Feeding difficulties

Speech-Language and Occupational Therapy address feeding and swallowing difficulties in infants and children. During therapy, strength and coordination of the jaw, lips, tongue and cheeks are addressed to receive and manage food. This includes providing strategies and techniques to address management of food to prevent or reduce coughing, choking, gagging, and aspiration when eating and drinking.

Picky eaters often present with limited diets, aversion to specific food groups or textures, and may have a limited diet of fewer than 20 foods. Often, parents and physician are concerned about a child who is a picky eater due to poor nutrition and slow weight gain.

Learn More About Feeding Difficulties

  • About This Treatment

    Infants and children with feeding difficulties typically have challenges with progressing from breast/bottle to purees, finger foods, and mixed textures; managing their foods when chewing and swallowing; or have a limited diet that affects his/her nutrition and/or weight gain/growth. Many of these children have significant medical histories, were born prematurely, or have had some other serious medical diagnosis that has impacted their ability to eat. Some may have had to have NG or G-tube feedings, or continue with tube feedings or supplemental nutrition such as Pediasure. Children on the autism spectrum and with sensory processing disorder often have feeding difficulties as well. These children may have developed food aversions that cause them to limit what they eat. Often, they exclude a food group or texture, and may have a restricted diet of fewer than 20 foods. As with other feeding difficulties, there may be concern for nutrition, weight gain and growth in these children.

  • Conditions Addressed

    Many diagnoses can present with feeding difficulties, and sometimes the cause is not known. Infants and children with feeding difficulties may have diagnoses of:

    • Prematurity
    • Failure to thrive
    • Cleft palate
    • Laryngomalacia
    • Esophageal or Tracheal malacia
    • Heart conditions
    • Genetic disorders
    • Down Syndrome
    • Chronic respiration difficulties
    • Reflux
    • Gastroesophageal Reflux Disease (GERD)

  • Typical Symptoms

    The following are signs and symptoms of feeding and swallowing problems in very young children:

    • 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
    • Difficulty transitioning from breast/bottle to purees and finger foods
    • 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 during or after eating
    • Frequent spitting up or vomiting
    • Recurring pneumonia or respiratory infections

  • Typical Symptoms of Picky Eaters

    The following are signs and symptoms of Picky Eaters:

    • Aversion or avoidance of most foods of specific texture or food group
    • Food range of less than 20 foods
    • Losing foods from the diet over time and new foods are not replacing those lost
    • Ongoing choking, gagging, or coughing during meals
    • Problems with vomiting when trying new foods
    • History of anxiety related to eating
    • Almost always eat different foods than the rest of the family
    • Often “grazes” when eating
    • May not be able to eat at the same time or table as the rest of the family
    • Family reports that mealtimes are always a challenge

  • Treatment Approach

    Information from the evaluation will determine areas of treatment for the child, which typically addresses underlying causes of the difficulty. Some children may not have adequate strength or endurance when eating, may not have good strength or control of the lips, tongue, cheeks, or jaw, while others may become anxious when interacting with new foods. Activities will address these underlying skills in a child-led manner where the child is presented with choices and given varying levels of support to move through the general hierarchy of steps to achieve managing or eating a new food. Toys, movement, and games are included in the feeding process to support, and reinforce the child’s attempts at eating or trying new foods. Parents are encouraged to observe and participate in all sessions to help the child learn new skills both in therapy and at home. Parents are required to bring all foods to therapy to accommodate the child’s dietary needs.

    Referrals to other professionals for medication, a swallow study, or nutritional support will be made as needed.

  • Find Your Location

    Explore or contact one of our locations for therapy availability.

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Children’s Therapy Corner provides therapeutic intervention for children. CTC was founded on the belief that there should be a place where families can come and learn about their child’s needs, in a supportive team atmosphere. We will work with you to provide direction and support for your family and your child. The goal is for your child to live their life to its fullest capacity.

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