The hidden impact of mouth breathing and open mouth posture on speech and feeding

ByLondon Speech and Feeding
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When most people think about speech or feeding difficulties, they picture the tongue, lips, or chewing skills, but how a child breathes at rest plays a surprisingly big role too.

Mouth breathing and open mouth resting posture can quietly influence everything from how a child’s face grows to how clearly they speak, to how confidently they chew and swallow. It’s something many parents never think about, until they start noticing the subtle signs.

Let’s explore why this happens, what to look for, and how to gently support better breathing and oral posture.

Recent research supports this link between mouth breathing and speech difficulties. For example, a 2022 study by Alhazmi et al., published in the Journal of Pharmacy and Bioallied Sciences, found that 81.7% of children aged 9–17 who breathed primarily through their mouths presented with speech sound disorders. The study highlights how mouth breathing can significantly influence orofacial development and articulation patterns.

💨 Why we’re designed to breathe through our nose

Our bodies are made for nasal breathing. When we breathe through the nose, the air is filtered, warmed, and humidified before reaching the lungs. The tongue naturally rests against the roof of the mouth, the lips close gently, and the jaw stays relaxed, all of which encourage healthy oral development.

In contrast, mouth breathing often means the tongue rests low in the mouth and the lips stay apart. Over time, this posture can subtly reshape how the muscles and bones of the face grow.

Children who breathe through their mouths most of the time may develop:

  • A longer face and narrower palate
  • Forward head posture
  • Slightly open lips and low tongue position at rest
  • A tendency toward drooling or noisy breathing
  • A dry mouth and consequently bad breath
  • At times the tongue pushes constantly against the front teeth causing them to grow forward (buck teeth)

These changes are not anyone’s fault, as they often start because of blocked noses, allergies, enlarged adenoids, low facial muscle tone or habits formed when a child was younger. But understanding the pattern helps us know how to support change.

🗣 How mouth breathing affects speech

Speech depends on precise coordination between the lips, tongue, and jaw. The resting position of these structures affects how ready they are to move.

  1. Reduced tongue strength and placement, i.e. the tongue rests low in the mouth (as it does in mouth breathing), it’s harder for children to lift it efficiently for sounds like /T/, /D/, /N/, /L/, and /S/. This can lead to speech that sounds slightly slushy or unclear, or a frontal lisp.
  2. Open mouth posture and resonance: An open mouth at rest may affect how air vibrates in the oral and nasal cavities. Children might have speech that sounds a bit ‘muffled’ or lacks crispness because the lips and jaw aren’t fully supporting articulation.
  3. Fatigue and breath control: Mouth breathing can lead to drier mouths and less efficient breath support. That can make longer sentences or conversations feel tiring, especially in noisy environments.

🥄 How mouth breathing affects feeding and chewing

Feeding involves the same structures that control speech, so posture and breathing patterns matter here, too.

  1. Chewing efficiency: Children who habitually keep their mouths open often have low tongue tone and reduced jaw stability. They may prefer softer foods, chew slowly, or struggle with mixed textures.
  2. Swallowing pattern: A tongue that rests low may push forward when swallowing. This ‘tongue-thrust swallow’ can interfere with efficient chewing and even affect dental alignment over time.
  3. Breathing while eating: Since it’s hard to chew, swallow, and breathe through the mouth simultaneously, children who can’t comfortably nasal breathe may rush bites or pause to catch their breath. This can contribute to coughing, choking, or food refusal.

Common signs to watch for

Parents often notice subtle clues before realising mouth breathing is a pattern. Some red flags include:

  • Lips habitually open at rest
  • Drooling after the toddler years
  • Snoring or noisy breathing during sleep
  • Preference for soft foods or grazing eating habits
  • Dark circles under the eyes due to allergies
  • Frequent colds, congestion, or mouth odour
  • Speech that sounds slushy or unclear despite good effort

If several of these sound familiar, it’s worth mentioning them to your child’s GP, dentist, or speech and language therapist.

👩‍⚕️ What can help

  1. Address the underlying cause: If nasal blockage, allergies, or enlarged adenoids are making nasal breathing difficult, a medical assessment is the first step. ENT specialists can rule out or treat physical causes.
  2. Encourage closed mouth rest: Gentle reminders like ‘Lips together, tongue up, breathe through your nose’ can help older children become aware of their resting posture. For younger ones, visual cues (stickers or mirrors) can make it a game.
  3. Build oral-motor strength and awareness: Speech therapists can design activities to strengthen the tongue and lips, improve jaw stability, and encourage balanced breathing. This might include blowing games, tongue-tip lifts, use of dental-palatal devices or oral-motor exercises disguised as play.
  4. Support good posture: Sometimes mouth breathing goes hand-in-hand with forward-head posture. Encouraging upright sitting during meals and screen time helps keep the airway open and supports better breathing habits.
  5. Make nasal breathing part of daily routines: Gentle nose-breathing practice during calm times (reading, bedtime, car rides) helps normalise it. Avoid making it a battle: calm, consistent reminders work best.

🌱 A gentle note on change

Patterns of mouth breathing develop over time, and change doesn’t happen overnight. It’s important to approach this with curiosity, not criticism. The aim isn’t ‘perfect breathing,’ but to give your child the tools and awareness to breathe comfortably and efficiently.

Small improvements in nasal breathing and resting posture can lead to big gains in speech clarity, eating confidence, and even sleep quality.

💡 The takeaway

Breathing seems automatic, and it is! but how we breathe matters. Mouth breathing and open-mouth posture can quietly shape how a child speaks, eats, and grows.

By noticing early signs, addressing underlying causes, and building supportive habits, you can help your child move toward stronger, clearer speech and more comfortable mealtimes.

Just like every area of development, progress starts with connection, patience, and gentle consistency, one calm breath at a time.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

References

Alhazmi, A., Alshamrani, A., Alhussain, A., et al. (2022). Mouth Breathing and Speech Disorders: A Multidisciplinary Study. Journal of Pharmacy and Bioallied Sciences 14(5):911. https://www.researchgate.net/publication/361978128_Mouth_breathing_and_speech_disorders_A_multidisciplinary_evaluation_based_on_the_etiology

Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

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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    As speech and Language therapists (SLTs), we know that where your tongue goes, so goes your sound. This blog post will explore why tongue placement is so vital for speech correction and how we use tools and techniques to help our clients find their ‘sweet spot’ for sound production.

    Let me show you here a little video clip where I am using my dentist’s mouth/teeth model to help my clients navigate their tongue movements.

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    The trouble with our tongue movements is that most of us never think about how the tongue has to move and what it does to: swallow, chew, drink, suck and speak. Most parents when asked to think about their own tongue placement for say the /S/ sound are completely lost as to what their tongue is doing. Yet, of course, they produce a perfect /S/ and perfect speech in general. The same goes for swallowing. When did you last think about what happens in your mouth when you swallow? I bet you have not thought about it. We ‘just do it’, right?

    Why is tongue placement so important?

    Accurate tongue placement is the foundation of clear articulation. When a child struggles with a particular sound, it’s often because his or her tongue isn’t quite reaching the right spot or moving in the correct way. For example, the /S/ sound requires the tongue to be slightly raised and positioned behind the top teeth, creating a narrow channel for air to flow through. If the tongue is too far forward, you might get a /TH/ sound instead. If it’s too far back, the /S/ can sound muffled.

    Visual aids: Our secret weapon

    We SLTs love our visual aids! They’re incredibly helpful for showing clients exactly where their tongue needs to be. Here are some of our favourite tools:

    • Mirrors: Mirrors provide instant feedback. Clients can see their tongue’s position and make adjustments in real-time. We often use hand mirrors or even the mirror on a compact for quick checks.
    • Tongue depressors: These simple tools can gently guide the tongue to the correct position. We might use them to show where the tongue tip should rest for the /L/ sound or how the sides of the tongue should touch the molars for the /K/ and /G/ sounds.
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    Beyond the tongue: The jaw’s role

    While the tongue takes centre stage, the jaw plays a supporting role. It provides a stable base for the tongue and helps control the opening and closing of the mouth. Sometimes, jaw stability is an issue, and we might use techniques to help clients find a comfortable and stable jaw position.

    Making it fun and engaging

    Learning correct tongue placement can be challenging, but we make it fun! We use games, stories, and playful activities to keep clients motivated. For younger children, we might use silly voices or pretend to be animals. For older children, we might incorporate their interests, like using a car analogy for tongue movements.

    The takeaway

    Correct tongue placement is essential for clear speech. By using visual aids, interactive techniques, and a bit of creativity, we can help our clients master their speech sounds and communicate with confidence.

    If you have any concerns about your child’s speech, don’t hesitate to reach out to a qualified speech and language therapist, we are here to help! Contact me via my contact form.

    Sonja McGeachie

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  • · ·

    Using AAC during play with your child

    ByLondon Speech and Feeding

    Playtime! It’s a magic time for exploration, learning, and connection.

    If your child is struggling to use words with his/her mouth, we can always use a robust Augmentative and Alternative Communication (AAC) device to help find their words. We know that using such a device does never stop or delay children to speak with their mouths. On the contrary it helps, enormously!

    Can playtime still be a blast? Absolutely! In fact, incorporating AAC into play can be a powerful way to boost communication skills, build confidence, and create a truly inclusive play experience. Here’s how to make it happen, with a focus on core words and core scripts for our GLP’s (the building blocks of communication used by everyone). In this video I am using the core word ‘IN’ and ‘MORE’.

    The Magic of Core Words

    Core words are the most frequently used words in everyday communication. They might be verbs like ‘want’, ‘more’, ‘go’, or ‘stop’, or adjectives like ‘happy’, ‘sad’, and ‘hot’. These words are the foundation for building sentences and expressing needs and desires. They’re perfect for children using AAC because they’re simple to understand and use.

    Let’s Play! Here’s How

    1. Choose Your AAC System

    Many options exist! It could be a low-tech picture board with core words, such as the one you see pasted on my cabinet door in the background, or it can be a dedicated AAC app on your tablet. Here I am using the GRID app but I also love using others, such as LAMP Words for Life.

    2. Make it Fun and Functional

    No pressure! Integrate your AAC system seamlessly into your play routine. Here are some ideas:

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    • Dress-up: Use core words to choose clothes (‘want’, ‘hat’, ‘shoes’).
    • Tea Party: Use core words to ask for and share (‘more’, ‘juice’, ‘give’).
    • Building Blocks: Use core words to describe what you’re building (‘tall’, ‘big’, ‘house’).
    • Dolls/Stuffed Animals: Use core words to act out scenarios (‘sleep’, ‘eat’, ‘cry’).
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    If your child is a Gestalt Language Processor you will want to model meaningful, fun scripts instead of single words! As above, but use phrases:

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    • Tea Party: Use scripts to ask for and share (‘I want more’, ‘more juice’, ‘give me this’).
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    3. Model, Model, Model

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    • When using core words for either Analytical or Gestalt Language Processors, try using good phrases. For example, instead of just saying ‘juice’, say, ‘you want more juice?’

    4. Make it a Team Effort

    Get everyone involved! Encourage siblings, grandparents, and caregivers to use the AAC system with your child during playtime. The more consistent the approach, the faster your child will learn and feel confident using their voice.

    5. Celebrate Progress, Big and Small!

    Every step counts! Acknowledge and celebrate your child’s efforts, whether it’s reaching for their AAC system or successfully using a core word. This positive reinforcement will keep them motivated.

    Remember

    • Playtime should be fun, not stressful. Don’t force your child to use their AAC system. Let them lead the way and follow their interests.
    • Every child develops at their own pace. Celebrate your child’s unique communication journey.
    • Seek professional help when needed. Your SLT can provide tailored strategies and resources to support your child’s development.

    By incorporating AAC and core words into playtime, you’re not just fostering communication; you’re creating a space for your child to thrive, explore, and build strong connections.

    So, grab those toys, power up your AAC system, and get ready for a playtime adventure filled with fun, connection and, therefore, communication!

    Don’t hesitate to contact me!

    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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  • When ‘star’ sounds like ‘dar’: Understanding speech sound disorders and the path to clearer speech

    ByLondon Speech and Feeding

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    In this clip, the child can already say ‘dar’ clearly. That’s our starting point.

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    This approach reduces frustration, builds confidence, and helps the sound stick not just in the therapy room, but out in the real world.

    Why this matters beyond one word

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    • giving the brain time to organise the sound sequence
    • and helping the child feel capable, not corrected

    When therapy feels safe and successful, children are far more likely to generalise their new sounds into everyday speech.

    Speech therapy works best when children feel supported not tested.

    If your child struggles with speech clarity

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    This is the kind of work I do every day building speech step by step, in a way that respects each child’s pace and strengths.

    Support can be gentle, effective, and empowering.

    If you’d like to learn more about how speech therapy can support your child, you’re always welcome to get in touch.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

    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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    Explore how to improve communication skills for a Gestalt Language Processor

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    Let’s break it down into steps to make these complicated words easier to understand. Once you have a deeper understanding, you will then be able to support your child or young person develop their communication skills in the best way as a Gestalt Language Processor. Remember not every child will be a Gestalt Language Processor; if your child uses echolalia and/or has a diagnosis of autism then your child’s way of processing language is most likely different to the classic way children typically learn language.

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    Top tip: You could think of an activity you and your child or young person take part in on a regular basis and brainstorm some key phrases that you could use.

    Need a boost in confidence to support your child’s gestalt language processing?

    Contact me.

    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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    Ten games to support communication in primary school aged children

    ByLondon Speech and Feeding

    When parents visit me with their child, their stress is palpable. Often parents don’t relish or even expect to be asked to practise strategies at home with their child between sessions. Let alone to practise whilst on holiday. I understand that you don’t necessarily want anything extra added to your daily ‘to do’ lists. This is why we try our best to incorporate all speech and language therapy practice into children’s daily activities.

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    On holiday you are unlikely to have your usual games and toys with you – so here is a nice little list of things you can use instead of traditional games and toys:

    If you can think of any other alternatives on holiday and would like to tell me about them, I would love to see your comments below. We can never have too many holiday games!!

    If you are at home over the summer and you do have some games in the cupboard you might want to dust these ones down or buy one or two new ones (if you want to).

    Most games have multiple uses, and it’s always best to adapt a game to match your child’s interests and what motivates them.

    So let’s start…

    1. Pop up pirate: pop a sword into the barrel and watch the pirate pop up randomly. Practise social skills, speech sounds, expressive language (e.g., put a sword on a picture, say the word/sentence then pick up the sword and push it into the barrel).
    2. Word games such as ‘ISpy’, ‘I went to the shop and I bought…’, ‘describe a person and guess who they are’: perfect for when you’re on the move, whether travelling or walking. You can play this anywhere and still support speech, language and communication. You could play ISpy using your child’s special sound, or ‘I went to the shop and bought all things beginning with [insert special sound here]’.
    3. Shopping list: Orchard game is a game to practise categorising. We explain the analogy of the brain being like a filing cabinet. If information is all in the correct place, it’s easier to find, retrieve and use. You can also practise specific speech sounds in this activity. You could also put the words in a sentence to add more of an expressive language element.
    4. Wiggly worms: this Orchard game is all about phonological (awareness of sounds) awareness. Matching a letter with the word. You can also practise the sounds in the words (e.g, g-o-l-d = gold; m-a-ke = make). Talk about the elements, e.g., ‘g-o-l-d’ has 4 sounds, 1 syllable; ‘m-a-ke has 3 sounds, one syllable. You can talk about what words rhyme with the different words and what makes a rhyming word (i.e., the middle and end sounds remain the same).
    5. Sound detectives: this Orchard game allows children to identify sounds. It also has an app (if your child prefers a tech-way of learning). Children identify the sound then they can add the picture card to their path and become closer to being a successful detective. This game can also support memory skills.
    6. Conversation cubes: throw the dice and start building a story. You can also create and use ‘colourful semantics’ sentence strips to support expressive (spoken) language as support to build the narrative.
    7. Think words: ‘name it, press it, pass it’. A great game to expand word knowledge. You can talk about the words at the end of each round exploring semantic (meanings) and phonemic (sounds) links. Your child can also develop social skills (such as attention, listening and turn-taking).
    8. Poo bingo: this is perfectly disgusting but equally fun for kids of about 3.5 years plus – if your child’s target is to practise /p/ sound this is the one for you. You can also learn all about the different animal’s poo, which I am sure you have always wanted to do!! The more we know about a word, the easier it is to store, retrieve and use. Yes, even talking about poo can help!! Also, it’s great for our visual learners.
    9. Simon says: a game that can be played indoors or outdoors. Parents can take turns being “Simon” and give various commands that your child must follow. This means that your child can practise their receptive (understanding of) language as well as their expressive language, speech sounds and social skills (such as turn-taking and initiating).
    10. Ker-plunk: this is perfect for practising your child’s special sound. Repetition is very important, but also can be monotonous, so finding a game that they enjoy is vital. Take turns to pull out a stick. Next, your child can either say their special sound or word (depending on what stage they are at) or hear a good model from other players.

    Do you still have questions? Contact Sonja for support.

    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.

    0
  • ·

    Transforming Mealtimes

    ByLondon Speech and Feeding
    Speech Therpaist in London

    Transforming Mealtimes

    Below are two reviews I got from grateful clients over the past 4-6 weeks; this blog is more about how Feeding Therapy can help you than blowing my own trumpet…. though that said, it is always so nice and gratifying to hear when parents are happy and hopeful about their little one’s feeding journey. Feeding Therapy is a substantial part of my work as a Children’s Speech and Language Therapist. One of my specialist subjects is Autism and we find that many children on the Autism Spectrum are very specific about eating, and will often refuse a range of typical family foods in favour of a narrow range of foods/snacks.

    Mostly, feeding difficulties are a combination and complex cocktail of factors that have contributed to the current status quo: sure, there may have been some physical problems to start off with, such as reflux causing the baby discomfort, constipation, a very tight tongue tie or a swallowing problem caused by neurological difficulties and of course sensory processing difficulties are also very physical experiences. We always begin with a very thorough case history taking and information gathering, followed by an oral assessment and observation of the actual swallow to establish what might have been – or still might be – the cause for the feeding difficulties.

    In most of the cases I see in my practice, the original obvious cause is no longer present, especially with older children. So, if the swallowing is fine, the reflux is no longer present, the tongue was divided (twice!) why are they still not eating much, refusing to try new foods, only accept certain textures etc.

    The answer is extremely complex and multi-faceted and this little blog is not covering any factors in detail (we would be here all night) -I mentioned sensory processing difficulties earlier on. These are mostly still present but often not acknowledged or recognised by parents. And it is certainly the case that one of the contributors is parental anxiety; this tends to run very high and has been for many months, sometimes years. This in turn often leads to very tense and unpleasant, endlessly long meal times and many times children are force-fed several times a day in order to “get something down there” as otherwise they would probably starve themselves.

    Additionally, parents end up only offering a very narrow range of foods because that is all their child will eat. This ends up in a vicious cycle of children being fed porridge-style food for all meal times and of course they won’t progress to more mature foods if these mature foods are never on offer.

    In order to help address and disentangle some of the issues I often introduce the “Division of Responsibility in Feeding” as researched and recommended by Ellyn Satter (The Satter Feeding Dynamics Model)

    Here are the main points of her approach:

    Children have a natural ability with eating, they eat as much as they need and they grow in the way that is right for them and they learn to eat what their parents eat. (E Satter). The parent is responsible for WHAT the child eats, WHERE and WHEN the child eats. The child is responsible for HOW MUCH they eat or WHETHER to eat. Satter proposes that parents should guide their child’s transition from nipple feeding through semi-solids, then thick and lumpy foods to finger foods and then on to normal family meals.

    Please note: this model is only appropriate for children where the original physical cause is no longer present!

    Of course it’s not easy! It requires a huge shift in thinking about feeding and it requires to trust our children to know what is best for them. This is very big for most parents, as it is not how we were brought up and it is not commonly known that babies and children know what is good for them!

    However, it is certainly true that parents who follow this particular approach and make small, steady changes in the way the offer foods, and in the way they create family meal times differently, children make very nice, pleasing progress and over some months we often see remarkable positive changes.

    I like to work in a team and especially for this type of problem it is essential to have a multi-disciplinary approach. A knowledgeable dietician is an enormous plus in any feeding team as is of course a

    Paediatrician and/ or a Gastroenterologist and the most important people in the team are the parents!

    Feeding Therapy is all about collaboration and a ‘team around the child” approach. When we have this in place and there is trust amongst the team members then we make fantastic progress.

    Do get in touch with me if you would like some help with your tricky feeder.

    Lovely Reviews

    I visited London Speech and Feeding a couple of days ago with my 8-month-old granddaughter and her mother. Sonja made us feel comfortable and at ease from our first introductions. She was able to pinpoint my granddaughter’s mum’s anxiety around weaning very quickly. She not only gave her the tools to do this successfully, but also really encouraged my granddaughter’s mum and instilled confidence that she had everything she needed to make this sometimes-difficult transition without further anxiety.

    Sonja was very thorough in her initial assessment of my granddaughter’s physical milestones and her developing speech. My granddaughter felt very comfortable with Sonja and happily played along with her. Then came the big moment – trying out various foods! We were amazed to see just how easily my granddaughter, with Sonja’s expert encouragement, took to sampling the wonderful array of different delicious morsels Sonja had prepared for the session. My granddaughter even drank from a cup for the first time! Wonderful!

    Sonja then emailed a summary of the session and an extensive array of resources with suggestions for my granddaughter’s mum which she has now put into action. My granddaughter’s mum couldn’t thank Sonja enough for her caring attitude, extensive knowledge, and warm professionalism. I have no hesitation in recommending Sonja, she’s a fantastic Feeding Therapist!

    –

    Sonja (and her lovely colleague, Sandra) were stupendous. I had brought my one-year-old son to see them as I was concerned that he wasn’t eating enough. They looked at his history and we ate together to make sure they had all the information they needed to give an accurate diagnosis. Whilst our outcome was that Henry was in fact doing brilliantly (and I just needed to chill out a bit!), I would imagine if there was something more serious going on, Sonja would make you feel just as supported and empowered as she did with us. Excellent follow-ups too. Money well spent for a bit of reassurance for a stressed out mama. Thank you, Sonja!

    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.