5% – 20% of children experience some sort of feeding or swallowing disorder. To help those kids who struggle, feeding therapy is a common service offered by speech language pathologists (SLPs). Feeding therapy is more than just “teaching a child to eat.” Therapists work closely with patients and their families to determine the source of the child’s difficulties and develop very specific therapies to make the entire process of eating easier and more enjoyable.
Pediatric Feeding Disorder or “PFD is defined as impaired oral intake that is not age-appropriate.” (www.asha.org) Feeding is developmental just like walking, talking and running. While it is easy to chalk your child’s eating preferences up to “picky eating,” that is not a safe assumption. In fact, 25% of “picky eaters” don’t just grow out of it. Assuming your child will “grow out of it” or eat when they are hungry can lead to a nutritional deficit which can cause delayed growth both physically and neurologically. To best avoid this scenario, early detection of PFD is key.
While “picky eating” is often used to describe children’s eating habits, other problems with feeding can be oral sensory, swallowing, oral motor, or structural.
Signs Your Child May Have PFD
You are the sole witness of your child’s meals. We want to equip you with the signs that may indicate they need feeding assistance:
- Repeatedly turns to a small handful of foods
- Refuses/cries when introduced to new foods
- Averse to new textures, tastes and smells
- Responds fearfully to foods
- Needs to be distracted by TV to eat
- Switches from loving a food to refusing it
- Gags or has difficulty swallowing
More feeding difficulty signs
- Prolonged time to eat
- Pocketing (or holding food in their mouth)
- Difficulty chewing
- Spit up or throw up often
- Not gaining weight or growing
- Gurgly, hoarse, or breathy voice during or after feedings
- Problems breastfeeding
- Failing to meet developmental feeding milestones, such as self-feeding
- Difficulty using age-appropriate utensils/devices
What Causes Feeding Disorders?
Some causes associated with Pediatric Feeding Disorders include:
- Developmental disability
- Genetic syndromes (Autism Spectrum Disorder)
- Side effects from medications
- Medical conditions such as heart disease, Gastroesophageal reflux disease, and allergies
- Neurological disorders
- Oral structural abnormalities
- Environmental factors or negative experiences
Pediatric Feeding Therapy (PFT) – Treatment for PFD
Pediatric feeding therapy is a performed by speech and occupational therapists with the support of doctors and nutritionists. The goal of PFT is to diagnose what might be causing the disorder or fear in your child and then equipping them with tools and positive experiences to overcome the struggles.
What Happens During PFT
- Teaching oral motor skills (drinking from a cup, eating from a spoon, swallowing, etc)
- Swallowing strategies to reduce choking or aspirating
- Introducing appropriate utensils for eating
- Adjusting proper positioning for successful feeding
- Improving texture tolerance
- Strengthening facial muscles for chewing and swallowing
- Increasing list of “acceptable“ foods
- Educating parents how to help during feeding times
How Can I Help my Child?
There are many ways that a parent can participate in PFT. In fact, parental involvement is crucial since most of your child’s eating experiences will happen at home with you and not with a registered speech language pathologist. To help at home, your therapist may give you positioning techniques you can encourage your child to use when chewing and swallowing. Modifying their diet can also play a key role. During therapy, new foods will be introduced and presented to your child until they reach their highest level of tolerance. Continue to offer your child these foods. Do not “jump the gun” and attempt to give your child a food they’ve disliked or feared in the past without instructions from your speech therapist to avoid regression.
Most of all be patient. Eating can be a very emotional and stressful experience for children with any degree of pediatric feeding disorder. Continue to encourage their progress and participation in therapy and be a positive presence when you sit down for mealtimes.
If your child exhibits any of the symptoms listed above or mealtimes have become a constant power struggle in your home, contact Colorado Spring Therapy Center for a consultation with your child. We want to help you and your child enjoy meals together!