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Infant & Young Child Feeding n Nutrition in Perspective
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Facebook Baby Friendly Hospital Initiative Hong Kong Association
 Apr  2019
Acceptance of Food During Complementary Feeding II

Dr. Luk Wai Yin


Developmental Readiness

At around 6 months of age, infants
display developmental signs of readiness
for complementary feeding which include
the ability to maintain an upright posture
for a short time when placed in a sitting
position and diminished tongue thrust
reflex. These coincide with the anatomic changes of growth of the oral cavity and lowering of laryngeal structures, that facilitate the transition from suckling to sucking and spoon feeding.

The chewing efficiency for solid food textures improves as infants develop the necessary oro-motor skills.Around 4 to 6 months, food is mashed by the tongue's upward and downward motions. From 8 months onwards, munching (food crushed by raising and lowering of the lower jaw) is firmly established and chewing becomes more efficient. Carruth and Skinner1 summarised the milestones of oral motor and fine motor skills related to feeding based on parent's report. (Table 1)


Table 1: Children’s Oral Motor Development and Fine Motor Development Related to Feeding Behaviour1


Oral Motor Development

Mean Age (Months)

Opens mouth when spoon approaches or touches lips


Tongue moves food to back of mouth to swallow


Uses tongue and mouth to explore shapes and texture


Eats food with tiny lumps without gagging


Chews softer foods, keeps most in mouth


Chews and swallows firmer foods without choking



Fine motor development

Mean Age (Months)

Reaches for spoon when hungry


Eats finger foods without gagging


Brings side of spoon to mouth


Picks up, dips foods and brings to mouth


Scoops puddings and brings to mouth


... ... 

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Key Messages:


1. Parents may introduce a variety of food textures according to the readiness of infants' oro-motor skills. Delayed introduction of appropriate food texture, for example, introducing small lumps after 10 months of age, could give rise to later refusal of solid foods.

隨著寶寶不同的口肌發展能力,家長可以給他嘗試不同質地的食物。太遲引進合適的食物質地( 例如: 10個月大後才開始吃有顆粒的泥蓉狀食物) 或會令寶寶對固體食物產生抗拒。

2. Enhancing infants' experience with foods and allowing them to experiment with different food textures would help their food acceptance.




3. For infants who have sensory food aversion, parents should engage

 in parental modelling, allow them to self-feed and monitor the extent of their exposure to new food.



4. In introducing a progression of textures to infants' diet, parents would base their practices on culture and tradition, and should take into account individual differences like temperament and sensory sensitivity.


Views expressed in this article are the author's and do not necessarily reflect the opinion or position of the BFHIHKA.


Editor-in-Chief: Dr Shirley SL Leung 
Illustration: Ms Cheryl Young

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