Myofunctional therapy and picky eating are more connected than most parents realize. And if your child snores, grinds their teeth, breathes through their mouth, or only eats soft foods, this post is going to connect every single dot. Understanding the connection between myofunctional therapy and picky eating can completely change how you approach your child’s food refusal.

This week on the Livin’Sky Podcast I sat down with Emily Hussey, speech language pathologist, feeding therapist, myofunctional therapist, and founder of Eats and Speaks. Emily takes a whole person approach to uncovering the root causes behind feeding challenges, speech delays, tongue ties, and orofacial dysfunction. And what she shared is some of the most practical and important information I have featured on this show.

What Is Myofunctional Therapy?

Myofunctional therapy is essentially physical therapy for the mouth and breathing. It can be provided by speech therapists, occupational therapists, physical therapists, and registered dental hygienists who have taken advanced specialized training. It is not typically part of standard professional training, which Emily acknowledges is a significant gap in the field.

The four main goals of myofunctional therapy are nasal breathing, the tongue resting up in the palate, a normal swallow pattern, and elimination of oral habits like pacifiers, thumb sucking, finger sucking, and nail biting.

To participate in true myofunctional therapy a child needs to be at a cognitive age of at least four and be able to follow instructions and perform exercises consistently at home. For younger children, oral motor therapy using food and tools is the more appropriate approach.

Why Nasal Breathing Is the Foundation of Everything

The palate, the roof of your mouth, is also the floor of your nose. When a child has a narrow palate their nasal passage is compressed and breathing through the nose becomes genuinely difficult. The body always takes the path of least resistance, so if nasal breathing is hard, mouth breathing takes over instead. An open mouth means the tongue cannot rest in the palate. And without the tongue sitting up there, it cannot support the growth and development of the face and jaw.

This is why Emily says airway trumps everything in the myofunctional world. Because every other goal depends on it.

Palate expansion, which my own son is currently being evaluated for, can change the shape of the nasal passage and make nasal breathing possible. Myofunctional therapy then teaches the tongue to use that new space correctly so the expansion is maintained and the airway continues to develop properly.

Tongue Ties: What Every Parent Needs to Know

This is one of the most misunderstood and mismanaged areas in pediatric health right now. And Emily was refreshingly direct about it.

Your first stop if you have a concern about a tongue tie should never be the release provider or the surgeon.

She used a simple analogy that stopped me completely. If your foot hurt you would not call a surgeon and book a procedure the next day. You would see your primary doctor, maybe a physical therapist, maybe a specialist. You would work through a process before anyone picked up a scalpel. The same logic applies to tongue ties.

The Correct First Step if Your Child Has a Tongue Tie

The right first step is to see a specialist trained in tongue tie assessment who can evaluate the function of the mouth, not just the appearance of the tissue. A classification system that rates tongue ties from one to four is not a severity rating. It is simply a descriptive tool for where the frenulum is attached. Function is what matters.

And here is the piece that most families do not know. A tongue tie release without proper preparation beforehand often does not produce the results families are hoping for. Just as releasing an arm that has been tethered does not immediately restore full function, releasing a tongue tie without bodywork, oral motor therapy, and wound care support before and after rarely resolves the underlying issue.

With infants Emily recommends bodywork to release tension patterns before the release, a stable weight gain trajectory, and a feeding specialist in the support team before proceeding. Older children need to show improvement in oral function before moving forward with release. Adults follow a similar logic to pre-surgical physical therapy.

The wound care piece is also non-negotiable. Most release providers Emily works with do diamond releases using a CO2 laser that leaves an open wound requiring active wound care management by parents. Without proper wound care reattachment can occur. Parents need to be fully prepared for this before proceeding.

What Myofunctional Therapy Has to Do With Picky Eating

This is where it gets deeply relevant for the families I work with every day.

Emily said something that I think every parent of a picky eater needs to hear. Kids cannot tell you that they prefer veggie straws because they are predictable and easy and they are not going to choke on them. They just know what feels safe and what does not. And over time they build a diet around the foods that feel manageable and avoid everything else.

That is not pickiness. That is compensation for an oral motor skill they never fully developed.

Here is what oral motor dysfunction can look like at the table:

A child who cannot lateralize food, meaning move it from one side of the mouth to the other, will gag when food moves too far back on the tongue. They will avoid anything that requires real chewing and stick to soft meltable textures.

A child with a narrow jaw from prolonged airway issues may develop a munch chew pattern instead of a rotary chew. Harder textures become genuinely difficult and they avoid them not out of preference but out of physical limitation.

A child with restricted tongue mobility from an unaddressed or improperly released tongue tie may struggle to move food around the mouth safely during eating.

Emily also made a point about chewing that I think is one of the most important things in this entire episode. Chewing stimulates the vagus nerve. It is physically soothing and regulating to the nervous system. When children are eating predominantly soft processed foods that require very little chewing, they are missing one of the most ancient and natural ways the body self-regulates. A dysregulated nervous system makes picky eating harder in every direction.

Infant Feeding Red Flags

Emily’s advice for expecting parents was emphatic and simple. Find a lactation specialist or feeding therapist before the baby arrives. Not after. Not when you are exhausted and struggling at 3am. Before.

Red flags to watch for after birth include pain during breastfeeding that persists, clicking or smacking sounds while feeding, baby coming on and off the breast frequently, prolonged dependence on a nipple shield or SNS system, significant digestive issues like gas and frequent spit-up, a strong head turn preference, aversion to tummy time, and in the first two weeks, a baby who is lifting their head unusually well. That last one surprises many parents. An exceptionally strong head lift in a newborn often signals significant tension in the body that can directly impact feeding.

Emily also reminded us that mom is part of the feeding dyad too. Even if baby is gaining weight, if mom is overwhelmed, in pain, or struggling, that is a reason to reach out. Too many mothers are dismissed because the baby’s weight is fine. The mother’s experience matters just as much.

Pacifiers: What Emily Actually Recommends

Emily is pro pacifier with clear boundaries.

She prefers a cylinder shaped pacifier over flat orthodontic shapes like the MAM pacifier because flat pacifiers disrupt tongue positioning and oral function. The goal is for the tongue to rest up in the palate and a flat pacifier works against that.

She wants pacifiers gone by twelve months when the bottle is weaned. Starting around fifteen to sixteen weeks she recommends introducing teethers to shift the focus to chewing, which stimulates the vagus nerve and supports jaw development. Pacifiers should be a soothing tool used when needed, not a default that goes in the mouth out of habit.

One Piece of Wisdom From Emily

When I asked Emily what she would leave parents with she said something that I am still thinking about.

Just because you can do it does not mean you should.

When parents are trying to do too many things at once, driven by anxiety and the pressure to fix everything, it can blur the reasons for doing any of them and create more stress for the whole family. Going slow, doing one thing at a time, and having a trusted provider who can help you sort out what actually needs to happen right now, that is the most effective approach.

And then she said something that connects directly to everything I teach about picky eating. Babies and children can read your energy at any age. When you are regulated and calm you help your child regulate. When you are panicked and stressed your child’s nervous system responds to that. Your own state is one of the most powerful tools you have.

About Emily Hussey

Emily Hussey is a speech language pathologist, feeding therapist, myofunctional therapist, and lactation counselor and the founder of Eats and Speaks in Rockford, Illinois. She takes a whole person approach to feeding challenges, speech delays, tongue ties, and orofacial dysfunction. Emily specializes in the connection between myofunctional therapy and picky eating in children of all ages. Find her at eatsandspeaks.com and on Instagram and Facebook at Eats and Speaks Therapy. Emily is also happy to help connect families outside her area with providers in her network.

About Lena Livinsky

Lena Livinsky is a speech language pathologist and holistic pediatric feeding specialist and the founder of Livin’Sky Kids. She helps overwhelmed moms of picky eaters understand what is actually driving their child’s food refusal using the BLOOM Framework. If you are wondering whether myofunctional therapy and picky eating are connected for your child specifically, Book a free Clarity Call

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