Feeding and Swallowing Disorders

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Feeding disorders include problems gathering food and getting ready to suck, chew, or swallow.
Swallowing disorders, also called dysphagia, are often the result in difficulty with the actual act of moving food from the mouth to the stomach. This can occur at different stages in the swallowing process:

• Oral phase – sucking, chewing, and moving food or liquid into the throat
• Pharyngeal phase – starting the swallow, squeezing food down the throat, and closing off the airway to prevent food or liquid from entering the airway (aspiration) or to prevent choking
• Esophageal phase – relaxing and tightening the openings at the top and bottom of the feeding tube in the throat (esophagus) and squeezing food through the esophagus into the stomach

Pediatric feeding and swallowing disorders are seen in 25-35% of typically developing children and 50-70% of children born premature or with chronic medical conditions.

Signs and Symptoms In Infancy

• Turning away from the bottle
• Refusing to close mouth around the nipple
• Lying with nipple in the mouth but not sucking
• Taking only a small amount and then refusing to continue
• Crying when placed into a feeding position
• Milk pouring out of baby’s mouth
• Feeding too quickly
• Feeding too slowly
• Falling asleep before the feed is completed
• Coughing when feeding
• Not consuming as much milk as expected
• Wanting more milk than expected
• Arching or stiffening of the body during feeding
• Irritability or lack of alertness during feeding
• Long feeding times, more than 30 mins
• Excessive drooling or food/liquid coming out of mouth or nose
• Frequent spitting up or vomiting
• Difficulty coordinating breathing with eating and drinking

Signs and Symptoms in Children 6 months and older

Children with feeding and swallowing problems have a wide variety of symptoms:

• Failure to accept different textures of food
• Difficulty chewing
• Coughing or gagging during meals
• Excessive drooling or food/liquid coming out of mouth or nose
• Difficulty coordinating breathing with eating and drinking
• Gurgly, hoarse, or breathy voice quality
• Frequent spitting up or vomiting
• Recurring pneumonia or respiratory infections
• Less than normal weight gain or growth

How are feeding and swallowing disorders diagnosed?

If your child demonstrates any of the symptoms above, you should discuss in detail with your pediatrician and/or a Speech Language Pathologist (SLP) for a full evaluation. The evaluation will consist of obtaining a full medical history, development and description of your child’s symptoms along with assessing your child’s strength and movement of the muscles involved in swallowing. It will be necessary for the SLP to observe your child eating and to note the symptoms that the child presents with. Specialized testing may be necessary to fully assess your child. These tests are performed either by a specialized SLP or gastro-intestinal doctor.

Early Intervention and Treatment

Treatment varies widely depending on the cause and symptoms of the feeding or swallowing problem.

Based on the results of the evaluation, the SLP along with the feeding team may recommend any of the following:

• Medical intervention (medicine for reflux)
• Direct feeding therapy designed to meet individual needs
• Nutritional changes
• Increasing acceptance of new foods, textures, and liquids
• Food temperature and texture changes
• Postural or positioning changes
• Behavior management
• Referral to other professionals
• Making the muscles of the mouth stronger
• Increasing tongue movement
• Improve chewing
• Improve sucking and/or drinking ability
• Coordinating the suck-swallow breath pattern
• Altering food textures and liquid thickness to ensure safe swallowing

The SLP may work as part of a feeding team, other team members include: Occupational therapist, physical therapist, physician, dietitian or nutritionist and developmental specialist.

If you have concerns about your child’s ability to feed/swallow please contact us for a feeding evaluation.

We look forward to assisting you and your child in reaching their maximal potential

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To initiate Feeding Therapy please Register Here and someone will be in contact with you within 24-48 hours.

You can also contact us via Email by clicking here if you have any  questions or to set up a phone consultation.