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The Pincer Grasp is NOT a Prerequisite to Starting Solid Foods

1/17/2018

 
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Many modern moms (and dads) rely on Facebook support groups for information about all things parenting - feeding, behavior, development, potty training, and even car seat safety. With the influx of resources comes an overload of information, including "rules" or "guidelines" that sometimes aren't based in evidence. One such example that has been floating around the interwebs is the idea that baby "should be developing a pincer grasp" to be ready for solids.

This is simply untrue. A baby does not have to have mastered, or be developing, a pincer grasp to be ready for solid foods.

What's more, a baby may develop an "emerging" pincer grasp early, but a true pincer grasp takes an extraordinary amount of fine motor skill on baby's part. It does not fully refine in most cases until 10-12 months. We can't wait until a true pincer grasp is mastered before offering food because we would be waiting too long. 
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This "pincer grasp" guideline found in circulating memes and graphics is not documented by any major medical group or health organization. To our knowledge, there is no data to connect this skill to baby's readiness for solid foods.

Does a pincer grasp help baby eat small pieces? Absolutely. Is it helpful when baby can do it? Totally! Is it an important developmental skill? Yes! However, baby can still pick up larger pieces of foods, usually the shape of a strip or stick, around 6 months. 

Before we go any further, let's officially define a pincer grasp. The pincer grasp is when baby touches just the end of their index finger to just the end of their thumb to form a circle in her fingers. Many of the grasps that babies use as they develop a pincer grasp allow them to pick up smaller foods, but they're not technically a perfect pincer until just the index and thumb touch at the ends. Since this is a sophisticated grasp/skill that takes months for babies to develop, it's something that should not be a pre-requisite to giving food. 

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We of course want baby to begin to develop her pincer grasp so she can pick up peas, quartered grapes, beans, and rice, but don't be discouraged if your six-month-old (or even your nine-month-old!) hasn't mastered this skill. It is normal. Remember, a true pincer grasp does not emerge in most babies until 10-12 months.

So, how can you best help your baby develop pincer grasp and fine motor skills in general? Like most things developmental, specific skills build on one another in infancy and childhood. We want to promote baby's skills early on and foster fine motor development so that baby is ready for eating all shapes of food, coloring, and eventually writing later in life.

No matter the age of your baby, you can do simple activities that help her eventually develop pincer grasp and more mature hand movement. Here are some developmental expectations and ways to help your baby with fine motor development, starting at birth. Remember, all babies develop a little differently, so contact your pediatrician if you're concerned about your baby's progress.

Newborn
Skills:
  • Strong grasp reflex.
  • Hands may open as you stretch out their elbows.

Family Activities:
  1. Touch and massage of both sides of baby's hands, rub with a soft cloth to teach her the safe meaning of touch from another person.
  2. Gently stroke the back of your child’s hand to stimulate a reflex that helps babies uncurl her fingers. The sooner babies open up their fingers, the sooner hand play begins.
  3. Avoid use of infant mittens, as this can slow down hand to face, hand to mouth development. I know many parents use mittens to prevent facial scratching due to how fast nails grow, but remember your baby was sucking on their fingers during pregnancy. She uses that sucking activity to calm and regulate her heart and breathing skills. Allow her to self-regulate using sucking.
 
1-2 Months
Skills:
  • Grasp reflex continues.
  • Baby can hold an object in their hand briefly if you place it there.
  • Baby is grabbing for blanket - the action of scratching increases and more opening and closing of the hands is seen.

Family Activities:
  1. Place Bright Starts Lots of Links “baby rings” inside of the infants’ hand. Allow her to hold a variety of other toys that encourage touching textures and shapes for the development of the hand and the palmer creases.
  2. Place your finger within your baby's hand and allow her to squeeze and release. This is a great exercise for improve baby's awareness of her palms and fingers. 
  3. Keep doing tummy time, chest to chest, and encouraging hands onto the floor or onto parent’s chests for hand development skills.
 
3-5 Months
Skills:
  • Uses fingers in a grasp without thumb involvement - this can begin as early as three months old.
  • The grasp reflex disappears and is replaced by what is called “sustained voluntary grasp.”
  • Tiny hands begin to accommodate to the shape of an object.
  • Sensory tactile awareness within the hand/palm develops.
  • Early transfer skills are seen.
 
Family Activities:
  1. Practice placing a variety of safe and developmentally-appropriate toys into your baby's palm and watch as the middle finger (which is the strongest, followed by the ring and little fingers) maintains a grasp briefly. Release is then involuntary.
  2. Practice stimulating the grasp and release skills with soft plush toys, plastic or wooden toys, and my favorite toy for use at this stage - the Skwish.
  3. While in tummy time, which is critical at this age, baby's palms and fingers are pressing onto the floor and hands are opening, closing and getting stronger in this position.
 
6 Months

We recommend starting complementary foods around 6 months and when baby is showing readiness signs, including independent sitting on the floor. Follow your baby’s development and challenge her to do a more complicated food as she demonstrates readiness signs, including practicing with more refined grasps. Your baby may start out a feeding with great excitement but can get messier and more frustrated as the meal progresses, since she might tire and fatigue easily. As your baby becomes a toddler, it is normal for her to start the meal without much mess, using utensils or pincer grasp, but she might revert to what I call “cave man style” eating - shoveling it in and getting messy - as she fills her belly. 

Skills:
  • Baby has consistent palmar grasp (fingers are flexed and thumb is still within the palm). She can hold an object and shake and bang it!
  • Fine motor skills at this time can vary depending on how strong your baby's trunk and postural strength may be.
  • If the baby is lying on her back with support through the trunk, she may be able to easily transfer and object from hand to hand. This is an easier position for baby because her back muscles are supported and stronger in this position versus when seated.
  • The “radial-palmar grasp” emerges. This is when the little finger part of the palm is initiating the grasp, and the thumb is in a hitch hiker position. However, baby most likely has not yet acquired a pincer grasp.
 
Family Activities:
  1. Encourage transferring toys from hand to hand. Offer baby one toy after another and watch how her hands are just joyous in learning about and adapting to the shape of a new toy.
  2. Encourage as much tummy time as possible. Pushing baby's palms down on the floor helps to strengthen her fine motor skills as she grows.

Food:
  1. Grasping for open cups, spoons and finger-foods are noted here. Baby wants to already be independent! Because baby does not know how to control their arms and grasp yet, if placed into high chair will throw everything. This is normal and expected for this age.
  2. Help baby drink from small cups including an open cup or Doidy cup. Introduce straw cups (Mr. Juice Bear, Zoli Bot cup, Lolla cup, and Munchkin cup).
  3. Start self-feeding (BLW) or spoon-feeding (Traditional Weaning) now.
  4. Encourage messy play.
  5. Types of foods to offer: long single finger shaped foods including: broccoli stems, French toast with peanut butter, waffle strips, avocado strips, banana strips, mango, sweet potato strips, soft meat or egg strips, softened vegetables.
  6. Introduce a loaded spoon now, but do not expect them to load it by themselves quite yet.
  7. Remember to eat with your child! Imitate!
 
7-9 Months
Skills:
  • Baby develops increased grip strength.
  • Baby masters the radial-palmar grasp
  • Baby is developing the radial-digital grasp (the use of an opposed thumb and finger tips), but this is still not a pincer grasp!
  • Baby begins to point and develops a pinch.
  • Baby is beginning to release objects into containers and loves to play dump and fill games.
 
Food:
  1. Continue with Baby Led Weaning - self-feeding, messy play, and practicing hand-to-mouth.
  2. Spoon feeding? Use a “Nuk “brush and or “Fluxy” oral motor toy for hand to mouth skills.
  3. Types of foods to offer: practice more dipping where the child’s hand is gripping something, like a steamed carrot of piece of cooked broccoli, and demonstrate dipping into yogurt/hummus/cream cheese mixed with nut butters.
  4. Progress to two-finger thickness sized foods, add more shapes in complexities for practicing grasping. Remember to add a bread crumb coating to slippery foods to help these developing fingers and palms not get too frustrated. Offer things that encourage more crumbs from muffins, banana and zucchini breads and ground meats and mashed potatoes to help foods stick together in their hands.
  5. Imitate eating with your child and eat with them often.​
The 7.5-month-old below is practicing his emerging pincer grasp with great attention. Even though he won't refine it for a few months, he's trying to slide his fingers together. Offering some smaller foods with larger pieces helps challenge your baby for the next developmental step.
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10-12 Months
Skills: 
  • The pincer grasp begins to emerge around 10 months (the ability to pick up a cracker).
  • Finger-tip pinch finally begins at 12 months (the ability to hold a Cheerio).
  • Your baby is beginning to use one hand to hold something and the opposite hand to operate the toy. This is the beginning of bimanual dexterity (think of removing a lid from a cream cheese container - one hand holds while the other hand pulls off the top). This is an important skill for cutting food, and eventually using scissors when older.
  • Baby's hands are learning how to push, pull, and squeeze, and wrists are learning to rotate.
 
Family Activities:
  1. Encourage removing socks and untying shoes.
  2. Practice hair brush and combing skills.
  3. To help refine pincer, offer beans or peas in an ice cube tray (one small piece of food in each pocket of the tray).

Food:
  1. Let baby self-feed and use cups. 
  2. Offer spoons and NumNum GOOtensils for self-feeding with utensils.
  3. Types of foods to offer: dried cereal, beans and lentils, cheese cubes, fresh fruits sliced and diced (this will help them practice picking up foods with new skills).
  4. Allow your baby to practice with loaded spoons and forks.
  5. Babies can enjoy most table food at this stage. Watch your baby and avoid offering choking hazards (whole nuts, uncut grapes/cherries, popcorn, chips, hard candy, gum) until 4 years old.
  6. Encourage thick soup and or smoothies from a straw or loaded spoon.
  7. Practice good behaviors around food - encourage baby to keep food on the tray and praise them when they do so. Ignore throwing instead of scolding, as baby may like the attention given to throwing. Sometimes throwing is baby telling you she's done with the meal.
  8. Be your child’s speed bump and slow her down when needed. Too much food on the tray can cause frustration, overwhelm, throwing and overstuffing. 
  9. Lastly, eat with your baby, imitate good habits - she is watching and learning.​​

Below is a video of an 11-month-old working on refining her pincer grasp. Notice how she still uses the middle finger with her index finger and thumb and reverts back to a more whole-hand grasp as well. With practice, she will use her true pincer grasp more and more!
Here's a video of a 12-month-old rockin' her pincer grasp:
Notice how this sweet baby (10 months) is focusing very hard on using his index and forefinger. As babies get older, their grasps get more specific and refined.
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This 11-month-old is practicing her pincer as well.
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This 14-month-old can use her pincer grasp to pick up a small pea. It takes a lot of practice to handle such small foods! 
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Baby Lou, one of our BLW online course models (now 14 months), is going in for some beans with his pincer grasp.
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Once a baby has a pincer grasp it is recommended to offer baby a wide variety of shapes and sizes of food. Remember, just because a child has a pincer grasp does not mean she will use it for every food. Encourage easier pick up of foods by sprinkling crumbs onto a slippery food item for better grip.

By 12 months, most babies will still prefer larger pieces of foods cut into long finger-shaped sizes instead of small bites sized pieces, but some may like to practice their pincer grasp over and over. Offer all safe sizes of food so that your baby can practice multiple skills. Eventually your baby will learn to load spoons and forks with food too! ​
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    Authors

    Megan and Judy, co-owners of Feeding Littles, bring you helpful info on food, nutrition, picky eating, and feeding young children. Megan McNamee MPH, RDN is a Registered Dietitian Nutritionist based in Scottsdale, Arizona. Judy Delaware, OTR/L is an Occupational Therapist specializing in feeding therapy with children 3 and under in Boulder, Colorado. Megan and Judy are both moms of two and love helping families develop a healthy appetite for all foods! 

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