Moving Ahead with Food: Matching Oral Motor Skills and Food Textures
Food Type
Pre-Solids
Puree
Thick Puree
Ground
Chopped Foods
Table Foods
Chewing stages
or
Oral Motor Skills
Suckling
(present at birth)
Sucking
Strong sucking or early
munching
Munching
Begins to move tongue
to follow foods.
Mature rotary chew
Developmental
Feeding Skills
to Note
Rooting
(present at birth)
Chew is more up-anddown
Attempts to hold bottle. Shows interest in
“guiding” spoon and
Decrease in gag reflex.
watching others eat.
Moving food front-toback with tongue.
Begins to sit with
support.
Foods to Offer
Breast milk or formula
Infant cereals should
look like a “heavy, thick
liquid” or applesauce.
Introduce blended,
strained, baby foods
(home-made or
commercial).
Indications for
Next Step
Cautions
Gradually increase the
thickness of pureed or
strained foods by adding
baby cereal, wheat
germ, or potato flakes.
Introduce hard
munchables.*
Strong, well-developed
sucking motion.
Learns to keep thick
purees in mouth.
May still have trouble
keeping pureed foods in
mouth.
Begins to use an up-anddown chewing motion.
Pay attention to
choking precautions.
Pay attention to
choking precautions.
Babies who have
lower muscle tone and
lower oral motor tone
may need specialized
supports for breast and
bottle feeding.
Do not add cereal to
bottle.
The beginning of a
sucking motion.
Always hold on to
one end of edible hard
munchables.
Decrease in gag reflex.
Uses cup more often.
Uses spoon and food
for sensory play, an
important part of
learning to eat textures.
“Helps” with
feeding and drinking
with increasing
independence.
Feeds self finger foods.
Begins to try utensils
independently.
Messy when feeding self.
Switches back-andforth between utensils
and fingers.
Mashed, cooked
vegetables, scrambled
egg, mashed soft-boiled
egg, cottage cheese.
Chop regular table foods Monitor easy-choke
in small, fine pieces.
foods for safety.
Introduce meltable hard
solids.*
Introduce finger foods
that are easily chewed.
Modify the list of foods
to watch as needed.
Introduce cubed foods
such as cheeses.
Introduce crunchy and
chewy foods such as raw
broccoli to build jaw
strength.
Side-to-side movement
of food with tongue.
Individualize foods for
likes and dislikes and
feeding abilities.
Pay attention to
choking precautions.
Pay attention to
choking precautions.
Pay attention to
choking precautions.
Allow for messiness.
Scraping food off face
with feeding spoon can
be sensorally offensive.
Do not mix textures
such as spaghetti
with meat sauce or
meatballs, peas in
mashed potatoes, and
so on.
Pay attention to
choking precautions.
Provide a safe and
acceptable way for your
child to remove foods
from mouth if they find
it offensive.
*Hard Munchable: A hard munchable is something that is hard to chew on and should not be allowed to break off or eaten. Hard munchables are both food and non-food items such
as spoons, teething toys, and carrots. When offering an edible hard munchable (such as a carrot), always hold on to one end. Take the item away when it looks like it may break off.
Edible hard munchables require adult supervision.
*Meltable Hard Solid. A meltable hard solid is a food that is not liquid, but will melt in the mouth. For example, teething biscuits, large pretzels (requires supervision in case it breaks off), and
zwieback toast.
Disclaimer: This information is designed as a general guide for introducing foods to young children based on typical stages of oral motor development and is not intended as individual advice.
Every child is unique. Always consult your pediatrician, speech therapist, or feeding team for guidance with feeding concerns.
Joan Guthrie Medlen, RD, LD, LLC ©2007. All Rights Reserved. Published by Phronesis Publishing • www.DownSyndromeNutrition.com • Phronesis@DownSyndromeNutrition.com
Creating Successful Mealtimes
Eating is a skill we learn. Learning to eat is the most complex thing we do. It is a behavior, or skill, that requires every part of our body: our organs,
muscles, and senses. It takes time, planning, and can be a mess. Some children whiz through the developmental stages of eating so fast you miss the
actual steps involved. Others take more time to experience each step of learning to eat. No matter what speed your child moves through oral motor
development and food textures, you play a big role in helping your child enjoy meals. Here are a few tips for creating an environment that will invite
your child to explore and enjoy food while learning the skills needed for eating.
Set the stage.
Lights! Camera! Action! Much like producing a good play or movie, setting the stage for a successful mealtime requires planning. As the producer
and director, mealtimes require planning for success: the food, the tools, and even the process of coming to the table. This includes having a chair
that fits, using the right spoons or dishes, and avoiding unnecessary distractions such as the television or video games during meal times. Remember
to include communication tools (such as communication cards or voice output devices) for children with disabilities along with any special feeding
equipment.
Explore!
“What does it smell like?” “What does it look like?” “What does it sound like if I throw it on the floor?” “What does it feel like if I mash it with
my hand?” These are all questions young food explorers must answer. Exploring food requires all of your senses. Your child needs to smell it. He
needs to look at it. He needs to listen to it. He needs to feel it with hands, feet, face, mouth, and more. And he needs to taste it. Eating the food is not
always the goal! When learning to eat, the physics of food are as important as the nutrition, taste, and pleasure of food. Your best defense is to plan
ahead and join in the fun! Put sheets on the floor, move your child’s chair away from the wall, and have something to clean your child off within
arm’s reach.
Communicate!
Learning to eat is a social event. This means mealtime is good time for communication. Babies, toddlers, and children learn by watching and
listening to you as you eat. They see your facial expressions, hear the tone of your voice, and experience the give-and-take of communication at
mealtimes. Your children learn a lot from watching you! So be an active, responsive communication partner. Join in the fun: explore and
talk about your food, with them.
As your child grows, mealtime remains one of the best times to promote communicating and sharing. A study by Dr.
Catherine Snow from Harvard’s Graduate School of Education looked at mealtime and learning language. They found
that the conversations around the family table teach children more vocabulary and forms of conversation than they
learn when you read to them. Other studies on family mealtimes show that sharing mealtimes may have a positive
impact on grades, relationship skills, mental health, and lower drug use.
Eat together! Talk together! Learn together!
www.DownSyndromeNutrition.com
©2007. All Rights Reserved.