What are feeding difficulties?
Feeding difficulties can occur for several reasons. One of these includes food aversions affecting the types of foods a child will accept into their diet. Food aversions can include rejecting foods of a certain color or texture. Some children may avoid entire types of foods such as all vegetables or starches. This may be due to delayed oral-motor skills or esophageal disorders making it difficult to chew, swallow, or even hold foods down. If a child has difficulty chewing crunchier textures but is still fed these foods, the child may cough or have trouble swallowing them since they were not chewed enough in the mouth. Children do not always have the language or ability to tell us why they do not enjoy a food. Imagine a toddler with reflux or esophageal motility issues not being able to tell their parent why they prefer pureed/smooth textures versus crunchy/harder textures. Therapy may target improving the strength, range of motion, or coordination of the tongue, lips, and cheeks. Therapy may also target behavioral or sensory approaches for improving tolerance of new foods. Feeding therapy should always be comfortable, relaxed, and fun!
Other feeding difficulties could be sensory-based. For example, a child may experience decreased sensation causing them to over-stuff food into their mouth. Others may experience hypersensitivity and gag once a spoon touches their mouth. Previous medical history such as having a g-tube early in life can also increase a child’s sensitivity to foods and even touch.
How I treat feeding difficulties:
I start by listening to concerns, tracking the child’s diet and mealtime behaviors, evaluating the mealtime routine, and completing a thorough oral and feeding evaluation with the child. Establishing trust and rapport is crucial for feeding therapy and can take time to build with a child. I use play and sensory-based approaches for increasing a child’s acceptance of new foods. For example, I would not encourage a child to bite a new food until they can see it, touch it, and experience it through play first. I provide caregiver and parent training to make mealtimes more enjoyable and less stressful. A home exercise program is given to help carryover strategies or exercises at home.