Healthy airway, healthy sleep: 4 ways you can shape your child’s airway health from day one 

Upper Air

Believe it or not, healthy sleep starts while a baby is still in mum’s tummy.

The way we learn to use the muscles for sucking and swallowing in utero is the beginning of healthy development of the jaws and upper airway, essential for good sleep.

So when it comes to your child’s airway health, it pays to start early. If your child is still young, you have a baby or you intend to have more children in the future, the information in this post will be particularly empowering. You’ll be able to shape your child’s airway health to a great degree.

Getting things right from day one may be simple, but it isn’t always easy – there’s a lot to keep an eye on! In this blog post I look at four key areas that contribute to optimal airway development, what can get in the way, and what you can do to help.

1. Breastfeed your child

The phrase ‘breast is best’ should be understood to refer not just to the nutritional benefits of the milk itself but also to the fact that breastfeeding encourages optimal airway development.

For airway health, a child needs proper facial bone and muscle stimulation and growth. Facial bone development is at maximum growth rate from birth to the age of two.

For the first six months of life, this stimulation occurs mostly with breastfeeding. As a baby grows, the structure of their face and mouth changes and so does the way the muscles work.

Correct breastfeeding helps keep the palate in a broad and flat shape, which encourages nose breathing. The tongue, cheeks and lips, which are all used for sucking during breastfeeding, also contribute to baby’s face, mouth and jaw growth.

What you can do

I promote breastfeeding as the best way to optimise your child’s airway health and encourage you to get the support you need to help you and your baby form a healthy breastfeeding attachment.

Sometimes, bottle-feeding is inevitable. When bottle-feeding, a baby’s tongue, cheeks and lips function poorly, yet the baby can still drink so there is no motivation to correct their form (as is essential in breastfeeding). Consequently, bottle-feeding ultimately compromises airway development.

If you bottle-feed, there are still several things you can do to ensure better facial development.

First, feed baby upright, which slows the flow and encourages sucking.

Second, use a bottle that requires the muscles of the face, mouth and throat to mimic sucking during breastfeeding as closely as possible. There are multiple bottle teats developed to mimic the breast, and there is promising research and product development in this area.

Third, supplement with massage and exercises to encourage use of all the orofacial muscles. This will ensure your baby’s face, mouth and throat muscles are getting the right kind of activity.

2. Encourage your child to nose breathe

Mouth breathing can start due to underlying allergies, colds, asthma, nasal obstruction or congestion, or having large tonsils and adenoids.

Mouth breathing is not merely a cosmetic issue. It comes with accompanying physical habits (mouth open, tongue low and forward) that lead to non-ideal face and jaw development, rendering children more vulnerable to sleep-disordered breathing.

Nose breathing, in contrast, brings 18% more oxygen to the brain and promotes full expression of sleep cycles, which means effective, regenerative sleep.

What you can do

With babies who have a habit of keeping their mouth open, gently and regularly adjust their body position and close their lips to encourage nose breathing (as long as they are not congested).

The nose is nature’s perfect instrument for taking air into the body because it has three engines – a heater to get the air ready for your body, a filter to make sure no sneaky germs get into your body, and a humidifier to make sure the air is not too dry for your body.

Kids love this concept: ‘You have three engines in your nose. Do you know what they are? Can you operate the engines?’

Encouraging nose breathing in your kids can be a lot of fun, and you can create challenges or games to help build good habits. (See my book for more tips and tricks).

3. Help your child develop proper chewing habits

Healthy development of the airway (and therefore, healthy sleep) goes hand in hand with using the muscles correctly. Chewing is key to this development.

When babies chew, it stimulates bone growth of the jaws and face. The chewing motion typically matures by twelve months, and by this time the tongue tip should be able to elevate up to the gum pad just behind the top teeth for a mature swallow.

Many children are not learning the skill of chewing early enough, and they develop a kind of learned helplessness. This is partly due to the common use of bottles, sippy-cups and soft foods.

Soft foods require no muscle work and are linked to modification of whole facial structure, leading to small, recessed lower jaws, crooked teeth and a compromised upper airway.

What you can do

You can do a lot to help your child develop healthy chewing habits. Here are some tips for babies:

  • Introduce textured foods early. Unfortunately, today we often introduce textured foods into our children’s diets too late, focusing on soft food. Introducing finger food alongside soft foods allows a baby to develop oro-motor control and use muscles correctly. Let your baby choose from a range of solid foods that require biting, gnawing and chewing.
  • Encourage your baby to chew on non-food items. Baby-safe feeders (mesh feeders with a cover) can be helpful when introducing your baby to solid foods. There are also special, safety-approved sensory toys to assist with chewing and biting. They are particularly helpful for kids with compromised oro-motor control, or at times you are not able to fully supervise young children.
  • Introduce an open cup early. Many parents are also surprised to learn that children can start drinking from an open cup at six months old. Have babies practise with a little water in cups so if they spill it it’s not a big deal.

When it comes to older kids, most parents focus primarily on manners and are unaware of how their kids are chewing. Manners have their place, but healthy orofacial development is a far higher priority. Thankfully, good chewing technique will achieve success in both.

Correct chewing means keeping lips together and engaging both sides of the mouth simultaneously, at a moderate pace and with a mix or vertical and mini horizontal jaw movements, until the food is soft and mushy, ready for the stomach

There are many things you can do to help older kids chew well. You’ll find some great chewing games and exercises in my book.

4. Promote proper speech patterns

The muscles used for breathing, sucking, chewing and swallowing are the same muscle systems that work for speech. Developing the muscles for facial expression and speech from day one therefore contributes to airway health.

Most babies start vocalising from two to three months old. Broadly speaking, children start using single words around twelve months of age, then start stringing two words together for an ever-increasing vocabulary by age two.

What you can do

To get kids’ speech and language off to a great start, prioritise any and every activity that encourages language skills. You can optimise development by reading, talking and singing to your baby from the time they are in utero!

When your baby starts sound play, cooing and gurgling, coo and gurgle back because it encourages more of the same – a real two-way interaction. Humming, singing, talking, laughing and clicking all activate the muscles of the mouth, face and throat, so speech, voice, facial expression, chewing, sucking and swallowing all go hand in hand when developing a healthy upper airway.

Early sound imitation will not only develop speech, oro-facial muscle control and verbal skills, but it will also create a sense of fun and connection between the two of you.

There are good resources online to help you develop your child’s speech. The Speech Pathology Australia website ( is a good start.

For those of you with older kids who may feel that they have ‘missed the boat’ on myo-optimisation, don’t despair – it is never too late. Myo can be undertaken throughout life.

Looking for more?

Let’s build a new generation of healthy sleepers!

With my book Sleep-Wrecked Kids, I support you to become the lifeguard of your child’s sleep. Packed full of information and practical help, it will get you on the way to good sleep for all the family. Order your copy here!

Sharon Moore

Author, speaker, sleep health advocate and speech pathologist

I'm Sharon Moore, author, speaker, sleep health advocate and speech pathologist at Well Spoken Upper Airway & Communication Solutions. I've seen more than 40,000 families over 4 decades of clinical work and I’ve seen first-hand how upper airway issues impact both health and happiness. The ripple effects span across family, school, community and society, and left untreated can last a life-time. I believe that great treatment transforms lives, the earlier the better and that everyone has a right to be happy, healthy and heard. I've worked in medical settings in Australia and London and currently run Well Spoken clinic in Canberra treating patients of all ages referred by medical and dental specialists for disorders of function of the upper airway that impact breathing, eating and communication.

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