The "Developmental Drooling" One

What is drooling?

Drooling is when the saliva flows outside of the mouth. 


What is developmental drooling?

Is when drooling occurs under two years of age with no underlying diagnosis. It is a developmental stage where their ability to coordinate & manage their saliva is still developing. 

Developmental drooling typically peaks around the time that our little ones begin teething and decreases around the 15-18month mark, disappearing by around two years of age

However, remember the “norms” for drooling are largely based on professional opinion, not on studies. We don’t have a lot of evidence-based info when it comes to measuring, diagnosing and treating drooling. But here’s what we do know.

Why does it happen?

Drooling may occur because of excessive production of saliva or a swallowing impairment. 

Some examples include:

  • A normal developmental stage

  • Teething

  • Triggers such as foods, nausea, sickness and emotions

  • An underlying disorder or syndrome

  • A physical factor such as enlarged tonsils or adenoids or a lesion

  • Gastroesophageal reflux

  • A side-effect of some medications


Managing the drooling

Some factors may increase drooling & what you can do to support your little one:

  • Wiping the saliva may stimulate the salivary glands (making little ones produce more saliva), dabbing is thought to be less stimulating

  • Sweet, sour and spicy foods may increase the volume of saliva

  • Mouthing: this is when a baby puts an object in their mouth to explore their world & to help with emotions such as self soothing, concentrating etc


Mouthing plays an important role in regulation and development. Exposure to different tastes is important for feeding development so please don’t avoid mouthing or certain tastes for developmental drooling (unless otherwise advised). Instead apply barrier cream & a fresh bib before they engage in these activities (if your little one tends to be irritated by the saliva). 


Why and when does the drooling stop? 

Drooling tends to stop when your little one’s oral sensory motor skills & mouth have matured compared to infancy (which is roughly around 2 years of age)


How much is too much?

Again, we don’t have a great amount of evidence on how to measure this. However, a “bib count” may be helpful in understanding whether the amount of drooling is age appropriate. If you are changing a bib (bib is completely wet from drool) more than two times a day over six months this is a good indication that you should seek an opinion from your GP or paediatrician. 

 

Something to think about

Please be mindful that the way we think about drooling may be ableist. Ableism is “… the system by which standards of human autonomy and capability are made as key indicators of human worth.” Be sensitive to the fact that drooling is common for children and adults with an underlying disorder or diagnosis and the social stigma surrounding this. 

While drooling can be developmentally appropriate it can also indicate something else may be going on. It is impossible to know just from the symptom of drooling. If you have any other concerns about your child’s development in addition to drooling you should seek an opinion from your GP or paediatrician. 

When to seek medical attention?

  • If your child is drooling beyond the above mentioned bib count

  • If the drooling has persisted longer than 2 years

  • If your little one has ongoing chest infections in combination

  • If they seem to be having trouble swallowing or managing their saliva (coughing, choking etc)


About the Author

Paediatric Speech Pathologist Jamie Williams

Jamie has worked as a speech pathologist for 13 years. She has had the privilege of working in a number of different settings including; community health, early intervention and non-government organisations.

She is the sole speech pathologist at Newcastle Paediatric Speech Pathology where she provides feeding and communication support to infants, children and their families. Her approach is centred around a little ones inherent strengths and learning about, honouring and supporting families in understanding how their little ones experience their world. She also runs an epic instagram page which can be found here


References and additional readings

Chen, T. & Daniel, S. (2021). Is bib count an accurate quantitative measure of drooling? International Journal of Paediatric Otorhinolaryngology https://doi.org/10.1016/j.ijporl.2021.110657 

Leung, A. & Kao, C. (1999) Drooling in children. Paediatrics & Child Health. http://doi.org/10.1093/pch/4.6.406 

Liddiard, K. (2016). The mouth and disability. Community Dental Health http://doi.org/10.1922/CDH_3715Liddiard04 

“Unspooling Drooling” – Katherine Sanchez, The Informed SLP. Retrieved from https://www.theinformedslp.com/review/unspooling-drooling

Royal Children’s Hospital Melbourne. Saliva Control in Children. An information guide for families and children https://www.rch.org.au/uploadedFiles/Main/Content/plastic/salivabook.pdf 

Penny Blunden