Excessive Drooling in Infants

Any parent of an infant is no stranger to drool. Drooling is a common practice for babies during the phase of development in which their needs are centered in the mouth – usually from about 3 to 6 months of age.

From there, drooling is still a fairly standard occurrence in healthy children under 2 years of age. Saliva has many necessary functions. It keeps the mouth moist, making it easier to swallow and soothing a baby’s gums while they are teething, for example.

Sometimes though, it may seem like your child is drooling a little too much. Typically, clinically excessive drooling involves low muscle tone, a lack of sensitivity in the lips and face, and difficulty swallowing. Although some drooling is normal in children up to 2 years of age, excessive drooling is also a commonly observed symptom in neurologically impaired children. It’s important to consult with your health care provider, as excessive drooling could potentially be a symptom of a more serious condition caused by a birth injury.

Is Excessive Drooling a Sign of Cerebral Palsy?

Cerebral palsy (CP) is a group of neurological disorders that affect one’s ability to move and maintain balance and posture. It is the most common motor disability in childhood. CP is caused by abnormal brain development or damage to the developing brain.

In cases of cerebral palsy, one of the affected muscular functions is oral muscular control, meaning that a child with CP will drool almost constantly. The drooling is usually related to:

  • Abnormalities in swallowing
  • Difficulty moving saliva to the back of the throat
  • Poor mouth closure
  • Jaw instability
  • Tongue thrusting

Keep in mind that uncontrollable drooling is only one of many symptoms of cerebral palsy. Before you assume that your child has this disorder, you should first consider whether they display any other symptoms. Children with cerebral palsy will also have writhing or spastic muscular movements, stiff muscles, inconsistencies in their muscle tone, and developmental delays.

Is Excessive Drooling a Sign of Bell’s Palsy?

Bell’s palsy is a temporary nerve disorder characterized by facial paralysis. It is caused by damage or trauma to the facial nerve. This nerve, which runs from the brainstem in the back of the skull to the face, governs the muscles on either side of the face that control blinking and facial expressions.

When Bell’s palsy occurs, the function of the facial nerve is disrupted, interrupting the link between the brain and facial muscles. As a result, people with Bell’s palsy experience facial weakness or partial paralysis. Bell’s palsy happens because the facial nerve becomes swollen and inflamed, likely due to a viral infection.

If your child develops Bell’s palsy, they will have a droopy, dry eyelid on one side of their face in addition to excessive drooling. Fortunately, Bell’s palsy is a temporary condition that can be treated with medication obtained from your health care provider.

Is Excessive Drooling a Sign of Autism?

One of the symptoms that children diagnosed with autism will usually experience, in addition to developmental delays, is difficulty with muscle control and sensitivity. Since children with autism have more difficulty controlling their facial muscles, drooling is a fairly common symptom.

For children diagnosed with autism, treatment options for drooling must be personally tailored to the child. Explore possible treatments with your child’s health care provider. For example, a speech-language pathologist or occupational therapist experienced in oral-sensitivity and muscle tone issues could potentially help.

Further Readings

Sforza, E., et al. (2022). Drooling outcome measures in paediatric disability: a systematic review. European Journal of Pediatrics, 1-18.

This study found that a combination of quantitative measures and parental questionnaires might adequately measure drooling in children. 

Bekkers, S., et al. (2021). Repeated onabotulinum neurotoxin A injections for drooling in children with neurodisability. Developmental Medicine & Child Neurology, 63(8), 991-997.

This study looked at the effectiveness of repeated Botox injections for the treatment of drooling in children with neurodisabilities. The researchers found that Botox injections remained effective throughout a patient’s treatment course. However, they found that the effect was diminished after each successive injection. 

Delsing, C. P., et al. (2021). Posterior drooling in children with cerebral palsy and other neurodevelopmental disorders. Developmental Medicine & Child Neurology, 63(9), 1093-1098.

This study looked at whether Botox injections, submandibular gland excisions, and bilateral submandibular duct ligations controlled drooling in children with neurological impairments. The researchers found that all three could treat drooling. They also found that submandibular gland excisions were the most effective.   

Riva, A., et al. (2021). Exploring treatments for drooling in children with neurological disorders. Expert Review of Neurotherapeutics, 21(2), 179-187.

This study looked at the challenges of treating drooling in children with neurological disorders. The researchers reported that the lack of reliable metrics that assess safety outcomes and efficacy limited researchers from identifying the best treatments. They highlighted the need for accurate metrics to better measure drooling treatment effectiveness. 

Speyer, R., et al. (2019). Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan: a systematic review and meta‐analyses. Developmental Medicine & Child Neurology, 61(11), 1249-1258.

This systemic review determined the prevalence of drooling, swallowing, and feeding problems in people with cerebral palsy (CP) throughout their lives. The results from 42 studies showed that drooling, swallowing, and feeding problems are very common in people with CP. As such, they experience an increased risk of malnutrition and dehydration, aspiration pneumonia, and poor quality of life.

Wang, L. et al. (2018). Drooling in cerebral palsy and its relationship with dysphagia and gross motor functioning. Chinese Journal of Physical Medicine and Rehabilitation, 12, 118-122.

This article looked at the drooling incidence and severity in children with cerebral palsy to determine whether there were possible correlations with oral dyskinesia, dysphagia, and gross motor function. Researchers found that one-third of the children with cerebral palsy suffered from drooling, leading them to conclude that there is a correlation between drooling severity and cerebral palsy, oral dyskinesia, dysphagia, and GMFCS levels.