Assuring Pediatric Nutrition in the Community
FREQUENTLY
USED GUIDELINES:
Assessing Nutritional Status - Feeding Skills
How do I assess
feeding skills?
The approximate ages at which certain feeding skills are developed are
listed below. This information is intended to provide a frame of reference
for milestones that should be reached before offering certain foods. Children
may develop skills at different ages (earlier or later). It is important
to offer foods that are appropriate to the child’s developmental stage.
The 10 month old who is beginning to finger feed is probably just as "normal"
as the 8 month old who is beginning to finger feed. When problems with
feeding exist (or are suspected), a child should be evaluated by a feeding
team, including a nutritionist, speech or occupational therapist, nurse,
and social worker.
APPROXIMATE AGE: 4-6 Months
Behaviors
- sits independently
- reaches for objects
- begins lip sound play - smacks, purses lips
- voluntarily moves lips and tongue
- begins muchning pattern
Indicates readiness for...
- offer soft, semi-solid, pureed foods from spook; e.g., infant cereal, pureed vegetables and fruits
APPROXIMATE AGE: 7-8 Months
Behaviors
- reaches for objects
- brings hand to mouth
- begins tongue lateralization
Indicates readiness for...
- finger-feeding large pieces of food
- offer ground junior or mashed table foods
APPROXIMATE AGE: 8-10 Months
Behaviors
- holds bottle to drink
- puts lips on rim of cup
- diagonal chewing emerges
Indicates readiness for...
- introduce cup
- offer coarsely chopped table foods, easily chewed soft meats
APPROXIMATE AGE: 11-12 Months
Behaviors
- rotary chewing begins
- swallows with lips closed
- picks up cup independently
- takes 4-5 continuous swallows
Indicates readiness for...
- increase textures, include more table foods
- begin spoon feeding
- continue to encourage drinking from cup
APPROXIMATE AGE: 18 Months
Behaviors
- tongue clears upper and lower lips
- can spoon-feed
- drinks from cup independently
Indicates readiness for...
- increase the number of foods from the family's menu; e.g., tender meats, soft fruits and vegetables
APPROXIMATE AGE: 24 Months
Behaviors
- begins to use fork
Indicates readiness for...
- continue to increase variety of textures in food pattern
Nardella M, et al. Nutrition Interventions for Children with Special Health Care Needs. Washington State Department of Health. 2002.
Trahms CM and Pipes PL. Nutrition in Infancy and Childhood, 6th edition. WCB-McGraw Hill. 1997.
Nevin Follino N. Pediatric Manual of Clinical Dietetics, 2nd edition. American Dietetic Association. 2003.