Feeding Milestones for Infants and Toddlers

The following information was shared by Feeding Therapist Brandi Watts on CBS6’s “Virginia This Morning” on March 27, 2008.

There are three areas to consider when you discuss development of feeding skills: Volume of food and drink, texture of food and variety of food.

Birth to 3 months
Initially, during the first 3 months after a child is born, variety is minimal with consumption of breast milk or formula for all caloric and fluid needs.  Volume can range any where from 2-6 ounces about 6 times a day (20-24 ounces per day).

4-6 months
Continue breast milk or formula.  As the baby develops head and trunk control for sitting and tongue thrusting has decreased, begin trials of rice cereal mixed with breast milk or formula.  Initial volumes of solids will be minimal, but with oral-motor practice, volumes will increase.  Volume goals for this age range are approximately 4-6 ounces of food and drink combined per meal for 4-6 feedings a day (24-32 ounces per day).

6-8 months
Continue breast milk or formula.  Begin offering smooth pureed table foods or processed baby foods.  Begin introducing single ingredient foods.  Foods should be introduced one at a time using the same food over 3 days.  Watch for allergic reactions.  Volumes should be 6-8 ounces per feeding for a total of 24-32 ounces a day.  At this age, juice can be introduced, but limit the intake to 3-4 ounces a day.  Cup drinking should also be introduced.

8-10 months
Continue breast milk or formula.  Volumes per meal should be approximately 7-8 ounces of fluid and 2-3 servings of smooth pureed starches and 2-3 servings of pureed fruits and vegetables.  Begin introduction of soft cooked (diced or fork mashed) vegetables, soft fruits, cheese, egg yolks and casseroles.  At this stage you will see lateral movement of the tongue and some vertical chewing patterns.  You can introduce the stage 3 baby foods. Trial self-feeding skills.  Continue cup drinking.

10-12 months
Continue introducing a wider variety of table foods to include breakfast bars, breads, pastas, dissolvable crackers, diced fruits and vegetables, diced meats, cheeses.  Volumes should include 16-32 ounces of breast milk or formula, 4 servings of starch per day, 4 servings of fruits and vegetables a day, 3-4 ounces of juice, and 1-2 ounces of protein per day.  Chewing and lateral tongue movement will be more efficient.  By 12 months, cup drinking should be the primary mode for liquid intake.

12-18 months
Chewing development continues with increasing variety of table foods.  As child gains independence and awareness of feeding, preferences will form; however, a true food preference takes approximately 15 ingested trials to form.  By 18 months chewing can be accomplished with the lips closed.  Rotary chewing is emerging. (sample meal plan attached)

18-24 months
By 24 months rotary chewing should be developed and at least 4-5 vegetables and 4-5 fruits accepted readily.  A variety of starches, legumes and meats should also be incorporated into the diet. (sample meal plan attached).

View a sample daily meal plan for a 12-23 month old.
View a sample daily meal plan for a 2-3 year old.

A wide variety of external and internal factors can negatively impact the volume, texture and variety of food that your child consumes.  Same examples include: 

1) Medical issues such as reflux, slow gastric emptying, allergies, aspiration, constipation, decrease in appetite, slow development of teeth

2)Behavioral/psychosocial issues such as anxiety can lead to food refusals, spitting food, gagging, vomiting, excessive crying/tantrumming, packing food or any negative mealtime behavior intended to control the meal and the feeder

3) Oral-motor delays could include variations of strength and range of motion in facial muscles, difficulty coordinating movement of the lips, tongue and jaw for chewing

4) Hypersensitivity in the mouth which leads to gagging/vomiting with certain textures or types of foods. 

A common misperception regarding feeding is that if the child is hungry enough, they will eat.  This is not true!  Children can have different hunger/thirst signals or none at all and if the child has had negative feeding experiences in the past, hunger will not make the child eat adequately!

When to be concerned

1) If your child is below the growth chart at the pediatrician’s office and your pediatrician expresses concerns regarding adequate calorie consumption.
2) If your child limits the amount of fruits or vegetables consumed and is not receiving adequate nutrients for optimal growth and development.
3) If your child is not eating age-appropriate textures or volumes. 
4) If your child has continued difficulty transitioning from smooth foods to foods with textures.
5) If your child has difficulty eating in different settings such as school, grandparents house or at the baby sitters.
6) Mealtimes are consistently unpleasant for you and the child
7) If your child has not developed emerging self-feeding or cup drinking skills by 24 months

What to do:
Don’t wait!  If you have concerns regarding your child’s feedings skills, the earlier intervention is obtained, the better outcomes will be.  Speak to your pediatrician or call the Children’s Hospital Feeding Program at (804) 228-5818 or (800) 443-0893.

Return to the Children’s Feeding Program Homepage

The information on this site is provided for informational and educational purposes only; it does not contain specific medical advice. If you have specific health questions or problems, consult a health care professional for personal medical advice.