Oral-motor development and complementary feeding approach in 8-month-old infants

In recent years there has been a rise in the prevalence of ‘baby-led’ introduction to solids (baby-led weaning, BLW), where infants independently feed on finger foods from the start of complementary feeding rather than being spoon-fed puréed food by their caregiver (parent-led weaning, PLW). It has been suggested that BLW may benefit language development. This may occur either by means of a greater participation in family meals, which provide opportunities for modeling language, or through an earlier practice of complex oral-motor and fine-motor skills by independently choosing, manipulating, and chewing food. There is already evidence for an association between oral-motor development and language ability in toddlers, in which complex oral-motor movement scores are positively correlated with the size of spoken vocabulary and sentence complexity. Additionally, it is well known that difficulties with oral-motor movement often co-occur with language dysfunction. However, there is still a lack of evidence concerning the relationship between early feeding experiences and developmental outcomes, including oral-motor development. We investigated the relationship between oral-motor functions, complementary feeding approach and developmental outcomes in 73 Italian typically developing 8-month-old infants. Mothers reported the complementary feeding method used (PLW, BLW, or mixed), and completed (i) the short form of the MacArthur-Bates Communicative Development Inventories (CDI, Caselli 2015), (ii) the Developmental Profile 3 (DP-3; Alpern 2007), and (iii) a socio demographic questionnaire. We recorded one meal for each child during a videocall and then coded oral-motor functioning through an adaptation of the Schedule for Oral Motor Assessment (SOMA, Skuse et al 1995). As dependent variable, we considered the difference (Delta score) between the SOMA score and the cut-off indicating atypical performance for each type of food (with a higher difference indicating a better performance). The Delta score did not significantly differ depending on the complementary feeding approach. However, it significantly differed according to the type of food infants consumed (H2 = 29.828, p < .001): children eating semisolid food performed better than children eating puréed or solid foods (semisolid vs purée: U = 85.0, p <0.001, N1 = 38, N2 = 23; semisolid vs solid: U = 92.0, p <.001, N1 = N2 = 23). Moreover, the Delta score was significantly higher for children who had already acquired the ability to crawl than for those who were not yet able to crawl (U = 579.5, p = .041, N1 = 53, N2 = 30). Finally, the Delta score was significantly correlated with (i) the DP-3 Motor subscale (rs = .323, p = .002, N = 83), (ii) the DP-3 Adaptive Behavior subscale (rs = .220, p = .045, N = 83), and (iii) the DP-3 General score (rs = .225, p = .040, N = 83), but not with language measures (CDI). In conclusion, oral-motor functioning in 8-month-old infants did not differ according to the complementary feeding approach; however, children fed semisolid food showed a better oral-motor functioning than those fed either puréed or solid, strengthening previous findings (Delaney & Arvedson 2008). Moreover, a better oral-motor functioning paralleled gross motor and adaptive behavior development, possibly anticipating a future better language development.