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Stages of Feeding and Oral Motor Development

Age: 3-5 Months

Food Types and Amount: Feedings are 7-8 ounces given over 4-6 feedings — 9-10 ounces taken around 5 months of age

Oral Motor Development

Suckle pattern remains with support of sucking pads Some loss of liquid may occur at this age due to replacing early physiological flexion with postural control of flexor movements—less tight than at birth 20 or more sucks, infrequent pauses for breathing

Age: 6 Months

Food Types and Amount: 9-10 ounces of food and liquid per 4-6 feedings a day — Introduced to Cereals and pureed foods

Oral Motor Development

Hold bottle independently Eagerly anticipate approach of bottle or spoon Suckle and sucking patterns present until sucking becomes dominant “Chews” with open mouth. Does not gag, choke, cough, vomit during meals. By 7 months, “chews” Cheerios and graham crackers. Lateral tongue movements are seen with placement of food on molar surfaces Cup drinking can be introduced at 4-6 months

Age: 9 Months

Food Types and Amount: Consuming liquids, pureed foods, ground and mashed table foods — 11 or more ounces of food and liquid per feeding

Oral Motor Development

Mouth continues to play primary role in sensory discovery Foods for biting and solids requiring chewing are included more frequently Sensory experiences provided by discriminative mouthing between 6 and 9 months has set the stage for lumpy solids. Protective gag reflex is less vigilant Self feeding finger foods Suckle movements still occur intermittently, especially if continued use of sippy cup or bottle Many babies are drinking from a straw at this age Clearing spoon with upper lip more prominent Can move food from center to side for chewing

Age: 12-18 months

Food Types and Amount: Coarsely chopped table foods and some easily chewed meats

Oral Motor Development

Cup drinking more prominent Bites through soft solids, such as a banana, transfers to the side. Chews completely with mouth open before swallowing. Able to chew chicken nuggets, French fries, soft carrots etc. Choking and gagging is not observed. Child enjoys self-feeding

Age: 2 years

Food Types and Amount: Skillfully swallows foods that have a combination of textures

Oral Motor Development

Accepts all new foods at least one time. Choking or gagging is not observed. Self-feeds entire meal. Tongue transfers food easily across midline of tongue Tongue is used to help clean food from upper and lower lips

When to refer to a specialist:

If mealtime is stressful for you or your child or if your child is exhibiting any of the following behaviors, ask your doctor for a referral for an evaluation of your child’s oral motor feeding skills and feeding behaviors:

• chokes, cough, gaggs, vomits, congestion during feeding
• fussing/irritability with feeding
• difficulty transitioning from smooth to textured foods
• accepts a small variety of food or refuses an entire category of foods
• refuses new foods and is a very picky eater
• doesn’t tolerate food on hands or face, turns head or locks lips, doesn’t want to self feed,
• does not chew foods or chews a minimal amount,, swallows food whole, whole food is identified in vomit or diapers
• “chews” with lips closed.

Stages of Feeding and Oral Motor Development
Published: March 2007 © Carolina Pediatric Therapy