Feeding Development Flashcards
Why is it important to learn about feeding?
- It is an essential ADL
- Needed for growth and nutrition
- Part of socialization
What are oral motor behaviors from birth to six months?
- Suckling: extension-retraction of the tongue, up and down jaw excursions, and loose approximation of the lips (lips are not definitively secure around the nipple)
- Sucking: negative pressure in the oral cavity, rhythmic up and down jaw movement, tongue tip elevated, firm approximation of the lips and minimal jaw excursion. It is a more nutritive process
What is the phasic bite reflex?
- Rhythmic bite and release pattern. Helpful for eventual munching and chewing
What is the rate of nutritive and non-nutritive suck-swallow-breathe pattern?
- Nutritive suck: 1 suck/second
- Non-nutritive suck: 2 sucks/second. It is faster but not an efficient pattern
What are oral motor behaviors from six to 30 months?
- Munching: flattening and spreading of the tongue combines with up and down jaw movements. It is a primitive motion
- Chewing: spreading and rolling movements of the tongue, tongue lateralization and rotary movements
- Tongue lateralization: movement of the tongue to the sides of the mouth to propel food between the teeth for chewing
- Rotary jaw movements: smooth interaction and integration of vertical, lateral, diagonal, and eventually circular movements of jaw used in chewing
- Controlled, sustained bite: easy, gradual closure of the teeth on the food, with an easy release of the food for chewing
In relation to food textures, what does it mean if a child has good head control and a more mature suck?
- Spoon feeding, strained, or pureed foods
- Suggested foods: infant cereal, 1st and 2nd stage baby foods, pureed table foods
In relation to food textures, what does it mean if a child can handle food through sucking action but cannot move food to sides of mouth?
- Thickened pureed or soft mashed foods
- Suggested foods: mashed potatoes, well cooked mashed vegetables, soft diced fruits, applesauce
In relation to food textures, what does it mean if a child begins up and down chewing movement?
- Ground table foods
- Suggest foods: ground fruits and vegetables, non-stringy meat mixed with gravy
In relation to food textures, what does it mean if a child has increased tongue and lip control and sits alone without support?
- Cup drinking
- Suggested foods: juice, formula, milk
What should a child have mastered by 1 year of age?
- Pureed/blended/strained foods
What should a child have mastered by 1.5 years of age?
- Ground/lumpy foods
What should a child have mastered by 1.5 to 2 years of age?
- Cut up/chunky/diced foods
What should a child have mastered by 2.5 to 3 years of age?
- All textures of table foods
What are the stages of introducing different textures of food?
- Stage 1: thin, pureed, no lumps
- Stage 2: ground/lumpy
- Stage 3: pureed with chunks
- Stage 4: table foods, smaller bites than an adult
What is the timeline for self-feeding development?
Finger feeding:
- 2 months: brings fisted hand to mouth (supine and prone)
- 3 months: hand to mouth with object
- 3.5 months: recognizes bottle
- 5-6 months: mouths and gums can melt crunchy food (i.e. baby crackers and puffs)
- 6-7 months: feeds self cracker
- 9 months: independent finger feeding
What is the timeline for spoon and fork skills?
- 9 months: will bang a cup
- 9.5 months: will stir spoon in imitation
- 12-14 months: will bring filled spoon to mouth, but turns it over in route (more pronated grasp pattern)
- 15-18 months: scoops food and will bring spoon/fork to mouth, spilling some
- 24 months: brings food to mouth with utensil (spoon or fork), palm facing up
- 4.5 to 5 years: uses knife to butter bread or cut soft food
What is the timeline for cup drinking?
- Birth to 4 months: accepts liquid from breast or bottle
- 4-6 months: able to drink from a cup if held by caregiver, poor lip seal. Most of the liquid will spill
- 9 months: able to hold and drink from bottle independently, able to drink from a cup (may spill), independent with sippy cup with valve
- 18 months: can skillfully drink from a cup with lid holding with two hands
- 24 months: can drink from an open cup with minimal spilling or liquid loss, by 30 months should be able to skillfully drink from open cup with one hand
- 4 to 4.5 years: can pour liquid from carton or pitcher
What are typical weight and length growth expectations during the first year of life?
- 6 months: weight doubles
- 12 months: weight triples and length increases 5-10 inches
What are typical weight and length growth expectations during the second year of life?
- Weight gain: 4-6 lbs
- Length gain: 4-5 inches
What are typical weight and length growth expectations during the third year of life?
- Weight gain: 3.5-5.5 lbs
- Length gain: 2-2.5 inches
What is the loss of growth if a child is not receiving adequate nutrition?
- Weight > length > HC
