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Eating and Drinking

Eating and Drinking are two of the most important things children do for health and development.  Mealtimes are also a time when children can learn important skills, and develop relationships.  When a child is struggling with eating, it can be a huge challenge for the whole family. 

Successful eating and drinking requires appropriate motor development throughout the body and mouth, normal sensory development, healthy routines, and most of all enjoyment of the experience!

There are several eating and drinking skills that can be a challenge for a child:

  • Breastfeeding or bottle feeding
  • Eating solid foods
  • Moving from smooth purees to textured foods
  • Chewing and swallowing food
  • Drinking from a cup
  • Feeding yourself (with fingers or utensils)
  • Eating the right amount of food
  • Getting enough nutrition
  • Taking part in mealtimes

Typical Developmental Milestones and Red Flags

Below are some of the typical milestones to expect as your child grows, followed by some red flags that might indicate a problem.  If you have a concern about your child at any age, you can contact us, or make a referral at any time.

Newborn

By 1 month of age, your child will:

  • Takes 2-4 ounces (60-120ml) of liquid per feed.  6-8 or more feedings  per day.
  • May lose some liquid from corners of mouth
  • Be able to do at least 2 sucks in a row before pausing to breathe
  • Have a rooting reflex where he will turn towards the breast or bottle when the side of his mouth is stroked
  • Have a suck and swallow reflex where she will open her mouth wide enough to latch onto the breast or bottle
  • Bring her hands to her mouth by 2 months

Infant 

By 3-4 months of age, your child will:

  • Take 4-7 ounces (120-280ml) of fluid per feed.  4-6 feedings per day.
  • Be able to do about 20 sucks before stopping to breathe.  Sucking, swallowing, and breathing are well-coordinated

By 5-6 months, your child will:

  • Take 9-10 ounces (270-300ml) of food and/or liquid per feed
  • Start to pat the bottle or breast with her hands during feeding
  • Start to eat small amounts of thin, pureed foods such as infant cereal or pureed fruit from a spoon
  • Start to suck on or bite on a baby cookie
  • Use some up and down chewing movements

By 7-8 months, your child will:

  • Start to eat thicker pureed foods at 7 months
  • Eat ground or junior baby foods, or mashed table foods by 8 months
  • Try to drink from a cup held for him, but may lose a lot of liquid.  May take large mouthfuls of liquid and cough/choke
  • Move his tongue up and down, and to the side when chewing food
  • Mouth and munch on the spoon, toys, and baby biscuits
  • Hold his own bottle

Between 9-12 months, your child will:

  • Take longer sequences of sucks with cup drinking, but may still have trouble coordinating drinking and breathing
  • Move her jaw and tongue a lot when chewing and moving food around in her mouth
  • Start to feed himself finger foods
  • Start to hold a spoon during meals, but may not feed herself with it yet
  • Bite and chew foods by himself

Toddler/Preschooler

Between 12-18 months, your child will:

  • Eat ground, mashed, or chopped table foods (including soft pieces of meat) by 15 months
  • Use her tongue well to move food from side to side in the mouth
  • Lose a bit of food or saliva out of the mouth while chewing
  • Bite foods well
  • Eat coarsely chopped table foods, including meats and raw vegetables by 18 months
  • Sometimes chew with lips closed
  • Drink from a cup well without losing liquid out of her mouth by 18 months
  • Feed herself using a spoon, dropping some food off the spoon
  • Start to refuse some foods

By 24 months (2 years), your child will:

  • Swallow well from a cup with good lip closure around cup and no loss of liquid
  • Swallow food well with good lip control and no loss of food
  • Chew with jaw movements that go round and round, as well as up/down and side to side
  • Know the difference between food and non-food items
  • Scoop foods with a spoon, with some spills
  • Start to stab food with a fork and get it to her mouth
  • Start to show clear likes and dislikes of some foods

Between 2 and 3 years of age, your child will:

  • Eat the same foods as the rest of the family
  • Feed himself well with a spoon and fork
  • Have definite food likes and dislikes
  • Refuse certain foods
  • Possibly start to become a “picky eater”
  • Wipe his own mouth and hands with a napkin or cloth
  • Start to serve herself at the table with some spills
  • Pour liquids into his cup from a small container

Red Flags for Eating and Drinking Problems

If your child is showing some of the following signs, it may be helpful to talk to your doctor or another health professional, such as a speech language pathologist, occupational therapist, dietician, or public health nurse.  To make a referral to our centre, please click here.

  • Arching or stiffening of the body during feeding
  • Coughing or choking during feeding
  • Being very irritable/fussy during or after feeding
  • Taking a really long time to feed (more than 30-45 minutes)
  • Frequent spitting up
  • Getting sick often with pneumonia or chest infections
  • Gurgly, hoarse, or breathy voice
  • Less than normal weight gain or growth
  • Lots of leakage of food or liquid from the mouth
  • Coughing, gagging, or throwing up during or after meals
  • Stuffing mouth with food
  • Holding food inside pockets in mouth for long periods
  • Difficulty accepting new textures of food
  • Avoidance behaviours to specific foods and textures (gagging, vomiting, blocking the spoon with hands or closed lips, crying, pushing food away, etc.)
  • Abnormal bowel movements that last longer than a few days (diarrhea, constipation, loose stool)
  • Skin reactions to foods (dry patches, hives, rashes) Note: If your child seems to be having a severe allergic reaction to a food (difficulty breathing, turning red, developing hives or rash on the face/chest), you should seek medical help immediately.