MOTOR AND ORAL MOTOR MILESTONES FOR FEEDING DEVELOPMENT

2½ - 3 ½ MONTHS OF AGE

Steady head control achieved

Rooting, gag, sucking, phasic bite reflex, palmomental reflex, transverse tongue reflex

Demonstrates many reflexes to protect the airway

Responds to stimulation in and around the mouth

Consumes breast milk or formula using a nipple

Coordinates breath support with 2-3 sucks of liquid before swallowing and breathing

4-6 MONTHS OF AGE

Beginning hand to mouth play (independent oral exploration of objects)

Increased reaching skills

Reaches for spoon when hungry

Opens mouth when spoon approaches or touches

Initial difficulty moving food back, which is active, rather than through changes in pressure

Tongue used to move purees to back of mouth

Tongue moves back and forth as food is introduced

Sucking foods rather than phasic biting

Able to keep foods in mouth vs. being re-fed

Munching pattern may appear near 6 months

Brings both hands up to clasp the bottle but requires some assistance

Consumes rice cereal or pureed fruit and pureed vegetable baby foods

Eats from a small infant/toddler spoon

6-7 MONTHS OF AGE

Trunk control sufficient for independent sitting for greater than 3-5 seconds

Stable head control in sitting (no head bobbing)

Transfers toys and food from one hand to the other

(7-9 months)

Lip closure supports movement of bolus to pharyngeal area

Able to bring top lip down on spoon to remove foods

With assist, able to break off pieces of meltable foods

Consistent tongue lateralization seen when foods presented to sides of tongue

(6-9 months)

Holds the bottle independently

Cleans the spoon with the upper lip

Eats pureed meats and a variety of pureed baby foods

8-10 MONTHS OF AGE

Trunk rotation and weight shift

Beginning to move in and out of positions

Voluntary release patterns

Uses fingers to rake food toward self

Puts finger in mouth to move food and keep it in

(7-9 months)

Mature tongue lateralization emerging

Active movement of foods from side of mouth to central tongue groove and back

Able to transition to slightly more texture (small bumps)

Chewing softer foods

10-12 MONTHS OF AGE

Independent sitting in a variety of positions

Pincer grasp developing

Pokes food with index finger

Uses fingers to self-feed soft, chopped foods

Clearing food off of lips emerges

Simple tongue protrusion may occur

More controlled biting, isolated from body movements

Full transfer of foods from sides across midline occurs, without difficulty

Rotary chewing begins to emerge

(9-12 months)

Demonstrates lip closure when swallowing liquids and soft solids

Begin self-feed by using fingers to grab (ie, soft crackers, cereal-Cheerios)

Begins to experiment drinking liquids from a sippy cup

Begins to consume mashed table foods

Drinks out of a sippy cup and attempts to hold the handle independently

Begins to drink from a straw

14-16 MONTHS OF AGE

Efficient finger feeding

Practicing utensil use versus effective use for volume

Typically "co-feeding" with a parent

Chews and swallows firmer foods without choking

Chews foods that produce juice

Able to keep most bites in mouth during chewing

Coordinates sucking, swallowing, and breathing patterns for longer sequences

Begins to eat finely chopped table foods

Bites through crunchy foods such as cookies and crackers

Moves food from side to side of the mouth during chewing

18-24 MONTHS OF AGE

Able to pick up, dip, and bring foods to mouth

Increasing utensil use (not efficient until after 24 months of age)

Scoops purees with utensil and brings to mouth

Feeds using a spoon but may still require assistance