Feeding disorders include problems gathering food and getting ready to suck, chew, or swallow it. For example, a child who cannot pick up food and get it to her mouth or cannot completely close her lips to keep food from falling out of her mouth may have a feeding disorder.
Swallowing disorders, also called dysphagia (dis-FAY-juh), 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
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.
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
- 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
How are feeding and swallowing disorders diagnosed?
If you suspect that your child is having difficulty eating, contact your pediatrician right away. Your pediatrician will examine your child and address any medical reasons for the feeding difficulties, including the presence of reflux or metabolic disorders. A speech-language pathologist (SLP) who specializes in treating children with feeding and swallowing disorders can evaluate your child and will:
- ask questions about your child’s medical history, development, and symptoms
- look at the strength and movement of the muscles involved in swallowing
- observe feeding to see your child’ s posture, behavior, and oral movements during eating and drinking
- perform special tests, if necessary, to evaluate swallowing, such as:
- modified barium swallow – child eats or drinks food or liquid with barium in it, and then the swallowing process is viewed on an X-ray.
- endoscopic assessment – a lighted scope is inserted through the nose, and the child’s swallow can be observed on a screen.
- (ASHA Article)
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