Early Intervention Support

Is My Baby’s Feeding Development Typical?

Eating is a huge part of our lives. When it does not work as you expect or is a stressful event – tension will inevitably develop. Successful feeding requires appropriate motor development throughout the body and mouth, good sensory integration techniques, healthy routines and most of all an enjoyment of the experience.

Infants Under Three Months

• During this critical time frame, your child will be eating liquids only
• Best feeding positions are reclined and or side lying
• Rooting and suck, swallow reflexes (baby turns toward stimulus tapping stroking of lips/cheeks and opens mouth wide enough to latch on to food source, and swallows) should be fully present at birth
• Suckle pattern during feeding will be observed, in and out movement of the tongue
• Tongue will protrude
• At approximately 2 months, infant will begin bringing hands to mouth
• Infant is working on coordination of suck, swallow and breath

Infants Under Three Months:

• Coughing throughout meal or when drinking
• Spitting up frequently after meals
• Abnormal bowel movements (constipation, diarrhea, loose stool) and frequency
• Skin reaction (dry patches, hives, rashes)
• Discomfort (crying, arching back, irritability, retching)

Babies Between Four and Six Months

• Baby will feed in semi-reclined position
• Visually recognizes bottle
• Continues to bring hands and toys/objects to mouth
• Uses hands to pat bottle/breast during feeding
• Begins to eat puree/smooth creamy foods by sucking food from a spoon
• Child should demonstrate a good coordination of suck and swallow
• By 6 months, child will swallow strained foods
• Recognizes the bottle or breast

Babies Between Four and Six Months:

• Coughing throughout meal or when drinking
• Spitting up frequently after meals
• Abnormal bowel movements (constipation, diarrhea, loose stool) and frequency
• Skin reaction (dry patches, hives, rashes)
• Discomfort (crying, arching back, irritability, retching)

Six to Eight Months

• Eating in more upright positions
• Tongue can lateralize/move toward cheeks
• Mouthing and munching spoon, toys and biter biscuits
• Holds own bottle
• Drinking from a cup held for child
• Eating mashed, soft table foods (potatoes, carrots, fruits, etc.) with creamy, lumpy texture
• Drooling less except for teething
• Bite and release observed
• Moves food around in mouth using tongue, bites and chews toys

Six to Eight Months:

• Coughing throughout meal or when drinking
• Spitting up frequently after meals
• Abnormal bowel movements (constipation, diarrhea, loose stool) and frequency
• Skin reaction (dry patches, hives, rashes)
• Discomfort (crying, arching back, irritability, retching)
• Limited diet (e.g. prefers eating same foods, same color, or same texture)
• Gag response to new or non-preferred foods
• Minimal fluid intake/adipsia (e.g. child will eat solid foods, but very little fluid intake)

Eight to Twelve Months

• Sitting upright during meals
• Biting and chewing foods voluntarily
• Eating finger foods with pureed meats
• Meats should stay one consistency below vegetables and fruit child is eating
• Controlled sustained bite
• Developing a rotary chew pattern
• Finger feeds self
• Holds spoon during meals
• Moves food around in mouth using tongue, bites and chews toys
• Finger feeds self, chews food

Eight to Twelve Months:

• Coughing throughout meal or when drinking
• Spitting up frequently after meals
• Abnormal bowel movements (constipation, diarrhea, loose stool) and frequency
• Skin reaction (dry patches, hives, rashes)
• Discomfort (crying, arching back, irritability, retching)
• Limited diet (e.g. prefers eating same foods, same color or same texture)
• Gag response to new or non-preferred foods
• Minimal fluid intake/adipsia (e.g. child will eat solid foods, but very little fluid intake)
• Limited variety of textures (e.g. prefers smooth/creamy foods or eating only crunchy foods)
• Excessive fluid intake (e.g. drinks bottle or from cup, but minimal food intake)

Twelve to Eighteen Months

• Eating table foods, but meat chopped/cut up very small
• Lips closed during chewing
• Appetite decreases during this time resulting in food refusal occasionally
• Brings a spoon to mouth and turns spoon over
• Holds and drinks from a cup with some spills
• Appetite decreases, may refuse food
• Scoops food with spoon, brings food to mouth

Twelve to Eighteen Months:

• Coughing throughout meal or when drinking
• Spitting up frequently after meals
• Abnormal bowel movements (constipation, diarrhea, loose stool) and frequency
• Skin reaction (dry patches, hives, rashes)
• Discomfort (crying, arching back, irritability, retching)
• Limited diet (e.g. prefers eating same foods, same color or same texture)
• Gag response to new or non-preferred foods
• Minimal fluid intake/adipsia (e.g. child will eat solid foods, but very little fluid intake)
• Limited variety of textures (e.g. prefers smooth/creamy foods or eating only crunchy foods)
• Excessive fluid intake (e.g. drinks bottle or from cup, but minimal food intake)
• Chewing skill deficits (e.g. eating only easy to swallow foods, not demonstrating safe or efficient chewing skills after 12 months)
• Food refusal (e.g. pushing food away, throwing foods, crying, tantrums at meal time)
• Excessive mouthing

Eighteen to Twenty-four Months

• Chewing with rotary jaw movements
• Distinguishes between food and non-food items
• Gives up bottle
• Gives empty bowl or dish to an adult
• Scooping foods to feed self, with some spills
• Plays/explores foods with hands
• Holds small cups with one hand
• Plays with food
• Knows the difference between food and non-food items
• Transitions to a cup
• Develops clear food preferences

Eighteen to Twenty-four Months:

• Coughing throughout meal or when drinking
• Spitting up frequently after meals
• Abnormal bowel movements (constipation, diarrhea, loose stool) and frequency
• Skin reaction (dry patches, hives, rashes)
• Discomfort (crying, arching back, irritability, retching)
• Limited diet (e.g. prefers eating same foods, same color or same texture)
• Gag response to new or non-preferred foods
• Minimal fluid intake/adipsia (e.g. child will eat solid foods, but very little fluid intake)
• Limited variety of textures (e.g. prefers smooth/creamy foods or eating only crunchy foods)
• Excessive fluid intake (e.g. drinks bottle or from cup, but minimal food intake)
• Chewing skill deficits (e.g. eating only easy to swallow foods, not demonstrating safe or efficient chewing skills after 12 months)
• Food refusal (e.g. pushing food away, throwing foods, crying, tantrums at meal time)
• Refusal to self-feed (e.g. finger foods or utensil use)
• Excessive mouthing

Twenty-four to Thirty Months

• Holds spoon between fingers, palm up
• May have definite food likes and dislikes
• Often the time “picky eater” shows up
• Unwraps food
• Holds spoon
• Washes hands
• May show dislike and refuse certain foods

Twenty-four to Thirty Months:

• Coughing throughout meal or when drinking
• Spitting up frequently after meals
• Abnormal bowel movements (constipation, diarrhea, loose stool) and frequency
• Skin reaction (dry patches, hives, rashes)
• Discomfort (crying, arching back, irritability, retching)
• Limited diet (e.g. prefers eating same foods, same color or same texture)
• Gag response to new or non-preferred foods
• Minimal fluid intake/adipsia (e.g. child will eat solid foods, but very little fluid intake)
• Limited variety of textures (e.g. prefers smooth/creamy foods or eating only crunchy foods)
• Excessive fluid intake (e.g. drinks bottle or from cup, but minimal food intake)
• Chewing skill deficits (e.g. eating only easy to swallow foods, not demonstrating safe or efficient chewing skills after 12 months)
• Food refusal (e.g. pushing food away, throwing foods, crying, tantrums at meal time)
• Refusal to self-feed (e.g. finger foods or utensil use)
• Excessive mouthing

Thirty to Thirty-Six Months

• Uses a fork to feed self
• Wipes mouth with napkin
• May reject many foods due to slower rate of growth and more mature sense of taste
• Attempts to serve self at table with spills
• Pours liquids from small containers

Thirty to Thirty-Six Months:

• Coughing throughout meal or when drinking
• Spitting up frequently after meals
• Abnormal bowel movements (constipation, diarrhea, loose stool) and frequency
• Skin reaction (dry patches, hives, rashes)
• Discomfort (crying, arching back, irritability, retching)
• Gag response to new or non-preferred foods
• Minimal fluid intake/adipsia (e.g. child will eat solid foods, but very little fluid intake)
• Limited variety of textures (e.g. prefers smooth/creamy foods or eating only crunchy foods)
• Excessive fluid intake (e.g. drinks bottle or from cup, but minimal food intake)
• Chewing skill deficits (e.g. eating only easy to swallow foods, not demonstrating safe or efficient chewing skills after 12 months)
• Food refusal (e.g. pushing food away, throwing foods, crying, tantrums at meal time)
• Refusal to self-feed (e.g. finger foods or utensil use)
• Excessive mouthing

*Based on Revised Hawaii Early Learning Profile copyright 1994 VORT corp.