Objective. Mouthing behavior in infants and young children <3 years old is
a poorly quantified yet normal part of early childhood development. Increas
ingly, safety and risk assessments involving materials that may be mouthed
depend on accurate estimates of oral contact time. This study reports the r
esults of an observational study performed to investigate and obtain data o
n mouthing behavior of objects for children up to 3 years old.
Methodology. The study used a standard diary form with instructions for par
ticipating parents to observe their child in a normal environment (primaril
y home), and to document both the type and duration of each item mouthed. P
hase I (pilot) consisted of 30 children each observed for 1 day, divided eq
ually between the ages of 0 to 18 months (n = 15) and 19 to 36 months (n =
15), whereas Phase II included more participants (n = 92 aged 0-18 months;
n = 95 aged 19-36 months). Phase III included observations for 5 nonconsecu
tive days over a 2-month period on 168 children between the ages of 3 to 18
months (at study initiation), and focused on total mouthing time of object
s, exclusive of pacifiers.
Results. The data collected during the first 2 phases were pooled and analy
zed together. For all participants between the ages of 0 and 18 months (n =
107), the average daily duration of mouthing objects included: pacifiers (
108 minutes), plastic toys (17 minutes), teethers (6 minutes), and other ob
jects (9 minutes). The results for children 19 to 36 months old (n = 110) i
ncluded: pacifiers (126 minutes), plastic toys (2 minutes), teethers (0 min
utes), and other objects (2 minutes). Although no significant difference ex
isted between the 2 age ranges for pacifier mouthing duration, a statistica
lly significant difference was observed for nonpacifier objects. For Phase
III, the average daily mouthing time for all objects (excluding pacifiers),
based on 5 nonconsecutive days of observation for 168 children, was 36 min
utes (n = 793 valid child observation days).
Conclusions. Results of this study indicate that mouthing behavior is depen
dent on age and the types of items that are mouthed. Duration of mouthing v
aries among children, with some consistently not mouthing any objects and w
ith a very small number mouthing objects for >2 hours a day. The study also
revealed wide variability in the types of objects mouthed, including many
nontoy objects. Children mouth pacifiers significantly longer than other ob
jects, regardless of age. Significantly increased mouthing time of all nonp
acifier objects is reported for children in the 0- to 18-month range compar
ed with the 19- to 36-month range.