Feeding and Fussy Eating
What is a feeding difficulty?
A feeding difficulty is any type of problem a child has surrounding eating and drinking. This is a common challenge that can make mealtimes stressful for parents and children. Feeding difficulties can present in a range of different ways from picky eating and textural preferences to significant issues that can impact a child’s overall wellbeing and their nutrition, growth and development, as well as the stress these impacts can have on families.
What are the signs or symptoms of feeding difficulties?
There are many varied signs of feeding difficulties. Here are some of the most common:
Picky Eating
Picky eating can be common in children as they transition to solids. This may include food refusal or aversion, eating a restricted range of foods and having extreme preferences. A short period of this is typical, however, if a restricted diet continues, a child might not receive the appropriate amount of nutrients they need to support their development.
Difficulty chewing or swallowing
Some children might have difficulties chewing or swallowing their food and drink. This can lead to choking, gagging or avoiding eating solid foods altogether. It’s important to investigate this as it may be as a result of lack of muscle strength or difficulty coordinating the muscles the way they need in order to eat appropriately.
Food Refusal
Some children may refuse to eat certain foods or may not want to eat at all. This can be due to sensory issues, (not liking textures or smells of food), medical issues (acid reflux or other stomach problems), or even behavioural issues (aversions due to negative experiences with eating).
Stomach or Digestive Problems
Issues such as reflux, food allergies, or constipation, can cause food avoidance or restriction as eating might feel uncomfortable or painful.
Mealtime Behaviour Challenges
Sometimes, feeding difficulties can be as a result of behavioural issues and/or anxiety. A child might try to take control at mealtime, refuse to eat, or be scared of trying new foods. This can be frustrating for families and children and can lead to nutritional deficits if the behaviours are not addressed appropriately.
What is a Paediatric Feeding Disorder?
A Paediatric Feeding Disorder (PFD) is when a child has difficulties maintaining or achieving appropriate growth and has difficulties maintaining their nutritional needs, as they are not eating or drinking enough, not able to chew or swallow adequately or food refusal. The child also may not eat in age-typical ways.
Children who present with PFD are at risk of developing Avoidant Restrictive Food Intake Disorder (ARFID). ARFID is a psychological condition diagnosed according to criteria in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) which involves significant weight loss (or failure to achieve expected weight gain or faltering growth in children), significant nutritional deficiency and dependence on enteral feeding or oral nutritional supplements.
How can speech pathologists support eating and drinking?
Speech Pathologists have detailed knowledge about the muscles and complex processes involved in feeding, including the mechanisms of chewing and swallowing, therefore are a great source of assistance.
Speech pathologists might:
- Provide advice about how to systematically change your child’s foods so that they accept a wider range when transitioning to solids
- Provide strategies regarding positioning of your child during mealtimes
- Provide education regarding different methods of feeding including cup drinking and spoon-feeding.
- Conduct regular therapy sessions aimed at reducing aversion to particular foods
- Recommend altering the characteristics of the foods and drinks on offer to your child.
- Recommend having an x-ray of your child to get a closer understanding of their swallowing technique – usually conducted through a hospital
- Work with other professionals where necessary such as a Dietician, Occupational Therapist, Pediatrician or GP.
At Box Hill Speech Pathology, we believe in offering a range of evidence-based treatment options for both children and adults.
Please head to our contact page for more information or call 9899 5494 to book an initial consultation.