Pediatric Feeding and Swallowing Disorders

The challenges of getting a child to eat can sometimes be daunting. It may simply be due to pure stubbornness, or a symptom of a feeding or swallowing disorder. Pediatric feeding disorders include  difficulty moving food to the mouth and getting ready to suck, chew, or swallow the food.   Children with feeding or swallowing problems exhibit a variety of symptoms that are different for every child.

Common symptoms include:

• Arching or stiffening of the body during feeding
• Irritability or lack of alertness during feeding
• Refusal of food or liquid
• Failure to accept different textures of food (e.g., only pureed foods or crunchy cereals) 
•  Lengthy feeding times (e.g., more than 30 minutes)
• Difficulty chewing
• Difficulty breast feeding
• Coughing or gagging during meals
• Excessive drooling or food/liquid coming out of the mouth or nose
• Difficulty coordinating breathing with eating and drinking
•  Increased stuffiness during meals
• Gurgly, hoarse, or breathy
• Frequent spitting up or vomiting
• Recurring pneumonia or respiratory infections
• Less than normal weight gain/growth

Children with swallowing or feeding disorders are at risk for dehydration, malnutrition, aspiration, upper respiratory infections, and isolation in social situations that involve eating.

The treatment used for feeding and swallowing disorders vary depending on the diagnosis of the underlying problem.  An evaluation is completed by a speech-language pathologist or occupational therapist to help determine the exact cause.

Based on the results of the feeding or swallowing evaluation, a therapist may recommend any of the following:

• Medical intervention (e.g., medicine for reflux)
• Direct feeding/swallowing therapy
• Nutritional changes (e.g. different foods, adding calories to food)
• Increasing acceptance of new foods or textures
• Food temperature & texture changes
• Postural or positioning changes (e.g., different seating)
• Behavior management techniques

Referral to other professionals, such  as a psychologist or dentist