Eating isn’t always easy: When to seek help for feeding concerns
November 10, 2022
Child holding fork and looking at plate of food

    When to seek help for feeding concerns  

    If mealtime isn’t easy at your home, you’re not alone. More than 1 in 37 kids under age 5 are diagnosed with pediatric feeding disorders in the U.S. each year, meaning their nutritional intake isn’t where it should be for their age.

    What do feeding disorders look like?

    Feeding difficulties are often multi-faceted, affected by medical, nutritional, skill level and/or behavioral factors. A “picky eater” may be highly selective about the foods they eat because of underlying GI discomfort, which has developed into anxiety about trying new foods. Other kids may have texture and sensory sensitivities, while still others require a g-tube for proper nutrition.

    Knowing that feeding concerns look different for each child, talk to your family’s pediatrician if you notice:

    • Your child is not eating enough food/can’t gain weight
    • Your child isn’t eating a variety of age-appropriate foods
    • Mealtimes or feedings are very stressful or difficult
    • Your child consistently complains of being uncomfortable from eating

    “It’s important to seek care for your child with feeding difficulties as soon as you notice an issue, because over time many children develop negative feeding behaviors that become more difficult to change as time goes on. Negative or maladaptive feeding habits can also hinder their growth and development,” said Tatiana Schrader, occupational therapist in our feeding program.

    How to help your child with a feeding disorder

    The pediatrician may recommend an evaluation with feeding specialists to help determine the causes of the issues and how to help.

    Some of the most common feeding disorders include:

    • G-tube dependence (receiving nutrition and medication through a tube in the stomach)
    • Malnutrition
    • GERD (gastroesophageal reflux disease – stomach acid flows back into the esophagus)
    • Dysphagia (swallowing difficulties)
    • Delayed chewing and/or swallowing skills
    • Selective eating
    • Eosinophilic esophagitis (esophagus becomes inflamed and swollen, typically caused by a reaction to food)
    • Difficulty with texture grading (having a hard time eating foods with certain textures)

    It’s important to note that for most kids with diagnosed feeding difficulties, there’s no “quick fix” or “magic wand” for the challenges they face. Care from an interdisciplinary team of experts is so important because of the different factors that often contribute to a child’s feeding difficulties. A medical and nutrition team helps to address underlying biological factors, while specially trained therapists assess and treat a variety of oral-motor and sensory skill deficits related to feeding. Finally, psychosocial support team members help address learned behaviors associated with mealtimes.

    Following the evaluation, a therapy schedule may be developed based on the frequency that would be most helpful for your child. Starting out, feeding therapy consists of the therapists building rapport with your child and family, and making a plan to address specific feeding goals gradually but in a focused, individualized way. The team also works with parents and caregivers on how to best support your child wherever they are on their feeding journey, which often requires a lot of practice and patience. Change and progress usually happen slowly with ups and downs along the way.

    Overcoming feeding challenges is unique for every child and family

    “Success for a child with a pediatric feeding disorder looks different depending on their strengths, skills, developmental level and motivation to eat,” explained Tatiana. “For a highly anxious and selective eater, being able to taste a new brand or flavor of yogurt might signify success. For a child learning to chew solid food, taking a small bite of a cracker and chewing it safely could show they’ve met their current goals. For a non-oral feeder, having them learn to tolerate oral-motor exercises to their face and mouth is a great first step at success in the feeding world.”

    For Theodore, success meant enjoying crackers, crunchy Chips Ahoy cookies and pasta, and no longer relying on a feeding tube for nutrition.

    Find more feeding facts and tips.


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