Feeding

Did you know that 25-40% of children experience feeding difficulties? Symptoms of a feeding disorder include:

• Refusal to eat or drink
• Choking, gagging, or vomiting when eating
• Only eating foods of a certain texture or color
• Not eating age-appropriate foods
• Difficulty chewing and/or swallowing
• Inappropriate behavior during feeding/mealtime such as kicking, biting, and hitting (ex. strategies to gain attention)
• Prolonged feeding time
• Best feeding occurs when child tired or when defenses are down

It should be noted that a feeding “disorder” is diagnosed only when the feeding difficulties last for a prolonged period of time. It is important to seek a consultation from your pediatrician, speech-language pathologist, and nutritionist to ensure that your child does not suffer from significant weight loss or become malnourished or dehydrated. In addition, a pediatrician should be consulted immediately in order to verify that the child does not have an underlying medical condition that may be causing the feeding difficulties. The pediatrician should examine the child’s digestive system; neurological system; ear, nose, and throat structures; breath support; orofacial structures; as well as assess oral motor function and swallowing. If a child is suffering from swallowing difficulties, a modified barium swallow (MBS) test, or videofluoroscopy, will most likely be utilized to assess the child’s swallowing. This X-ray test, which is performed by a speech-language pathologist, looks at all of the structures involved in the swallowing process. During the test the child will be given small amounts of thin and thick barium, a textured puree (such as applesauce) with barium, and a cookie or cracker with barium to swallow. Each phase of the swallow is examined and recorded. If results of the MBS are normal, the child’s developmental and feeding history should be assessed and a feeding evaluation should be performed.

Treatment of feeding disorders often involves a team of specialists including the pediatrician, gastroenterologist, nutritionist, and speech-language pathologist. It is important to start treatment early for best results. Depending on the severity of the feeding disorder, treatment may begin with becoming acquainted with sitting in a feeding chair, using feeding utensils, aromas of food, and feeling different textures of food. Once the child is comfortable with these aspects of feeding, foods are introduced. First, thin pureed foods (jarred purees) are introduced, followed by thick purees and home-prepared purees, textured purees, mashed foods, and then soft table foods. Many children with feeding disorders may also have sensory and oral motor difficulties. A speech-language pathologist can address these additional issues during feeding therapy. It is important to never force-feed a child and to offer new foods in a positive manner.

If you are concerned that your child may be experiencing feeding difficulty, you may want to consider having your child screened by a Speech-Language Pathologist who specializes in these issues.