Sensory Integration Dysfunction

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What to expect

Normal development of eating, drinking and swallowing

Normal development of eating, drinking and swallowing is as follows:

  • 0-2 months
  • 3-4 months
  • 5-6 months
  • 7-8 months
  • 9-12 months
  • 12-14 months
  • 15-18 months
  • 19-21 months
  • 24 months
  • 24-48 months

2 months

  • Uses a sucking pattern whilst feeding with some liquid lost.
  • Swallow consists of a suck swallow pattern.
  • Pattern consists of two or more sucks followed by a pause to swallow.
  • Typically has two to four ounces of liquid for each feed, six or more times a day.
  • 3 – 4 months
  • Feeding consists of four to seven ounces of liquid per feeding, four- six times a day.
  • Swallowing pattern consists of suck, swallow, breathe sequence, this is well coordinated. Pattern usually consists of 20 or more sucks.
  • Swallow is not usually followed by an obvious pause when infant is hungry.
  • At four months sucking reflex is usually lost, sucking now becomes and intentional act. Tongue thrust reflex is also lost which helps the infant's ability to accept spoon fed smooth puree.

months

  • Infants can now accept pureed foods, cereals and liquids.
  • Usually four-six feeds a day with nine to ten ounces of food or liquid per feed.
  • Uses bite release (phasic bite pattern) which is often uncontrolled. When given a soft biscuit, the infant may suck the biscuit rather than biting it.
  • May use up / down chewing pattern.

months

  • Infant now accepts thicker pureed food (7 months) and mashed food (8 months).
  • Able to open jaw as response to seeing a spoon, tongues reflex accepts spoon when entering the mouth.
  • Suck, swallow, breathe sequences become longer. Infant will accept liquid from a cup however may suck continuously followed by an uncoordinated swallow; a lot of liquid may be lost.
  • More movement of the tongue apparent; tongue will move up / down in a munching pattern.

2 months

  • Sequences of continuous sucks become longer when given liquid via a cup; swallow may still be uncoordinated with cup drinking.
  • Will hold a soft biscuit in the mouth without biting all the way, this biting pattern is known as graded biting and may be alternated with a phasic bite pattern.
  • Up / down movement of the jaw when chewing, this may vary in speed.
  • Moves tongue from side to side when food is placed at the side of the mouth; starting to move food from the centre of the tongue to the side.
  • At around 10 months the infant will be able to use their lips to take food from the spoon.
  • Able to independently finger feed.

4 months

  • The child will now accept liquids, mashed or table-foods which are well cut up; this may include easy chewable meats.
  • Controlled bite used when given a soft biscuit. May use phasic bite and sucking when given harder biscuits.
  • Will use lips when chewing, food and saliva may be lost during chewing.
  • Now able to move food from the centre of the mouth to the biting surfaces.
  • When drinking liquid from a cup uses a sucking movement, some liquid may be lost. Sucking is followed by a quick swallow with no pause. If liquid flows to quickly coughing may occur.

18 months

  • Phasic bite pattern will stop being used at around 15 months. The baby will now use a controlled, sustained bite (head may be pulled slightly back)
  • At 18 months the baby can be given table foods (cut up).
  • Able to chew with lips closed (the may be inconsistent).
  • Solid food swallowed with minimal leakage of food or liquid.
  • Well-coordinated swallowing pattern.
  • Top lip used as a seal over cup when drinking.
  • Upper and lower lips used when chewing and cleaning food.
  • Jaw pattern consists of diagonal rotatory movement.

1 months

  • Well established bite, able to open mouth to bite thicker foods.
  • onths

  • Able to swallow solid food with good lip closure, no food lost.
  • Able to swallow liquid from a cup with ease, good lip closure and no loss of liquid.
  • Can now move food easily within the mouth with no pause.
  • Now able to stabilise the drinking cup with no need to bite on the edge of the cup.
  • Chewing pattern consists of rotatory and vertical jaw movements.

48 months

  • Now able to eat the same food as the family.
  • Grinding movement when chewing usually occurs at 48 months.

is important to note that this acts as a guide only and there will be a variation in the development of feeding and swallowing in each child.

your child is not following the normal development of feeding and swallowing, they may have an eating, drinking or swallowing difficulty. For more information please see our page on warning signs of eating, drinking and swallowing difficulties.

you feel that your child is failing to meet the normal development of feeding and swallowing or you have any concerns over your child's eating and drinking ability please contact us by emailing office@slt.co.uk or calling 0330 0885 643.


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To speak to a Speech and Language Therapist or to book an appointment, call us on 0161 883 0111 or email office@slt.co.uk

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