Feeding difficulties in children can be complex, encompassing a range of challenges. Understanding and addressing these issues requires a nuanced approach that combines expertise in pediatric feeding, along with a deep understanding of pediatric development. A comprehensive evaluation must consider four closely related domains: medical, psychosocial, feeding skill-based systems and their associated nutritional complications.
Medical factors may include oropharyngeal impairments, gastroesophageal deficits, aerodigestive disease, congenital heart disease, as well as neurological or neurodevelopmental disorders. Nutritional factors include reduced diversity of oral intake due to reduced quantity or variety of food or drinks, which may often lead to malnutrition. Feeding skill factors may include sensory-motor deficits within the child’s oropharyngeal structures or abnormalities of the musculature. Skill-based dysfunction is described as when feeding is not safe, age-appropriate, or safe, which may lead to aspiration, choking, gagging, vomiting, or fatigue Finally, psychosocial factors usually are a result of developmental delays, mental and behavioral health problems, social influences, or environmental factors.
Because pediatric feeding disorders can significantly impact a child’s social, emotional, cognitive, and physical function, as well as lead to increased caregiver stress, approaches must be holistic, addressing not only the underlying medical implications or, but also considering the child’s physical development, sensory differences, and social, emotional, and environmental factors that influence their abilities.
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Article written by Stephanie Sorrentino, M.S., CCC-SLP
Edited by Selena Reece, M.S., CCC-SLP, BCS-S
Disclosures:
Stephanie receives an honorarium for completion of this presentation. Stephanie owns Bite-Sized Beginnings and is employed at Xavier University and Gracent. There are no non-financial relationships to disclose.
Resources:
Goday PS, Huh SY, Silverman A, Lukens CT, Dodrill P, Cohen SS, Delaney AL, Feuling MB, Noel RJ, Gisel E, Kenzer A, Kessler DB, Kraus de Camargo O, Browne J, Phalen JA. Pediatric Feeding Disorder: Consensus Definition and Conceptual Framework. J Pediatr Gastroenterol Nutr. 2019 Jan;68(1):124-129. doi: 10.1097/MPG.0000000000002188. PMID: 30358739; PMCID: PMC6314510.
