A 5-month-old demonstrates involuntary protrusion of the tongue during oropharyngeal transit. What is the best course of action?

• A. Change texture to a thinner solid
• B. Place the food on the hard palate
• C. Train the parent in oral motor exercises to reduce tongue thrust
• D. Wait to see if this behavior disappears by 7 months

Answer: (D)

A tongue protrusion during swallowing in a 5-month-old is often a normal, developmentally driven tongue thrust that tends to integrate as oral motor control matures. Because this reflex can resolve on its own as coordination of the lips, jaw, and tongue improves, the best course is to monitor and re-evaluate around seven months to confirm it has disappeared.

Interventions aimed at changing texture or teaching oral-motor exercises aren’t indicated for a self-limited reflex in an otherwise healthy infant, and they don’t reliably alter development. Altering textures or manipulating the palate won’t address the underlying reflex and could complicate feeding.

If the tongue thrust persists beyond the usual window or is accompanied by feeding difficulties (coughing, choking, poor intake, or weight gain concerns), then a formal evaluation would be warranted.