• arching or stiffening of the body during feeding
  
• irritability or lack of alertness during feeding
  
• refusing food or liquid
  
• failure to accept different textures of food (e.g., only pureed foods or crunchy cereals)
  
• long 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 voice quality
  
• frequent spitting up or vomiting
  
• recurring pneumonia or respiratory infections
  
• less than normal weight gain or growth
  

As a result, children may be at risk for:

• dehydration or poor nutrition
  
• aspiration (food or liquid entering the airway) or penetration
  
• pneumonia or repeated upper respiratory infections that can lead to chronic lung disease
  
• embarrassment or isolation in social situations involving eating
  

What treatments are available for children with feeding and swallowing disorders?

Treatment varies greatly depending on the cause and symptoms of the swallowing problem.

Based on the results of the feeding and swallowing evaluation, the OT or SLP may recommend any of the following:

• medical intervention (e.g., medicine for reflux)
  
• direct feeding therapy designed to meet individual needs
  
• nutritional changes (e.g., different foods, adding calories to food)
  
• increasing acceptance of new foods or textures
  
• food temperature and texture changes
  
• postural or positioning changes (e.g., different seating)
  
• behavior management techniques
  
• referral to other professionals, such as a psychologist or dentist
  

If feeding therapy with an OT or SLP is recommended, the focus on intervention may include the following:

• making the muscles of the mouth stronger
  
• increasing tongue movement
  
• improving chewing
  
• increasing acceptance of different foods and liquids
  
• improving sucking and/or drinking ability
  
• coordinating the suck-swallow-breath pattern (for infants)
  
• altering food textures and liquid thickness to ensure safe swallowing
  
• using utensils and drinking from cups
  
• bottle/breast feeding
  
• G-Tube weaning;
  

Adapted from  the American Speech-Language-Hearing Association (ASHA) Website.

Feeding and Swallowing Disorders (Dysphagia)

What are feeding and swallowing disorders?

Feeding disorders include problems gathering food and getting ready to suck, chew, or swallow it.   A child who cannot chew their food sufficiently, swallow easily, or who coughs, chokes or gags when eating or drinking may have a swallowing disorder.  A picky feeder may not eat foods of certain textures, temperatures or colors or foods of different brands/shapes.  In its most severe form, a child may have to eat through a G-Tube or have failure to thrive.

What are some signs or symptoms of feeding and swallowing disorders in children?

Children with feeding and swallowing problems have a wide variety of symptoms. Not all signs and symptoms are present in every child.