Abstract
The transition from pureed to textured foods is a critical developmental milestone in infancy, which requires the integration of oral sensory processing and oral-motor skills. Hinderances in sensory processing, such as hyperreactivity or reduced sensory differentiation, may interfere with texture acceptance and delay feeding progression. This systematic review examines the impact of oral sensory processing difficulties on the transition to textured foods in typically developing children under two years of age.A systematic search of studies published from 2015 onwards was conducted, including a variety of study designs. Due to heterogeneity in methods and outcomes, findings were synthesized using a thematic analysis approach. Fifteen studies met the inclusion criteria. Four key themes were identified: sensory hyperreactivity, timing of texture introduction, structured exposure, and measurement gaps, alongside a cross-cutting theme of contextual variability.Infants with sensory hyperreactivity were more likely to exhibit gagging, food refusal, and prolonged reliance on purees. Delayed introduction of textured foods beyond 9–10 months was associated with increased feeding difficulties and reduced dietary variety. Structured exposure through sensory-motor and responsive feeding interventions improved texture acceptance and feeding behaviors. However, most studies relied on caregiver-reported measures, highlighting a lack of objective sensory assessment tools. Variations in cultural feeding practices and study methodologies further limited generalizability. Overall, oral sensory processing plays a significant role in early feeding development. Early, appropriately timed exposure to textured foods and targeted interventions may support successful feeding progression, though further research using standardized and objective measures is needed.