles, all animals and animal related items, etc etc you get the idea. (I am not suggesting you need to do a whole KONMARIon everything, (thoughto be honest I do think personally there is merit to her approach but I digress).

It works a treat not having ALL toys available at all times. Let me quickly tell you a little story about my childhood which may sound draconian to most of you, but we are talking late 50’s now in post war Germany….. What happened in my and many families for Christmas was this: your dolls house or railway tracks – and I am talking industrial tracks with electricity and proper little trains, your little shop or dolls-kitchen, all of it came down from the attic and was put up over night by one’s dad or uncle in possession of a screwdriver and some DIY skills, in readiness for the big event, this being the 24th of December, the Holy Evening. We children knew this, of course, and started talking about seeing our beloved toys again for Christmas and the period thereafter until about the 6th of January. We couldn’t wait to play with our toys and it was total bliss and happiness for about 4 weeks where we literally played day and evening with those toys. (We did get some new ones as well to be fair, but I cannot remember any of the new ones.) All that I now remember, in great detail and fondness, was my shop, my kitchenette (Victorian, splendid!), my dolls house and my cousin’s most fabulous intricate railway track. All of our toys occupied the entire basement of our home and this was where we played and played and played. Until the 6th of January. Oh yes… that was always a sad day of course when everything was packed away until…..December!!!! yep…. I vaguely recall there being a ‘special day-out’ with little treats arranged for us all and whilst away, the toys were taken up into the attic.

Like I say, it may seem somewhat outdated as an idea…but I actually am so glad I had that experience because I believe it has helped me with my language learning, my imaginative play, my ability to share and play with others, attention focus and last but not least it helped me learn to value my toys and appreciate the things I have more deeply than would otherwise have been the case (no research there, just my opinion).

Now I am not suggesting you do this, and indeed I never did this with my own kids either (I don’t have a large basement for starters)…. But I did rotate their toys quite a bit, inspired by the basic notion of my childhood experience.

The benefits are obvious if you think about it: apart from greatly reducing clutter at home, there are so many benefits of toy rotation for children. Just like us, children often find too many things all lying about unsettling; and especially our children with sensory processing difficulties can lose their sense of ease and calm very easily when overwhelmed by too many toys on offer. This is when they become restless and start roaming from one toy to the next without any focus or functional play. Additionally, just like adults, kids get bored with having the same toys or playing the same games, of course!

Anything that we always have available is by definition no longer novel or interesting.

Children who struggle to attend and listen due to developmental delays perhaps, or neuro-diverse development, possibly Attention Deficit or other diagnoses, have an increased tendency to roam, pick up and discard items as they often get distracted so very easily.

I recommend selecting a small range of toys for one week to start with. Ease your way in! Nothing is written in stone, it is not an exact science, rather more an intuitive strategy of picking what feels right for your child. If you have bags or boxes of small toy categories, as described earlier, now it becomes quite easy to decide on what toy groups to bring out.

I will give you an example – you could think of it as a TOY DIET!… so, like a food diet, you think of your food groups that you need daily and you put a menu together that has one of each group; however most of us don’t have the exact same foods everyday, we vary it so it’s a nice, healthy and enjoyable balanced diet. The same with the toys, so for instance:

Toy Rotation ‘Diet’

Week 1
- Construction Group: Legos/ Duplos (not a ton, but a nice amount so you can actually build something)
- Puzzles: Animal Farm Puzzle Vehicles: Cars and the Car Run
- Action figures: Mr and Mrs Potatoe head Musical Instruments: Cylophone
- Mark-making: Bunch of crayons/paper plates
- Books: I wrote to the Zoo/ Hungry Caterpillar
Week 2
- Construction Group: Train tracks
- Puzzles: Rainbow puzzle
- Vehicles: Trains and Planes
- Action figures: doll house figures
- Musical Instruments: Drum set
- Mark making: Bingo daubers and fun bingo sheets
- Books: Bear Hunt/ Rainbow fish
Larger Toy Items

Don’t worry about rotating those: they can be a steady back-drop to the category items your child has available: today/this week it might be animals feeding in the kitchen. Next week it might be action figures or Mr and Mrs Potatoe Head. The following week, there might be playdough out so then that can be used in the kitchen together with some Paw Patrol figures, etc. Like I said: most of us do not have a handy and empty basement or attic to store away large amounts of stuff so we do need to be pragmatic.

Tidy Up

This is often simply too overwhelming for children and the best they can do, if you are very lucky, is to throw everything into one big box, which is not what you want!

However, if you have 4-5 clearly labelled boxes for each category, now Tidying up can become a nice little activity in and of itself. Example: let’s put all the cars into the red car box, let’s count how many cars we have! Let’s see if we can find all the cars that I have hidden and then put them into the red car box! Let’s see what colours our cars are as we tidy them away…..endless possibilities for a little language development as well as a tidy bedroom, you can see this is a WINNER! You’re welcome! ☺

How To Prepare

Should you ask your child for permission to rotate their toys?… Erm… no! I think that would be like asking your little sweet-toothed cherub if she minded having the 5th ice-cream taken away… we know the answer to that one! Just decide on it, get your boxes organised, perhaps a cabinet bought or made – Ikea do simple ones – and then one day when your child is out, or in bed, you can start collecting all the toys and sifting through them – you might even want to weed out a few as you realise they are broken, bits are missing, that one scratches the floorboards, that one makes too loud a noise…etc… and then hurrah ! You are left with a load of toys that are brilliant and good for rotating. Let the fun begin!

Electronics

A last little note on ELECTRONIC TOYS – they are, in my humble opinion, fiendishly attractive and all-consumingly fascinating for little ones…and they are mostly counterproductive to creative play. Children who are prone to repetitive behaviours, repetitive play and reduced attention span will often focus on these beeping, singing, pinging toys to the exclusion of everything and everyone else around them. This may not really be great for your child if he/she is struggling to jointly attend with other children or yourselves; or if your little one has sensory processing difficulties or lacks imaginative play.

I would highly recommend that you reduce those electronic books/toys to a minimum and only bring them out very occasionally, preferably when you yourself need a little break! The same goes for the television, laptop and tablet of course! Please consider REDUCING or entirely REMOVING all electronics from your toddler if you would like to help your child to play, to focus on a range of toys and to build their creativity and joint attention.

Summary

Rotating your child’s toys is a fantastically useful strategy that will help your child develop focus and play more independently, while also helping you reduce clutter in your home.
- Simply make sure a good range of toy groups are available at any one time.
- Carefully select only a few items of each group.
- Don’t worry about rotating big toys. These toys providea great back-drop for your child’s creative play, almost as part of the furniture.
- Keep the toys that are having a little breakout of reach and, if possible, out of sight. Out of sight is usually out of mind and therefore your child will be able to enjoy what is in front of them and not pester you all day for the thing they cannot have.
- Think LESS IS MORE! There are no strict rules on how many items you can have out, but on average I would recommend one or two per category at the most.
- Try to keep to a regular rotation and to make sure they have time to really explore their toys fully. Once a week is a good place to start.
- Reduce/eliminate electronic toys – This is so important!
- Trust and relax knowing that you are helping and facilitating your child to really enjoy their toys, and to deepen their creativity and focus.
Let me know, drop me a line and tell me how you are getting on with this. I would love to know!

🙂

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
READ MORE Toy rotation – A good idea?
Autism Therapy · Feeding · Neurodiversity · Speech and Language Therapy · Top tips

Managing mealtime sensory overload at holiday gatherings: Supporting children with allergies and feeding differences
ByLondon Speech and Feeding December 17, 2025December 16, 2025
Holiday meals are meant to be joyful and something we all look forward to. But for many children and their families, these occasions can be overwhelming and be the cause of dread and worry. The combination of new smells, unfamiliar foods, loud environments, social expectations, and allergy anxieties can quickly turn what should be a festive time into a stressful one.

For parents of children with sensory processing differences, selective eating challenges, or food allergies, holiday gatherings often require careful planning and a big dose of tolerance and compassion. The good news is that with awareness and a few gentle strategies, you can support your child to feel safe, regulated, and included during festive meals without pressure, tears, or discomfort.

Let’s explore how to make holiday mealtimes calmer, safer, and more connected this season.

🎄 Why holiday meals feel so overwhelming

Holiday gatherings usually combine several sensory triggers all at once:
- Noisy, chaotic rooms
- Strong smells from a mix of foods we don’t normally cook
- Multiple conversations happening at once
- Bright lights, Christmas décor, flickering candles
- Unfamiliar foods with unexpected textures
- Expectations to ‘try everything’ or ‘enjoy it’s sooo good!’
- New environments, seating arrangements, or routines
For children with sensory sensitivities, this can feel like a tidal wave of input. Research shows that children who are sensory-sensitive often have heightened responses to smell, taste, and texture, which may lead to avoidance or distress at mealtimes (Cermak, Curtin, & Bandini, 2010).

Add food allergies into the picture and anxiety increases even further for both children and parents. A 2020 study by DunnGalvin et al. found that children with food allergies experience significantly higher stress in shared eating environments, especially when food preparation or contamination risk is hard to control.

So, if your child becomes tearful, shuts down, or refuses to sit at the festive table, it isn’t ‘bad behaviour.’ It’s sensory overload, heightened vigilance, or discomfort communicating through their body.

🌟 Preparing your child for a calmer festive meal

Preparation is especially important for sensory-sensitive or allergy-aware children. Here’s how to set them up for success:

1. Offer predictability through previewing

Before the event, show your child pictures of:
- where you’re going
- who will be there
- the types of foods that might be served
- where they might sit
A visual schedule or social story can help reduce anxiety and give your child a sense of control.

2. Pack safe foods without apology

If your child has allergies or selective eating, bring:
- ‘Safe foods’ you know they will eat
- Backup snacks
- A separate (their own) plate, if needed
- Emergency medication
Announce clear, firm boundaries such as:

‘Ok people, these are Jamie’s safe foods — we’ll stick with these today.’ This will help relatives understand without pressure or judgement.

3. Choose seating that supports sensory regulation

If possible, seat your child:
- at the end of the table
- near a familiar adult
- away from the kitchen (strong smells)
- away from noise clusters
- give them their favourite toy or fidget whilst waiting
Let them take breaks when needed. This isn’t ‘rude,’ it’s self-regulation.

🍽️ Supporting children during the meal

1. Focus on connection, not consumption

The holidays are not the time to expand your child’s food range. Keeping mealtimes low-pressure actually supports long-term progress.

In fact, the research is clear: pressuring children to eat decreases acceptance and increases refusal (Galloway et al., 2006).

So instead of ‘Just try it!’ try:
- ‘You don’t have to eat it, you can look at it.’
- ‘You’re in charge of what goes in your mouth.’
- ‘You can keep your safe foods on your plate.’
2. Protect your child’s allergy safety

Holiday meals often include:
- cross-contamination risks
- shared utensils
- buffets
- homemade dishes without ingredient lists
Use gentle but firm scripts:
- ‘Because of Ellie’s allergies, we’ll keep her plate separate.’
- ‘We’ll serve her food ourselves to make sure she stays safe.’
Confidence in your boundary helps others respect it.

3. Manage sensory load in real time

Offer:
- headphones
- a small chew or fidget toy
- a designated ‘calm corner’
- time outside for fresh air
- a predictable signal for breaks (e.g., a hand squeeze or card)
Remember, sensory regulation is healthcare, not ‘giving in.’

4. Model calm eating

Children learn most from watching.

Slow, happy bites and relaxed facial expressions tell the nervous system: ‘This environment is safe’.

💛 What to say to well-meaning relatives

Families often have big feelings about food. You can prepare nice phrases like:
- ‘We’re focusing on helping him feel safe around food today.’
- ‘She has allergies, so we’re sticking to our plan.’
- ‘We’re avoiding pressure because it helps him eat better long term.’
- ‘We’re celebrating together, eating is not the goal today.’
Setting expectations ahead of time can reduce awkward moments later.

🎁 The bigger picture: It’s about safety, not ‘picky eating’

Children with allergies, sensory differences, or feeding challenges aren’t trying to be difficult. They are trying to stay safe, regulated, and comfortable.

Your calm presence, gentle boundaries, and preparation create the conditions for a holiday that feels peaceful, not pressured.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

📚Research References

Cermak, S. A., Curtin, C., & Bandini, L. G. (2010). Food selectivity and sensory sensitivity in children with autism spectrum disorders. Journal of the American Dietetic Association, 110(2), 238–246.

DunnGalvin, A. et al. (2020). APPEAL-2: A pan-European qualitative study to explore the burden of peanut-allergic children, teenagers and their caregivers. Clinical & Experimental Allergy, 50(11), 1238–1248.

Galloway, A. T., Fiorito, L. M., Francis, L. A., & Birch, L. L. (2006). ‘Finish your soup!’ Counterproductive effects of pressuring children to eat on intake and affect. Appetite, 46(3), 318–323.

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READ MORE Managing mealtime sensory overload at holiday gatherings: Supporting children with allergies and feeding differences
Speech and Language Therapy

What is Total Communication, and why your child might need it more than just speech
ByLondon Speech and Feeding April 22, 2026April 21, 2026
When a child’s speech is difficult to understand, it can feel overwhelming for everyone involved. As a parent, your instinct is often to focus on helping your child ‘talk properly’. And that makes complete sense. Speech is important. But here’s the key message I want to share with you:

Speech is just one way to communicate.

And when speech is not yet clear, not yet reliable, or not yet available, children need other ways to get their message across.

This is where Total Communication comes in.

What is Total Communication?

Total Communication is an approach that encourages the use of all available ways to communicate, not just speech.

This can include:
- spoken words
- gestures and pointing
- facial expressions
- signing (such as Makaton)
- pictures or symbols
- drawing
- electronic AAC (Augmentative and Alternative Communication), such as apps like LAMP Words for Life
It’s not about replacing speech. It’s about supporting communication in every possible way.

Think of it like this: if speech is currently unclear or limited, why restrict a child to the hardest route? Why not give them more tools to succeed?

‘But won’t this stop my child from talking?’

This is one of the most common concerns I hear in clinic.

Parents often worry that if a child starts using signs or a communication device, they will become ‘dependent’ on it and stop trying to talk.

The research tells us something very different.

Studies consistently show that AAC does not prevent speech development. In fact, it often supports it.
- A review by Millar, Light & Schlosser (2006) found that AAC interventions do not reduce speech production and may actually increase it.
- Romski & Sevcik (2005) demonstrated that children given AAC often develop stronger overall communication skills, including spoken language.
- More recent work continues to show that providing AAC early can accelerate language development, not delay it.
So rather than ‘giving up on speech’, using AAC is actually building the foundations that speech needs.

Why Total Communication matters, especially for unintelligible children

When a child is very difficult to understand, they are often experiencing a hidden frustration:

‘I know what I want to say, but no one understands me.’

Over time, this can lead to:
- reduced confidence
- behavioural frustration
- withdrawal from communication
- fewer opportunities to practise language
If a child cannot successfully communicate, they communicate less. And when they communicate less, their language development slows down.

Total Communication breaks this cycle.

By giving a child reliable ways to be understood, we:
- reduce frustration
- increase interaction
- build confidence
- create more opportunities for language learning
And importantly, we allow them to show us what they already know.

AAC is a bridge, not a barrier

Using AAC (whether that’s pointing to pictures, signing, or using a device) does something powerful:

It separates language from speech.

A child might have lots of ideas, vocabulary, and understanding but their speech system (especially in cases like phonological disorder or childhood apraxia of speech) cannot yet keep up.

AAC allows the child to:
- express complex ideas now
- practise sentence structure
- develop vocabulary
- take part in conversations
All while their speech is still developing.

In other words, AAC doesn’t replace speech. It keeps language moving forward while speech catches up.

What does this look like in real life?

In therapy, I often use a combination of approaches:
- modelling simple signs alongside speech
- pointing to symbols while talking
- encouraging children to gesture or show
- using drawings to support understanding
- incorporating an AAC device such as LAMP Words for Life
You might see a child:
- say part of a word
- point to a symbol
- use a gesture
- and look at you expectantly
That is communication success.

And success builds motivation.

‘I just want them to talk’

Of course you do. And I do too!! That’s always the goal.

But here’s the important shift in thinking:

Children learn to talk by communicating, not by waiting until speech is perfect.

If we hold out for clear speech before allowing other communication methods, we risk:
- limiting their ability to interact
- reducing practice opportunities
- increasing frustration
But if we support all communication, we give them:
- more chances to express themselves
- more positive communication experiences
- more input and feedback
And that is what drives progress.

A balanced approach

Total Communication doesn’t mean ‘speech is no longer important’.

It means:
- we continue targeted speech therapy
- we work on sounds and clarity
- and we support communication in the meantime
It’s not either/or.

It’s both/and.

Final thought

If your child’s speech is difficult to understand, the most important question is not:

‘Are they talking clearly yet?’

It’s:

‘Can they successfully communicate?’

Because communication is the foundation of:
- relationships
- learning
- confidence
- wellbeing
And every child deserves a voice, in whatever form that voice takes right now.

Feel free to contact me if your child needs help with speech and communication.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

References (parent-friendly):
- Romski M & Sevcik R. (2005) Augmentative communication and early intervention: Myths and realities. Infants & Young Children. 18:174-185.
- Millar DC, Light JC, Schlosser RW. (2006) The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: a research review. J Speech Lang Hear Res. 49(2):248-264.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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READ MORE What is Total Communication, and why your child might need it more than just speech
Feeding · Speech and Language Therapy

The great air debate: How different swallowing patterns impact breastfeeding and reflux
ByLondon Speech and Feeding November 5, 2025November 6, 2025
The great air debate

As a Speech and Language Therapist specialising in infant feeding, I often hear from worried mums describing their breastfed baby’s fussiness. ‘My baby is so burpy and gassy,’ ‘might it be reflux?’ or ‘she just seems uncomfortable after every feed’. While these concerns are incredibly valid and distressing for both baby and mum (and dads!), the underlying cause isn’t always what you might think. Often, the culprit isn’t primarily a digestive issue, but rather a mechanical one: how effectively your baby is managing air during feeding.

Many parents are told their baby has ‘colic’ or ‘reflux’ and are offered solutions that don’t quite hit the mark because they overlook a fundamental aspect of feeding: the suck-swallow-breathe sequence. Understanding this intricate dance can be the key to unlocking a calmer, happier feeding experience for your baby and you.

Understanding the suck-swallow-breathe sequence

Your baby’s mouth, tongue, jaw, and throat muscles work together in a precise rhythm like a beautifully orchestrated symphony. First your baby draws milk, then swallows it, and then takes a breath, all without interruption. This is the ideal suck-swallow-breathe (SSB) sequence.

When the SSB sequence functions optimally, a baby latches deeply, creates good suction, draws milk, swallows efficiently, and then pauses just long enough to take a gentle breath before the next suck. This smooth, coordinated process minimises the amount of air swallowed.

However, for various reasons (it could be a shallow latch, oral motor challenges, an uncoordinated suck, or even an overly fast milk flow) this sequence can get a bit out of sync. Instead of a smooth rhythm, you might see:
- Suck-suck-swallow-gasp!: Too much air pulled in with the swallow.
- Rapid, shallow sucking followed by gulping: Inefficient milk transfer and air intake.
- Clicking noises during feeding: Loss of suction, indicating air entry.
- Frequent detaching and re-latching: Often to ‘catch a breath’ or because of discomfort.
Each of these patterns can lead to increased air intake.

The root cause: Air trapping leading to a gassy breastfed baby

When a baby swallows too much air during a feed, that air must go somewhere. It builds up in the stomach, causing bloating, discomfort, and often leads to the familiar reflux-like symptoms parents describe: arching, spitting up, burping excessively, or simply appearing distressed.

It’s a common misconception that all gassiness or reflux symptoms in a breastfed baby are due to something in the mother’s diet or a genuine digestive disorder. While these can be factors, as an SLT, we first look at the mechanics of the feed. If a baby is constantly struggling to maintain a seal, sucking inefficiently, or having to gulp to keep up with flow, he or she is inevitably swallowing air. This air then creates pressure, which can push milk back up (silent reflux) or out (visible reflux).

Think of it like trying to drink through a straw with a hole in it. You’re sucking, but you’re also pulling in air, making it harder to get the liquid and leaving you with more bubbles in your stomach.

Why mechanical speech therapy assessment is key

This is where the distinction between a medical diagnosis (true gastro oesophageal reflux disease or GORD) and a functional feeding challenge becomes critical. A paediatrician will assess for medical causes and may prescribe medication to reduce stomach acid. This can be appropriate for severe cases of GORD.

However, if the primary issue is air being trapped due to a suboptimal suck-swallow pattern, medication only treats the symptom (acid burning) and not the root cause (air intake). This is precisely where a Speech and Language Therapist specialising in infant feeding comes in.

My role is to meticulously observe and assess your baby’s oral motor skills, latch, tongue function, and the efficiency of their SSB sequence. I look for subtle signs of inefficiency that contribute to excessive air swallowing.
- Is the tongue elevating correctly to create suction?
- Is the jaw stable, or is it excessively moving?
- Is the latch deep enough to prevent air leaks?
- Can the baby coordinate suck, swallow, and breathe without gasping?
By identifying these mechanical challenges, I can then implement targeted strategies to improve feeding efficiency and reduce air intake, often leading to a significant reduction in reflux-like symptoms and overall discomfort.

Strategies to optimise air management during breastfeeding

The good news is that many babies can learn to feed more efficiently with the right support. Here are some general strategies we might explore:
1. Optimise latch and position: A deep, asymmetric latch is crucial. Experiment with different positions that allow for a deeper latch and better head/neck alignment, such as laid-back feeding or upright positions.
2. Paced feeding (even at the breast): If your milk flow is very fast, consider removing your baby from the breast briefly if you hear excessive gulping or see him or her struggling to breathe. This allows him or her to catch up and manage the flow.
3. Support the jaw and cheeks: Sometimes, gentle support to the baby’s jaw or cheeks can help them maintain a more stable, efficient suck. I can demonstrate specific techniques for this.
4. Burping effectively: While burping won’t get rid of all swallowed air, upright burping positions and gentle back rubs can help release some of it.
5. Pre-feed oral preparation: Gentle oral massage or stretches before a feed can sometimes ‘wake up’ the oral muscles and improve coordination.
Addressing the ‘Great Air Debate’ isn’t about blaming anyone; it’s about empowering parents with a deeper understanding of their baby’s feeding mechanics. By focusing on the how, not just the what, we can often resolve persistent feeding challenges, reduce discomfort, and make breastfeeding a more joyful, peaceful experience for both you and your little one.

If you suspect your baby’s gassiness or reflux symptoms are related to how they are managing air during feeds, don’t hesitate to reach out for a specialist assessment.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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Autism Therapy · Neurodiversity · Speech and Language Therapy · Top tips

Following your child’s lead: A playful path to AAC success
ByLondon Speech and Feeding August 27, 2024August 23, 2024
Unlocking playtime: A guide to child-led learning

Does your child struggle to focus on toys or activities? Do they dart away as soon as you approach? You’re not alone!

The key to unlocking your child’s potential lies in following their lead. Let them guide the play session, and watch their engagement and focus soar.

Why Child-Led Play Works:
- Empowerment: Children feel in control, sparking their curiosity and motivation.
- Focused attention: They’ll stay engaged with activities for longer periods.
- Reduced frustration: By stepping back and observing, you eliminate the pressure and stress that often comes with directed play.
How to Implement Child-Led Play:
1. Prepare the environment: Set out a limited selection of engaging toys.
2. Observe and wait: Sit back, watch, and listen to your child’s interests.
3. Embrace the moment: Resist the urge to direct or question; simply enjoy the process.
Remember: This simple approach can transform playtime and support your child’s development. Give it a try for a week and see the difference!

#OWLing #hanenmorethanwords

Observe, Wait, Listen. It’s a powerful formula for unlocking your child’s potential.

You will likely see:
- Your child will stay put with any toy for longer whilst you are near them.
- Your child will tolerate you being nearby and he/she won’t move away.
- Your child will start giving you brief glances of enjoyment, or perhaps they will hand things to you, or they might take your hand and lead it to something that needs opening etc.
- In other words, you will see that there suddenly is JOINT PLAY. Yes, granted it may not be according to your adult agenda, but there will be more togetherness than there was before. And this is the START of communication and social engagement.
USE Core words and a coreboard — to help your child understand the power of words

Core words are the building blocks of communication. Try using a coreboard like the one below, they are versatile and can be used in countless ways. By modelling these words naturally during play, you expose your child to their meaning and function in context. This approach is far more effective than isolated drill and practice, more powerful than flashcards!

Photo by lemonlenz

A Winning Combination

Combining child-led play and AAC modelling creates a magic effect. To summarise:
- Increased engagement: When you follow your child’s lead, they are more likely to be engaged and receptive to learning. This creates optimal conditions for introducing AAC core words.
- Natural learning: By modelling AAC core words in the context of play, you help your child understand their meaning and purpose naturally. This fosters generalisation and spontaneous use.
- Building relationships: Shared play experiences strengthen the bond between you and your child. This trust and connection are essential for successful communication.
- Reduced pressure: Modelling AAC core words without expectation removes the pressure to produce language. This allows your child to explore communication at their own pace.
- Expanded vocabulary: As your child becomes more comfortable with AAC, they will begin to incorporate core words into their own communication. This leads to vocabulary growth and increased independence.
Practical Tips
- Observe and respond: Pay close attention to your child’s interests and actions. Respond to their cues with enthusiasm and support.
- Keep it simple: Start with a few core words and gradually introduce new ones as your child’s skills develop.
- Be patient: Language learning takes time. Celebrate small successes and avoid frustration.
- Have fun: Remember, play is supposed to be enjoyable for both you and your child. Relax and have fun together!
Example:

Photo by lemonlenz

Let’s say your child is playing with a pop-up toy like you see me do in the above photograph. Here, I followed my child’s lead by waiting to see what she wanted to do with the toy. You are now OWLING! (Observe Wait and Listen)

Once I noticed that there was repetitive opening of the flaps going on I then pointed to OPEN and MORE on the board, as I said: ‘let’s OPEN this one’ / let’s see MORE animals’ / ‘MORE cow! it says moo!’ ‘OPEN another one’ and so on.

Important to know, we are not expecting our child to respond verbally or with AAC, but we are providing language input and demonstrating how these words can be used with enthusiasm.

Naturally in time your child will look at the board and at your pointing and they will eventually want to copy you!

By incorporating these strategies into your daily interactions, you can create a supportive environment that fosters language development and communication growth. If you would like more guidance please get in touch and book in for a consultation, some individual therapy and/ or some parent coaching.

I look forward to supporting you. Please contact me and let’s see how.

Sonja McGeachie

Early Intervention Speech and Language Therapist

Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

The London Speech and Feeding Practice

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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Autism Therapy · Neurodiversity · Speech and Language Therapy

LAMP Words for Life: A revolutionary AAC system
ByLondon Speech and Feeding October 28, 2024October 28, 2024
Introduction

When working with non-speaking or minimally speaking children the LAMP Words for Life AAC (Augmentative and Alternative Communication) system is my absolute go-to every time. For me it stands out as a revolutionary system that has transformed the lives of many of my non-speaking students. LAMP Words for Life is a ROBUST, comprehensive language-based AAC system and it is designed to help any user to express their thoughts, feelings, and needs effectively, thereby achieving maximal independence in their daily life. A winner!

There is a whole host of AAC apps and systems out there and each has their own advantages and benefits for sure. I have tried a good number of other systems. I do also like certain features of other AAC systems for sure. For example GRID: I love the versatility of GRID and the ease of editing the system is fantastic.

Why I think it works so well

However, strangely I always return to LAMP when push comes to shove. I have thought very carefully about it and so here are my thoughts on why this is and why it works so well:
1. Intuitive interface: LAMP Words for Life features are for me really user-friendly and it is easy to navigate and understand (this is very important for non-techy people). I think it makes sense and it is accessible to users of all ages and abilities. Yes the pictures are a little bit different to other symbol systems we use, especially here in the UK to be sure, and this is one of the reasons why it is good to have a variety of systems available, so that we can cater for students who are used to other symbols or do very well with specific symbol core boards. I have learned though that the pictures are not that important when using LAMP because the entire system is based on MOTOR PLANNING. And once one knows the motor plan to find a picture it is in our brain and we do not look at the picture any more. So, the motor plan to find a word is much more important when using LAMP than worrying about what the picture looks like.
2. Comprehensive vocabulary: The system offers a vast vocabulary of words and phrases, covering a wide range of topics and contexts. This enables users to express themselves effectively on a variety of subjects. That said, almost every time I use LAMP there is a little word I need and it’s not on there. But that’s not a problem: for example, I was looking for ‘sunglasses’ the other day. Sure, there is ‘sun’ and ‘glasses’ but that would be two separate motor plans and for my student that would be too many for now, so it was very easy to quickly add the new word ‘sunglasses’ under ‘accessories’ or ‘beach wear’ — I added it within less than one minute. Likewise, there are a ton of words which cater for the US market, and I tend to change them to fit the UK vocabulary like ‘nappy’ for ‘diaper’. Or I delete them entirely if I feel my child will never need to use a certain word like ‘conference’ or ‘nun’. PS: should they get to a point of using the system as an adult independently then these words can surely be added again, or if my student ever moves to the US then the words can be changed back to US terms again without any problem.
3. Grammar support: LAMP provides built-in grammar support, helping users construct grammatically correct sentences. This can be particularly beneficial for individuals with language processing difficulties. But what I love about the way LAMP is organised here is that, in contrast with other systems I have used, it does not PREDICT what you want to say, it lets the user decide and find the right grammatical structure. I appreciate this because, just like I hate my phone or email offering predictive text or offer corrections to my words, I really do not get the systems that offer automatically a grammar change which mostly I don’t want. Where that is the case, I am often confused and hindered in finding the correct wording. I love the simplicity of LAMP and at the same the complexity that can be achieved gradually with practice. LAMP is fully designed to enable a user to build up not only vocabulary but a full language system. On a course recently I was able to hear adult LAMP users speaking to the audience in full and quick grammatically well-rounded sentences on a host of topics.
4. Customisation: LAMP can be customised to meet the individual needs of each user. This includes options for adjusting the vocabulary, layout, and accessibility features. It is not as easy to edit as GRID I will say and that can cause me a little bit of frustration at times, but on balance I still vastly prefer the system as a whole. It can also be customised quite well for Gestalt Language Processors. It takes a little bit of practice and thinking about how best to do this but I have found a way that works well which I demonstrate in the short video clip.
5. Community support: LAMP Words for Life has a thriving community of users on Facebook and this is so valuable and inspiring. Therapists and families of LAMP users alike share experiences, provide resources, and offer encouragement. This can be a valuable source of support for both users and their families.
6. Comprehensive support: LAMP Words for Life offers quick and thorough support services, including training, resources, and ongoing assistance. This is invaluable and reassuring for both users and caregivers.
7. Research-based: The development of LAMP Words for Life is based on extensive research and evidence-based practices. This ensures that the system is grounded in sound scientific principles.
Conclusion

To conclude LAMP Words for Life is a powerful AAC which provides us with a means of effective communication, language development, and social interaction. Whether you are a parent of a non-speaking child or a speech therapist looking for innovative AAC solutions, LAMP Words for Life is worth exploring.

Example on how to use AAC at story time

Feel free to contact me if you need help with your child.

Sonja McGeachie

Early Intervention Speech and Language Therapist

Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

The London Speech and Feeding Practice

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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