What is a feeding disorder?

A feeding disorder is present when a child is not able to take their full nutrition and hydration needs by mouth.


What causes a feeding disorder?

Children can develop disordered feeding for a variety of reasons and frequently the underlying cause can be difficult to pinpoint. The following are risk factors that can contribute to a feeding disorder:

  • Prematurity.
  • Neurological impairment.
  • Respiratory impairment
  • Structural anomalies.
  • Craniofacial conditions
  • Cleft lip and/or palate
  • Ankyloglossia/ Tongue Tie
  • Disease processes.
  • Cardiorespiratory conditions.
  • Autistic spectrum disorder.
  • Impairments in family feeding patterns.
  • Metabolic disorders.
  • Behavioral disorders.
  • Gastroesophageal reflux.
  • Food allergies.
  • Eosinophillic esophagitis.
  • Rumination Syndrome

What are the symptoms of a feeding disorder?

The symptoms of a feeding disorder can vary and not all children will exhibit all symptoms. Some parents may find that they must force feed their child by using distractions or dragging out meals over a long period of time in order to get the child to eat. While many children, especially toddlers and preschoolers, can be picky eaters, some children with feeding disorders are often very picky and are only willing to eat a very limited amount (types) of foods—sometimes as few as 10 foods or less. Children with a feeding disorder may also exhibit some or all of the following symptoms:

  • Persistent difficulty with feeding.
  • Refusal to eat food (refusal behaviors).
  • Difficulty with age-appropriate foods or textures.
  • Pain or distress with feeding.
  • Poor weight gain (failure to thrive).
  • Bottle or breast feeding only while the child is asleep.
  • Family history of feeding disorders.
  • Child can only eat small amounts.
  • Aspiration (swallowing difficulty).

WHEN SHOULD A CHILD BE REFERRED FOR FEEDING THERAPY?

Mealtimes are a great time for bonding and enjoying new experiences. Unfortunately, for some children, it can be a stressful and challenging time. If any of the behaviors below are affecting a child’s ability to safely eat, meet nutritional needs or enjoy the mealtime experience, the child may benefit from receiving a feeding evaluation.

  • Infant demonstrating signs of difficulty with coordinating the suck/swallow/breath pattern during bottle or breastfeeding.
  • Feeding time taking longer than 30 minutes for infants, and 30 to 40 minutes for toddlers or young children.
  • Difficulty chewing foods, typically swallowing food in whole pieces.
  • Difficulty swallowing foods or refuses to swallow certain types of food consistencies.
  • Refuses to eat certain food textures or has difficulty transitioning from one texture to another texture (ex: from bottle feedings to purees, from purees to soft solids or mixed textured foods).
  • Gags on, avoids or is very sensitive to certain food textures, food temperatures and/or flavors.
  • Struggles to control and coordinate moving food around in mouth, chewing and preparing to swallow food.
  • Fussy or irritable with feeding.
  • The child seems congestion during feedings or after.
  • Frequently coughs when eating.
  • Gags and chokes when eating.
  • Frequently vomits during or immediately after eating or drinking.
  • Refuses or rarely tries new foods.
  • Pushes food away.
  • Has difficulty transitioning from gastric tube (G tube) feedings to oral feedings.
  • Negative mealtime behaviors (infant cries, arches, pulls away from food; child refuses to eat, tantrums at mealtimes or “shuts-down” and does not engage in mealtime).
  • Known to be a “picky eater” who eats a limited variety of foods or consistencies.