Feeding & Swallowing Milestones
This framework for Feeding and Swallowing Milestones was adapted from Pediatric Swallowing and Feeding: Assessment and Management by Joan C. Arvedson and Linda Brodsky as well as the American Speech and Hearing Association (ASHA) Feeding Infants & Toddlers Strategies for Safe, Stress-free Mealtimes by Jessica L. McCarthy for the Mosaic Child Project. It should also be noted that this is only a general idea of when children reach specific milestones for eating and it is not rigid. Feeding and Swallowing deficits or disorders (dysphagia) are significant to a child's health, nutrition, hydration, and growth. If you suspect that your child may be having difficulties, trust your gut and refer to your pediatrician.
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Nipple feeding(breast or bottle)
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Hand to mouth movements begin. Opens mouth to suck fist especially if hungry.
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Semi-flexed posture during feeding.
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Gag response to food and objects in the mouth is noticeable and typical.
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Moves tongue in and out, and up and down.
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Responds to stimulation in and around mouth. Turns head toward nipple when parent strokes the cheeks. This signals that the baby is ready to eat.
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Coordinates breath with two to three sucks of liquid before swallowing and breathing (Suck-Swallow-Breathe Pattern).
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Interacts with parent during feeding through gaze.
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Begins to put hands on bottle during feeding
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Spoon feeding introduced around 4 months
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Holds the bottle independently.
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Gag response decreases as they become more used to food.
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Upright position during feeding.
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Increases lip closure around spoon and cleans spoon with upper lip.
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Helps parent with spoon.
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Accepts spoon feeding of thin and smooth pureed food.
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Begins to move food from side to side of the mouth.
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Eruption of front teeth.
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Begins to finger feed solids.
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Munching (vertical chewing pattern) begins.
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Able to suck liquids from cup.
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Drinks from cup held by parent.
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Drinks out of a sippy cup and attempts to hold the handle independently.
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Begins to drink from open cup.
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Begins to drink through a straw.
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Eats thicker foods and different food textures.
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Begins to chew in a rotary (circular) motion.
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Bites into harder foods.
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Increased finger feeding of small, soft, dissolvable foods.
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Intentionally reaches for spoon.
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Can close the lips to clear the spoon.
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Begins to close lips while swallowing liquids and soft solids.
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Chews softer, lumpy, mashed foods and keeps most food in the mouth.
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Grasps spoon with whole hand for self-feeding.
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Holds cup independently with both hands.
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Holds and tips bottle independently.
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Copes with most food textures offered but still has some difficulty.
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Begins to reject certain foods.
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4-5 consecutive sips when drinking.
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Begins to eat chopped foods.
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Bites through crunchy foods like cookies and crackers.
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Moves the food in mouth from side to side as they chew.
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Primarily feeds self but may still need help.
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Chews a wide range of food textures.
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Mouth and jaw (oral) movements are more precise.
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Swallows with lips closed.
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Feeds self using a spoon but may still need assistance.
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Circular jaw movement (rotary chewing).
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Chews and drinks with lips closed.
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Holds cup with one hand without spilling.
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Fills spoon with finger.
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Eats a wide range of foods and drinks.
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Complete and total self-feeding.
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Uses fork and can scoop with spoon.