LONG ISLAND FEEDING THERAPY FOR BABIES, TODDLERS, AND CHILDREN

Feeding and swallowing disorders in children are often difficult to spot at first. Most of the time, children who struggle during mealtimes are simply assumed to be picky eaters. And while this is true for many, there are other signs and symptoms that family members can consider to distinguish between a child who is a picky eater or one with a feeding problem. These include:

• back arching and stiffening during meal times
• crying, fussing, or falling asleep when feeding
• throwing tantrums when presented with new or unfamiliar foods
• trouble breathing while eating or drinking
• coughing, choking, or gagging during meals
• preference for specific textures of food (crunch or soft food) or aversion to a particular food group
• taking a long time to eat or simply refusing
• struggling to chew or swallow
• excessive drooling during meals, has liquid come out of mouth or nose, or gets stuffy
• frequently spitting or throwing up
• not gaining weight or growing
• eating less than 20 types of foods
• refusing to eat meals with the family or a group

Meanwhile, a child who is a picky eater may sometimes exhibit similar behaviors as someone with a feeding disorder. However, there are key differences to monitor. Typical signs of a picky eater are:

• eats a limited variety of foods (around 30 types)
• consumes enough calories daily for growth and nutrition
• often loses interest in a particular food but will accept it again after a certain period
• accepts and eats at least one food from all food groups
• allows new or unfamiliar food on the plate even if they do not touch or eat it

Treatment for feeding or swallowing disorders starts with getting a comprehensive check on the child’s general health. A pediatrician can assess the child’s growth and weight based on what is appropriate for his or her age. Children must also be checked for any condition that interferes with feeding skills. If your child’s doctor determines that there is cause for concern, a speech-language pathologist (SLP) may be consulted to conduct an assessment and provide a diagnosis.

During the evaluation, the SLP will:

• ask questions about the child’s medical history and overall development
• observe how the child moves his or her mouth, tongue, and jaw when eating and drinking various foods and liquids. 
• watch how the child eats and take note of the way he or she picks up food, chews, swallows, and drinks
• observe the child’s behavior during meals
• consider the parent child interactions
• assess mealtime routines 
• conduct additional special tests, if necessary

Once a diagnosis is made, the SLP may work as part of a team to design a feeding therapy plan for the child. This team may include an occupational or physical therapist, a dietitian or nutritionist, a physician or nurse, or a developmental specialist.

As part of the multidisciplinary team, the SLP can help your child address the following issues:

• improving the child’s tongue and jaw movement
• Improving lateral chewing
• introducing new foods and drinks
• improving the way the child sucks from a bottle or drinks from a cup
• adjusting textures of food and thickness of liquids to make swallowing easier
• encouraging good behavior during meals, such as increased focus at meal times, not refusing food, and not fussing
• addressing the child’s sensory issues (how the food feels in his or her mouth or hands)

• Serving a piece or spoonful of every food offered on the child’s plate. Whether the child eats it or not, the goal is to familiarize them with the food’s texture, smell, color, and where it comes from.
• Including at least one food that the child is guaranteed to eat in order to expose the child to new foods while still ensuring they are eating the right amount of food.
• Parents modeling good eating habits and describing the food and its taste.
• Praising the child’s attempt to eat or explore new foods but taking care to not let the child be the sole focus of the meal.

At Brooklyn Letters, our feeding therapy involves improving the underlying feeding skills and eating habits of babies, toddlers, and preschoolers. We assess the child’s sucking, swallowing, chewing patterns, diet, behavior, and the home environment during meal time time. Once we pinpoint the underlying problem(s), we create a family treatment plan. Some children require additional one-on-one feeding therapy. We demonstrate to the parent how to tackle their child s feeding and/or eating delay.