Every parent has stories about that time when their child had a tantrum and threw their food. Of course it was in public. It was a disaster – the food went everywhere. And those dirty looks… What happens if these feeding / swallowing problems / food refusal / food avoidance tantrums are a daily, almost every mealtime occurrence? Is your guilty secret that your child only likes ‘junk’ food? And at this point ‘something is better than nothing’ – a child can’t live on air!
How speech pathology can treat feeding and swallowing problems in children
What is a feeding versus an eating disorder? And when is it a swallowing disorder?
How do you know if your child’s funny quirks about foods are normal?
What about food refusal, fussiness about sauce, or tantrums if food touch each other?
You probably have a freezer packed with an unwanted oversupply of frozen butter-bean or quinoa banana mash puree cubes… You stock chicken nuggets because that’s all your child will eat and you try to hide that they only eat chips when you go on playdates in the park.
So what’s normal and when is it a ‘real’ problem that needs addressing?
Many children are fussy at mealtimes. This in itself is not necessarily a problem. When a child is a ‘picky eater’, refusing to eat certain foods or only eats food presented in a particular way it can be hard to work out if it is an eating or feeding disorder.
Both feeding and eating disorders are clinically seen as being within the same category and have overlapping diagnostic criteria. Both are characterised by a disordered relationship with food.
Feeding disorders are more commonly associated with children, and eating disorders more commonly associated with teens and adults.
Eating behaviours that are causing a lack of nutrition, hindering growth, causing weight loss, dehydration are a health concern. Other behaviours such as food allergies, gagging, vomiting, consistently refusing foods or liquids may point towards an underlying medical swallowing condition.
Patterns of reducing appetite or reducing range of foods that are eaten may also point to a feeding disorder that require a team management approach. In this case a GP should have overview of the child’s medical health. An onward referral to the speech pathologist is recommended to assess the feeding or swallowing concern with a view to provide therapy.
1 Redle, E. – Evidence- based Intervention for Toddlers with Sensorimotor Feeding Disorders. PsychCorp Volume 7, Issue 4 Dec 2012 https://www.asha.org/articlesummary.aspx?id=8589952357. Accessed 11 Jan. 2019.
2 Manikam, R., Perman, J. A. (2000) Pediatric feeding disorders. Journal of Clinical Gastroenterology 2000 Jan;30(1):34-46. https://www.ncbi.nlm.nih.gov/pubmed/10636208. Accessed 11 Jan. 2019.
3 Feeding Disorders Related to Autism Spectrum Disorders. Marcus Autism Centre http://www.marcus.org/Clinical-Services/Feeding. Accessed 11 Jan. 2019.
4 Feeding and swallowing disorders in children – American Speech Language hearing Association. https://www.asha.org/public/speech/swallowing/feeding-and-swallowing-disorders-in-children/. Accessed 11 Jan. 2019.
5 Fraker, C., Walbert, L., Cox, S., & Fishbein, M. (2007) Food Chaining: The Proven 6-Step Plan to Stop Picky Eating, Solve Feeding Problems, and Expand Your Child’s Diet. ISBN 1600940161
6 Sharpe, W. G., et al. (2016) Intensive, Manual-based Intervention for Pediatric Feeding Disorders: Results from a Randomised Pilot Trial. Journal of Pediatric Gastroenterology and Nutrition. 2016 Apr;62(4):658-63 https://www.ncbi.nlm.nih.gov/pubmed/26628445. Accessed 11 Jan. 2019.
7 Ravi, B. K. (2017) Food Refusal in Children. Journal of Clinical Nutrition & Dietetics. http://clinical-nutrition.imedpub.com/food-refusal-in-children.php?aid=19865. Accessed 15 Jan. 2019.