Lip-closing pressure during food intake from a spoon in normal children

Understanding the refinement of self-feeding skills is useful for the assessment of oral functional development in children.

To determine normative data on lip closing during food intake in the development of independent spoon-feeding in normal children, we tested the hypothesis that lip-closing pressure and spoon operation differ depending on food type.

Fifteen normal children (eight boys, seven girls; mean age: 6.5 years) were asked to eat test foods (2, 3 and 5 g of yogurt and cream cheese) freely with a spoon. Lip-closing pressures and kinematic data on spoon operation were recorded simultaneously with a strain gauge transducer embedded in the spoon and Vicon motion analysis, respectively.

In the most common lip-pressure pattern, only positive pressure was generated. In the second most common pattern, negative pressure occurred first, followed by positive pressure; this pattern was seen infrequently. Positive pressure (P < .001), pressure duration (P < .001) and spoon intra-oral time (P < .05) during intake of cream cheese (an adhesive food) were significantly greater than those during intake of yogurt (a non-adhesive food). Pressure onset occurred at the beginning of the spoon withdrawal period or at the turning point from spoon insertion to withdrawal, depending on the food.

Lip-closing force and spoon operation varied depending on food type in preschool and early elementary school children. Our findings suggest the need to consider the importance of food diversity and to pay attention to the spoon withdrawal period when assessing the development and maturation of lip function.