Did you know that there are milestones for children’s oral motor skills, just like there are milestones for skills like crawling and sitting? Eating requires complex coordination of muscles of the neck, jaw, cheeks, tongue, and more. You can promote their ability and willingness to accept a variety of foods by focusing on the developmental milestones below:
Infants typically begin by mouthing their hands, and then bringing objects to their mouth around 2-6 months. Mouthing allows children to develop hand-to-mouth motor skills needed for self-feeding. It also is important to desensitize and map out their mouths. Infants are born with their gag reflex more forward in their mouths, and as they mouth objects (especially those with extensions like this), they are able to slowly desensitize their mouth and push the reflex towards the back of their tongue. As objects touch different areas of their mouth, and their tongue and jaw interact with them, they also gain more internal awareness of different surfaces within their oral cavity. This helps down the line with moving food around more precisely inside their mouth to chew and manage it safely.
How to Help:
You can help your child bring their hands to their mouth to encourage them to develop that pattern. Once they are doing that on their own, you can also guide them to bring toys to their mouths. Over time and with some trial-and-error, they will begin bringing almost everything to their mouths! It can also be great to give them a full carrot or a big apple slice to mouth and taste (before they are able to remove any chunks).
In order to be able to use their jaw and tongues most effectively for eating solid foods, children need to develop the ability to hold their head steady when sitting supported. From the 4-6 month old range as head control is developing, children transition to being able to eat (both solids and liquids) more upright (45-90 degrees). Especially for baby led weaning or foods other than thin purees, it will be important that your child is able to maintain head control in a supportive seat (like a high chair). This will ensure that they can focus all of their attention on eating, instead of protecting themselves from injury.
How to Help:
Everything from tummy time, to rolling, to supported sitting is extremely helpful for developing head control. Work on gradually decreasing the support they need in sitting, from upper torso to mid or lower back. Also work on having them pull up to sitting from their backs, looking for them to engage their arms and tuck their chin in. Consult with your child’s OT or PT to ensure that this is safe for their unique needs and level.
Munching occurs as little ones learn how to move food both forward and back (using their tongue), and up and down (using their jaw). This skill sets the stage for chewing. During this time you’ll often see the child stick out their tongue while they swallow. This skill typically emerges from the 6-9 month range. Munching promotes stability of the jaw, development of tongue control, and the ability to manage mashed table foods (instead of thin purees).
How to Help:
When spoon feeding, rest the spoon on their lower lip so they have to close their lips in order to remove the puree from the spoon. This will encourage more jaw movement as well. Encourage play with teethers like this or this that have protrusions. Help guide the teethers to their gums on either side and apply some light rhythmic pressure downward to try to encourage up and down jaw movement. Deliver purees towards the front of their mouth, instead of placing the spoon on the middle of their tongue–this will encourage them to learn how to move food backwards in their mouths as well.
Tongue lateralization is a complex oral motor skill that develops over time in children. Essentially it is the ability of the tongue to move side-to-side in the mouth. It typically begins between 8-12 months of age. This supports holding foods on molars for chewing, as well as cleaning food out from the inside of the cheeks or face. Tongue lateralization helps children safely manage meltable solids like puffs, as well as soft cubes like avocado, and progressing to soft mechanical foods like pasta or scrambled eggs.
How to help:
To assist lateralization of the tongue inside the teeth, try coating one side of the spoon bottom with crumbs of a puff and place the spoon towards that side of the mouth. Your child’s tongue will be more likely to gravitate towards that direction due to the increased texture and input. When your child can manage longer dissolvable crackers like THESE, guide them to place the cracker towards the sides of their mouth. Eventually see if they are able to move a small puff from the front of their tongue to their molars/gums to chew/munch. Listening for audible crunching gives some indication of their accuracy with this. Stay tuned for a future blog topic for more details about how to encourage external tongue lateralization, as well as lateralization to reach pockets between the gums and cheek.
As your child approaches the rotary chewing skill, you will see more open mouth up and down jaw movements while chewing. You’ll then begin to see more diagonal movements of their jaw as they chew. Eventually, with a rotary chew, you will notice that their jaw moves in a more circular pattern when chewing more difficult texture. Rotary chewing allows children to break through fibers in things like meats, fibrous fruits or vegetables (like oranges), and edible peels/skins of fruits. If your child has difficulty with this skill, they may chew food for extended periods, pocket the fibers of foods, or spit out fibers with the juice removed.
How to Help
First, ensure that your little one has rotation skills from a gross motor perspective. Oral motor skills follow gross motor, so ensure they are able to turn their trunk when sitting and cross midline during play. If they’re not, and even if they are inconsistently, encourage this during play! In general to promote rotary chew, we recommend strategically presenting and preparing foods. If they do not have lateralization, vertical chew, or diagonal chew in place, we need to start there. Try dissolvable stick shapes, like veggie straws or very thin pretzels and help them place the end right on their molars/ pre-molar gums. As they get the feedback from crunching, and crumbs start to touch their tongue, we can often trigger a diagonal or rotary chew. Presenting very very small pieces of meat or snack bars to that molar area can also help. Just make sure they are not going to immediately swallow these pieces, give no more than one at a time, and ensure they are small enough to not be chokeable.
We hope you found some valuable information regarding just some of the important milestones for oral and feeding skills. As always, this information is for general purposes and if your child has specific needs, please consult with a feeding specialist if there may be safety concerns.