The Basics of Feeding: A Workshop in Pediatric Dysphagia. Part II.

The Basics of Feeding:A Workshop in Pediatric Dysphagia. Part II. Stacy Antoniadis, MA, MPH, CCC/SLP Lisa McCarty, MS, CCC/SLP Julie McCollum Daly,BS, OTR/L Cindy Straub, BS

Typical Feeding Development and Nutrition

Birth to Two Months • Motor • Flexion • Disorganized movements • A Total Neck Reflex (ATNR) - 2 months

Birth to Two Months • Oral Motor Skills and Intake • Sucking/suckling pattern • Tongue moves back and forward • Middle portion of lips active • Lower lip & mandible move together

Birth to Two Months • Self-Feeding Skills • Rooting reflex • Gag reflex • Hands to mouth

Three to Four Months • Motor • Weight bearing on forearms to counteract gravity, begins pushing downward to elevate head • Improved head control • Hands together - supine • Increased back extension • Hands to knees • 2-handed symmetrical reach • Ulnar palmar grasp

Three to Four Months • Oral Motor Skills and Intake • Increased lip movements • Up/down pattern of suck • Little loss of liquid • Introduction to cereals/pureed • Introduction to cup - maybe

Three to Four Months • Self-Feeding Skills • Recognition of nipple/bottle • Pulls feeder’s hand to mouth • Hand to mouth while holding object • Pats bottle with one/both hands

Five to Seven Months • Motor • Extended arm weight bearing • Independent sitting • Increased mobility • Manipulates toys

Five to Seven Months • Oral Motor Skills and Intake • Stable jaw until spoon in mouth • Increased activity of upper lip • Cereals and pureed foods • Mouths and gums solids • Munching • Drinks from cup when held

Five to Seven Months • Self-Feeding Skills • Holds bottle independently • Recognizes spoon/opens mouth

Eight to Ten Months • Motor • Creeps • Equilibrium reactions • Transitional movements • Pulls to stand • Cruises • Uses hands for functions • Thumb and finger grasps • inferior pincer • 3-jaw chuck

Eight to Ten Months • Oral Motor Skills and Intake • Cheeks/lips dimple • Increased tongue lateralization • Vertical chew begins • Ground junior and mashed table foods • Wary of new foods; spits out

Eight to Ten Months • Self-Feeding Skills • Takes from spoon, controlled • Finger foods to mouth • Reaches for spoon • Bangs spoon

Ten to Twelve Months • Motor • Independent walking • One hand holds/another manipulates • Neat pincer grasp

Nutrition Basics • Dietary guidelines • Food group pyramid • Vitamin and mineral requirements • Growth • length for age • weight for age • head circumference

The Basics of Feeding: A Workshop in Pediatric Dysphagia. Part II.