pediatric therapy articles
Stages of Feeding and Oral Motor Development
| Age/ months |
Food Types and Amount |
Oral Motor Development |
| Newborn Feeding |
Feedings are typically 2-6 ounces given every 3-4 hours |
- Sucking pads provide oral stability for suck.
- Jaw and front of tongue provide positive pressure on the nipple followed by jaw lowering and back of tongue to add a negative pressure component
- Stripping action is in place—this is the early in-and-out suckle movement of the tongue that extracts liquid
- 2 or more sucks prior to breathe or swallow
|
| 3-5 Months |
Feedings are 7-8 ounces given over 4-6 feedings
9-10 ounces taken around 5 months of age |
- 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
|
| 6 Months |
9-10 ounces of food and liquid per 4-6 feedings a day
Introduced to Cereals and pureed foods |
- 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
|
| 9 Months |
Consuming liquids, pureed foods, ground and mashed table foods
11 or more ounces of food and liquid per feeding |
- 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
|
| 12-18 months |
Coarsely chopped table foods and some easily chewed meats |
- 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
|
| 2 years |
Skillfully swallows foods that have a combination of textures |
- 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
