Pediatric Feeding & Swallowing Disorders
It is important that your child eat enough to grow and be healthy. There are many possible reasons why your child may not eat. He may have stomach or breathing problems, or his muscles may be weak. He may be very sensitive to how foods feel in his mouth. However, there may be no clear reason why your child refuses to eat.
If your child has a feeding and swallowing problem, he may:
- Not eat or drink
- Cough and choke when eating
- Get food in his lungs, called aspiration
- Make mealtimes stressful for the whole family
- Not eat at school or with friends
Speech-language pathologists, or SLPs, work with children who have speech, language, and swallowing problems. An SLP can find out what is causing your child's feeding and swallowing issues through an evaluation. During this evaluation, the SLP will ask you about the problems your child is having; ask for information from your doctor about your child's health; look at how your child moves her lips, tongue, and jaw; and watch your child nurse or eat.
If therapy is recommended, your SLP will work on feeding and swallowing in different ways and show you how to help your child eat. While treatment varies greatly depending on the cause and symptoms of the swallowing problem, it may include:
- Exercises for strength, sensation, and coordination of muscles involved in feeding and swallowing
- Recommendations for special foods, equipment, or techniques to improve feeding and swallowing
(American Speech-Language-Hearing Association © 2010)
Who is Most at Risk for Feeding & Swallowing Issues?
- Children with nervous system disorders:
- Cerebral Palsy
- Meningitis
- Encephalopathy
- Children with Autism Spectrum Disorder
- Children with a G-tube (or NG tube)
- Children with gastrointestinal motility disorders
- Children with prematurity/low birth weight
- Children with heart disease
- Children with cleft lip or palate
- Children with conditions affecting the airway
- Children with food allergies
- Children with behavior management issues
Red Flags for Parents
- Ongoing poor weight gain (rate re: percentiles falling) or weight loss
- Ongoing choking, gagging or coughing during meals
- Ongoing problems with vomiting
- More than one incident of nasal reflux
- History of a traumatic choking incident
- History of eating and breathing coordination problems, with ongoing respiratory issues
- Inability to transition to baby food purees by 10 months of age
- Inability to accept any table food solids by 12 months of age
- Inability to transition from breast/bottle to a cup by 16 months of age
- Has not weaned off baby foods by 16 months of age
- Aversion or avoidance of all foods in specific texture or food group
- Food range of less than 20 foods, especially if foods are being dropped over time with no new foods replacing those lost
- An infant who cries and/or arches at most meals
- Family is fighting about food and feeding (i.e. Meals are battles)
- Parent repeatedly reports that the child is difficult for everyone to feed
- Parental history of an eating disorder, with a child not meeting weight goals
(Kay A. Toomey, Ph.D. © 2002)
Seeking Treatment at the Speech & Hearing Center
If you believe your child may be suffering from a feeding disorder, please call 423.622.6900 to schedule your child's evaluation with Ashley Johnson, MCD, CCC-SLP.
