Developmental Stages In Infant Feeding Game

Developmental Stages

In

Infant Feeding Game

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Presenter’s Notes

Kit Contents:

• Facilitator guide which includes:

– Icebreaker, introduction to topic, instructions for game.

– 4 - One page information sheets that provide an introduction to

each of the four developmental stages.

– Questions and answers for each of the 25 developmental skill

statements categorized by the four developmental stages.

• 4 laminated category cards: Newborn to 4 Months, 5 - 6 Months, 7 - 8

Months, and 9 - 12 Months.

• 25 laminated cards with developmental skill statement and

corresponding information on back.

Materials for Icebreaker (not included in kit):

• Straws, cups, spoons

• Food items:

– Liquid (water or milk)

– Smooth Food ( yogurt, pudding)

– Solid Food (requires chewing or biting)

– See Icebreaker for complete details

Purpose of Activity:

• Create parent’s awareness that feeding skills usually follow a

sequence and that a baby needs to master one feeding skill before

they can go onto the next.

• Normalize that all infants develop at their own rate and ability.

• To let parents know what to expect related to their baby’s feeding

and drinking skills and to know which food textures an infant can cope

with at what ages.

Activity Instructions:

1. Tape the four different age category cards (Newborn – 4 months, 5 – 6

months, 7 – 8 months and 9 months – 12 months) onto the wall with

space between each card.

2. Hand out laminated developmental skill statement cards to

participants.

3. Have participants, one by one, read the card to the group.

4. Either as an individual or with group support, have the participant

guess which age category the skill belongs to.

5. Have the participant or facilitator read the back of the card to the

group. The information on the back of the card provides more

information about the skill and how it is important for feeding.

6. Tape the participant card to the category where it fits best. (Note: One

developmental skill card fits across all categories and can be placed in

any of the categories.)

7. The introduction sheet for each of the four developmental stage

categories can be used by the facilitator to:

• highlight some of the differences in the categories at the

beginning of the game

• provide extra information as you go through the participant cards

• summarize each category at the end of the game

IMPORTANT: Keep in mind there is great variation between babies and no

two babies are alike. Sometimes a baby is the only one who knows their

developmental timetable.

Icebreaker Suggestion

• Have participants sip a liquid through a straw and then drink from a

cup. Discuss how they feel different.

• Have participants eat something smooth from a spoon (example,

yogurt) and something they must bite and chew (examples are fruit,

cracker, bread). Discuss how they feel different.

• This activity helps to illustrate the mechanics of drinking and eating

including being able to control where food is in the mouth, chewing,

and swallowing. To better understand oral-motor development ask

participants what their tongue and mouth did when they ate.

• The things we do with our mouth when we eat and drink are

automatic for adults. Your baby must learn these skills!

Introduction to Topic: (share with participants)

• Teaching a child to eat is part of parenting. Ellyn Satter has compared

it to planning a trip. You are going to be somewhere by a certain time,

which in this case is the end of the first year. At this time baby will be

seated at the family table, finger-feeding table food and drinking from

a cup. From the beginning of this trip until you arrive, there will be

constant transitions.

• In order to get through this time of rapid change with minimum hassle,

there needs to be progression from liquid food to lumpy food and then

to soft table food when baby is ready.

• Feeding a baby can be an intense and exciting experience for both

parent and child. A child’s relationship with food during milk-feeding,

the introduction of solid foods and the transition to family foods is

important for health and development and can influence a child’s

eating habits for the rest of their life.

• Today’s session will talk about the skills your baby will develop during

the first year and how these relate to feeding.

• Keep in mind that there is great variation between babies and

sometimes a baby is the only one who knows their developmental

time table!

Introduction

Newborn to 4 months

• A newborn baby’s nervous system and digestive system is maturing and

the brain is growing rapidly.

• Starting at birth, babies know how much they need to eat. At no other time

in a person’s life is there the ability to regulate food intake with such

precision.

• A baby is born with the need to be understood and will eat better when

cues and signals are followed. The following are cues a baby might use to

let you know they are hungry or full.

I’m Hungry

• Looks at your face

• Turns head toward you

• Makes loud feeding sounds

• Fussing

I’m Full

• Stops nursing

• Relaxes

• Pushes away

• Looks away

• Yawns or falls asleep

• Arches back

At this age babies do best when cuddled during

nipple-feeding from breast or bottle

Questions and Answers for Newborn to 4 Month

Developmental Skill Statements

Baby has poor head control

Newborn – 4 Months

• A young infant who is unable to hold their head straight will not be able to have an active role in eating. They will have a difficult time sitting in a high chair and leaning forward to accept food.

• Regular tummy time helps strengthen the muscles needed for this gross motor skill.

• A baby will enjoy eating solids when they are developmentally ready, usually closer to 6 months.

Baby roots for nipple


• Infants are born with the rooting reflex. They will turn toward the nipple when it touches their cheek.

• The rooting reflex is obvious in a young infant and disappears gradually with age.

Infant is cuddled during nipple-feeds from breast or bottle

From Birth On…

• Cuddling a baby while feeding is important to establish bonding and trust between the infant and caregiver.

• This should occur during all stages of infancy, not only the first few months!

Baby is able to swallow liquids well, but when offered a spoon most food ends up around the mouth


• The newborn is born with limited feeding skills and when presented with a nipple can open their mouth. For the most part they know how to latch on and suck, but are not ready to eat solid food from a spoon until closer to six months.

Baby can bring a toy to their mouth

Newborn to 4 Months

• First the baby will find their fingers and bring them to their mouth. Then it happens with a toy!

• This is a motor skill involving hand-eye coordination which is necessary for self-feeding when older.

Infant will often experience their first growth spurt

Newborn to 4 Months

• Although growth spurts can happen at any time, it’s common for them to hit at:

– about 10 days

– between 3 – 6 weeks

– 3 months

– 6 months

• Most last for only a few days. Babies can gain weight and length very quickly during a growth spurt.

• Signs of a growth spurt :

– baby seems hungrier than usual

– baby may sleep more

– baby may get up more to feed

– baby may be cranky

• Sometimes mothers wonder if they are making enough breast milk during a growth spurt because baby might never seem to be full. Continue to breast feed as often as baby wants to and your body will keep pace with baby’s appetite.

Baby’s stomach size could be compared to the size of a cherry

Newborn to 4 Months

• A newborn’s stomach is very small – that’s why they must eat so often.

• Closer to 4 months it might be compared to the size of a plum.

• An infant’s stomach size increases with growth. A one year old might have the stomach about the size of a fist or baseball and is able to eat more at one time and therefore eat less often.

Introduction

5 – 6 Months

• Growth of your baby during their first year of life is greater than it will be

during any other stage of childhood.*

• High growth means high appetite. Expect grow spurts between 3-6

weeks, 3 months, and 6 months. Breastfeed more often during growth

spurts to meet the increasing demands of your baby.

• At around 6 months of age your baby’s digestive tract becomes mature

enough to handle solids and breastmilk is no longer enough to cover iron

needs. Iron stores start to run low. Now is the time to offer high iron

pureed foods from a spoon. Examples include infant cereal, meats, egg,

tofu and legumes (split peas, beans, lentils).

• Readiness for solids becomes apparent at this age and is determined by:

– a combination of gross motor skills (large muscles) and oral motor

skills (mouth, tongue, swallowing).

– a desire to control eating which is shown by baby leaning forward,

opening his mouth or rejecting foods to show fullness.

*Size does not determine the health of a baby – steady growth does!

Questions and Answers for 5- 6 Months


Baby has good head control

5 – 6 Months

• This is one of the physical traits that occurs at around 5 – 6 months

indicating an infant’s body is ready physically for solid foods.

• The baby is able to hold their head up which helps them to sit up

straight and swallow.

Baby follows food with their eyes

5 – 6 Months

• Following food with their eyes is one physical sign baby is ready for

solids.

• Other signs of readiness to eat are:

– ability to sit in a highchair alone or with a bit of support

– opening their mouth when they see food coming

– holding their head up

– reaching out to grab the spoon to put it in their mouth

Baby uses their whole hand to grab objects

5 – 6 Months

• At about 5 or 6 months babies start to get better hand-eye coordination.

• They will rake an object toward themselves and start passing objects

from one hand to another.

• You might notice baby likes to put objects they have picked up into their

mouth. It could be a sign baby is getting ready to eat solid foods.

Baby is easily able to eat pureed food from a spoon

5 – 6 Months

• By close to 6 months babies can use their upper lip to take food from a spoon rather than trying to suck at it.

• They are able to move food to the back of their mouth and swallow.

• If baby pushes food out and more ends up on the face than in the mouth, it may be a sign baby isn’t ready.

• Some spoon feeding tips:

– Use a soft tipped, shallow spoon

– Don’t overload the spoon

– Let baby enjoy touching the food in their bowl as you feed

– Be guided by your baby, wait for them to open their mouth before offering food

Baby is able to show feeling full by turning head away, pushing spoon away, holding food in their mouth, clenching their mouth shut, spitting food out

5 – 6 Months

• A six month old baby who eats solids can show they have had enough by doing all the things listed.

• Milk-fed infants might stop sucking, spit out the nipple, turn their head away or slow their feeding pace.

• Older infants might throw food and signal “no” to unwanted food.

Infant iron stores begin to run out

5 – 6 Months

• Iron is important for baby’s growth and brain development.

• By about 6 months of age babies need more iron from their diet.

• Offer iron-rich foods as the first foods. Examples: beef, chicken, turkey, pork, fish, eggs, legumes (split peas beans, lentils), chickpeas, tofu, iron fortified baby cereals.

• There is no need to measure foods to ensure adequate iron intake – instead, offer high iron foods a couple of times each day. Baby should be well established on high iron foods, before moving on to other foods.

Baby might gag when learning to swallow solid foods

5 – 6 Months

• The gag reflex is a protective reflex that prevents the ingestion of food

pieces that are too large to be swallowed.

• As an infant gets more used to foods and textures the gag reflex usually

declines.

• Do not hesitate to offer lumpy foods early on – around 7 months – to

promote good oral motor skills.

• Gagging is seen less soften in infants who begin lumpy foods at an

early versus later age.

• Start by leaving some lumps in the foods you prepare for baby. This

can be as simple as pureeing them less.

Baby can start drinking from an open cup

5 – 6 Months

• Once a baby is eating solids it is a good time to start introducing an

open cup at meal times.

• Sippy cups are not needed. Language specialists say open cups help

build the oral motor strength needed for talking.

Introduction

7 – 8 Months

• It is normal for babies to have individual texture preferences and not

uncommon for some babies to want to move quickly from pureed foods

and straight to table foods. Others may prefer pureed foods for a bit

longer.

• At this age the child is able to mash food with an up and down motion

and push food around with the mouth and tongue. Offer lumpy or

mashed up foods.

• Babies also like to explore food with touch and are able to palm food

and scrape it from hand into mouth. This is the beginning of self-feeding.

By 6 months 68% of babies are grasping food with their hands (2004

study).

• Babies are born preferring sweet tastes and might reject bitter and sour

but most have a willingness to at least try an item. Flavor learning

research shows that frequent exposure to fruit and vegetables during

infancy increases acceptance even as your child gets older.

• Babies will often make facial expressions when introduced to new foods.

Instead of focusing on this or how much a child eats of a new food,

parents should notice willingness to try an item. Funny faces with a new

food are to be expected.

Baby has been eating mainly pureed foods since 6 months.

It is now time to move on!

Questions and Answers for 7- 8 Months


Baby scrapes food from hand into mouth

7 – 8 Months

• At this age babies start to want to do things for themselves. They might

grab the spoon and clam up when a caregiver tries to feed them. Take

the message and allow them small pieces of soft food.

• At this age babies can palm food. A palmar grasp means holding food

between the fingers and palm and then scraping the food from hand to

mouth.

• Always be there to supervise.

Infant is able to eat lumpy food and pieces of soft food

7 – 8 Months

• Examples of soft foods are chopped cooked vegetables, canned or

cooked fruit, strips of bread or tortilla, mashed cooked beans, cheese,

sticky rice, cooked pasta, fish, eggs, tofu, ground meats.

Baby is able to munch or mash food with an up and down motion

7 – 8 Months

• Infants don’t need teeth to chew. Most can gum food if it is soft and

moist.

• Babies learn to chew before they get most of their teeth.

Baby begins to recognize foods

7 – 8 Months

• Infants learn to recognize faces, sounds and smells. They also quickly

learn the taste and smell of milk early in infancy.

• At around 7 months babies begin to recognize foods they have already

tried.

Introduction

9 – 12 Months

• By this age, caregivers and babies have learned to read each other’s

cues both verbal and non-verbal. This is important for attachment and

bonding. Babies now start using words and sounds to show hunger

and may shake their head to mean “no” or be able to say or sign “all

done” when finished.

• Make the meal location pleasant and free of distraction with the child

sitting comfortably and facing others.

• Offer developmentally appropriate food as part of a regular routine of

meals and snacks.

• Continue being responsive with feeding. Watch for and respect the

child’s signals of hunger and fullness.

• Attend to your child’s signals of hunger and fullness. Assist them when

they want you to, but don’t do for a child what he is capable of

doing for himself!

• Giving your baby healthy food is important, but just as important is

connecting with others at mealtimes. Using hands-free feeders for

bottles while baby is in stroller, serving squeezable baby food in the car

and sitting children alone to eat while parents rush to do other things

should not be done as a regular practice.

• Try to take time together to eat as a family.

Remember to eat together as often as possible. Family meals are

important. Do not rob yourself or your child the joy of human

interactions when eating.

Questions and Answers for 9 - 12 Months


Baby is able to sit up alone, with no props

9 – 12 Months

• About one-third of infants can sit alone without support between the ages of 4 – 6 months.

• By 9 months 97% can sit unsupported.

Baby points to food

9 – 12 Months

• 9 – 12 month old infants will often point to foods they know or like.

Baby is able to pick up small objects between thumb and forefinger

9 – 12 months

• 9 – 12 month old infants can pick up objects with little effort.

• Once they have something in their hand they may hand it over to you or drop it to watch you pick it up.

• Their pincer grasp is improving, which means they can pick up small objects such as dry cereal and peas between their thumb and forefinger.

• 98% of babies can pick food up with their fingers by 11 months.

Baby is self-feeding soft table foods

9 – 12 Months

• Baby easily sits without help in a high chair and is getting better at picking up small pieces of food and transferring it from hand to mouth.

• They enjoy self-feeding everything from the family table that is soft and cut up. Examples include casseroles, toast, crackers, tender chopped meat, soft ripe fruit (bananas, peaches, pears, avocados, melon), cooked vegetables and dry cereals.

• Older babies can bite through different textures of foods when teeth have erupted.

Baby begins to understand short words like “bye”

9 – 12 Months

• Some babies say their first word at 9 months and some are able to

shake their head to mean “no”.

• Toddlers begin saying “no” more often or might name a food they want

at about 12 months.

• At 12 months toddlers understand a lot but may not be able to speak

many words. Toddlers taught sign language are able to sign simple

words like “more” or “milk”.

Where Can I Get Help?

“Developmental Stages in Infant Feeding ”

has been developed and produced in partnership by

Healthy Child Manitoba and Cheryl Ogaranko, Registered Dietitian

If you have questions about feeding

your family, you can call

• .

Newborn

To

4 Months

5 – 6

Months

7 – 8

Months

9 – 12

Months


Newborn – 4 Months • A young infant who is unable to hold their head straight will not be

able to have an active role in eating. They will have a difficult time sitting in a high chair and leaning forward to accept food.

• Regular tummy time helps strengthen the muscles needed for this gross motor skill.

• A baby will enjoy eating solids when they are developmentally ready, usually closer to 6 months.


Newborn – 4 Months • Infants are born with the rooting reflex. They will turn toward the

nipple when it touches their cheek.

• The rooting reflex is obvious in a young infant and disappears gradually with age.

Infant is cuddled during nipple-feeds

from breast or bottle

Baby is able to swallow liquids well, but when offered a spoon most food

ends up around the mouth

Infant is cuddled during nipple-feeds from breast or bottle

From Birth On… • Cuddling a baby while feeding is important to establish bonding and

trust between the infant and caregiver.

• This should occur during all stages of infancy, not only the first few months!

Baby is able to swallow liquids well, but when offered a spoon most food ends up around the mouth

Newborn – 4 Months • The newborn is born with limited feeding skills and when presented

with a nipple can open their mouth. For the most part they know how to latch on and suck, but are not ready to eat solid food from a spoon until closer to six months.


Infant will often experience their first

growth spurt


Newborn to 4 Months • First the baby will find their fingers and bring them to their mouth.

Then it happens with a toy!

• This is a motor skill involving hand-eye coordination which is necessary for self-feeding when older.

Infant will often experience their first growth spurt

Newborn to 4 Months • Although growth spurts can happen at any time, it’s common for them to hit at

– about 10 days

– between 3 – 6 weeks

– 3 months

– 6 months

• Most last for only a few days. Babies can gain weight and length very quickly during a growth spurt.

• Signs of a growth spurt :

– baby seems hungrier than usual

– baby may sleep more

– baby may get up more to feed

– baby may be cranky

• Sometimes mothers wonder if they are making enough breast milk during a growth spurt because baby might never seem to be full. Continue to breastfeed as often as baby wants to and your body will keep pace with baby’s appetite.

Baby’s stomach size could be compared

to the size of a cherry


Baby’s stomach size could be compared to the size of a cherry

Newborn to 4 Months • A newborn’s stomach is very small – that’s why they must eat so

often.

• Closer to 4 months it might be compared to the size of a plum.

• An infant’s stomach size increases with growth. A one year old might have a stomach about the size of a fist or baseball and is able to eat more at one time and therefore eat less often.


5 – 6 Months • This is one of the physical traits that occurs at around 5 – 6 months

indicating an infant’s body is ready physically for solid foods.

• The baby is able to hold their head up which helps them to sit up straight and swallow.


5 – 6 Months • Following food with their eyes is one physical sign baby is ready for

solids.

• Other signs of readiness to eat are:

– ability to sit in a highchair alone or with a bit of support

– opening their mouth when they see food coming

– holding their head up

– reaching out to grab the spoon to put it in their mouth


5 – 6 Months • At about 5 or 6 months babies start to get better hand-eye

coordination.

• They will rake an object toward themselves and start passing objects from one hand to another.

• You might notice baby likes to put objects they have picked up into their mouth. It could be a sign baby is getting ready to eat solid foods.

Baby is easily able to eat pureed food

from a spoon

Baby is part of the family table when it comes to

eating

Baby is easily able to eat pureed food from a spoon

5 – 6 Months • By close to 6 months babies can use their upper lip to take food from a

spoon rather than trying to suck at it.

• They are able to move food to the back of their mouth and swallow.

• If baby pushes food out and more ends up on the face than in the mouth, it may be a sign baby isn’t ready.

• Some spoon feeding tips:

– Use a soft tipped, shallow spoon

– Don’t overload the spoon

– Let baby enjoy touching the food in their bowl as you feed

– Be guided by your baby. Wait for them to open their mouth before offering food

Baby is part of the family table when it comes to eating

5 – 6 Months • As soon as baby is eating solids (at around 6 months), they can

benefit from family meals. They learn by watching and are also exposed to the same foods you want them to eat later on.

• Bringing baby to the table teaches that eating is a social act and not only about them.

• Pull the high chair up to the table.

• Make a point to eat together as often as possible. Most meals should happen in a designated area – for example in the high chair at home.

Baby is able to show feeling full by: • turning head away • pushing spoon away • holding food in their mouth • clenching their mouth shut • spitting food out

Infant iron stores begin to run out

Baby is able to show feeling full by turning head away, pushing spoon away, holding food in their mouth, clenching their mouth shut, spitting food out 5 – 6 Months • A six month old baby who eats solids can show they have had

enough by doing all the things listed. • Milk -fed infants might stop sucking, spit out the nipple, turn their

head away or slow their feeding pace. • Older infants might throw food and signal “no” to unwanted food.

Infant iron stores begin to run out 5 – 6 Months • Iron is important for baby’s growth and brain development. • By about 6 months of age babies need more iron from their diet. • Offer iron-rich foods as the first foods. Examples: beef, chicken,

turkey, pork, fish, eggs, legumes (split peas beans, lentils), chickpeas, tofu, iron fortified baby cereals.

• There is no need to measure foods to ensure adequate iron intake – instead, offer high iron foods a couple of times each day. Get baby well established on high iron foods, before moving on to other foods.


5 – 6 Months • The gag reflex is a protective reflex that prevents the ingestion of food pieces

that are too large to be swallowed.

• As an infant gets more used to foods and textures, the gag reflex usually declines.

• Do not hesitate to offer lumpy foods early on – around 7 months – to promote good oral motor skills.

• Gagging is seen less often in infants who begin lumpy foods at an early versus later age.

• Start by leaving some lumps in the foods you prepare for baby. This can be as simple as pureeing them less.


5 – 6 Months • Once a baby is eating solids it is a good time to start introducing an

open cup at meal times.

• Sippy cups are not needed. Language specialists say open cups help build the oral motor strength needed for talking.

Baby scrapes food from

hand into mouth


Baby scrapes food from hand into mouth

7 – 8 Months • At this age babies start to want to do things for themselves. They

might grab the spoon and clam up when a caregiver tries to feed them. Take the message and allow them small pieces of soft food.

• At this age babies can palm food. A palmar grasp means holding food between the fingers and palm and then scraping the food from hand to mouth.

• Always be there to supervise.


7 – 8 Months • Examples of soft foods are chopped cooked vegetables, canned or

cooked fruit, strips of bread or tortilla, mashed cooked beans, cheese, sticky rice, cooked pasta, fish, eggs, tofu, ground meats.

Baby is able to munch or mash food with an up

and down motion


Baby is able to munch or mash food with an up and down motion

7 – 8 Months • Infants don’t need teeth to chew. Most can gum food if it is soft and

moist.

• Babies learn to chew before they get most of their teeth.


7 – 8 Months • Infants learn to recognize faces, sounds and smells. They also

quickly learn the taste and smell of milk early in infancy.

• At around 7 months babies begin to recognize foods they have already tried.


Baby points to food


9 – 12 Months • About one-third of infants can sit alone without support between

the ages of 4 – 6 months.

• By 9 months 97% can sit unsupported.

Baby points to food

9 – 12 Months • 9 – 12 month old infants will often point to foods they know or like.

Baby is able to pick up small objects between thumb and

forefinger

Baby is self-feeding soft table foods

Baby is able to pick up small objects between thumb and forefinger 9 – 12 Months • 9 – 12 month old infants can pick up objects with little effort. • Once they have something in their hand they may hand it over to

you or drop it to watch you pick it up. • Their pincer grasp is improving, which means they can pick up small

objects such as dry cereal and peas between their thumb and forefinger.

• 98% of babies can pick food up with their fingers by 11 months.

Baby is self-feeding soft table foods 9 – 12 Months • Baby easily sits without help in a high chair and is getting better at

picking up small pieces of food and transferring it from hand to mouth.

• They enjoy self-feeding everything from the family table that is soft and cut up. Examples include casseroles, toast, crackers, tender chopped meat, soft ripe fruit (bananas, peaches, pears, avocados, melon), cooked vegetables and dry cereals.

• Older babies can bite through different textures of foods when teeth have erupted.


9 – 12 Months • Some babies say their first word at 9 months and some are able to

shake their head to mean “no”.

• Toddlers begin saying “no” more often or might name a food they want at about 12 months.

• At 12 months, toddlers understand a lot but may not be able to speak many words. Toddlers taught sign language are able to sign simple words like “more” or “milk”.

Developmental Stages In Infant Feeding Game

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