What are Pediatric Feeding Disorders?

[This article is the first in an ongoing series on pediatric feeding disorders relating to therapy specifics, diverse populations, and more.]

A pediatric feeding disorder is characterized by an impaired oral intake that is not age appropriate and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction. An impaired oral intake refers to limited consumption of food and liquids that meet nutritional and hydration requirements.

A child with a pediatric feeding disorder (PFD) may present with:

1. Coughing and/or choking on liquid or food
2. Difficulty transitioning from purees to solid foods
3. An extremely picky eater
4. Only eats crunchy snack-like food
5. Gets upset when nonpreferred food are offered
6. Refuses to eat crunchy foods and/or prefers soft/moist food
7. Holding food in their mouth during and after meals
8. Difficulty chewing appropriately

The skills required to eat begin developing in the womb and progress through childhood. A child may present with a pediatric feeding disorder as an infant, toddler, or school-aged child. There are four domains that are assessed to determine if a child has a PFD: medical, nutrition, feeding skill, and psychosocial. Examples of each domain are as follows:

Medical

1. Weakened lungs/difficulty breathing during oral feeding.
2. Aspiration (choking)
3. Recurring pneumonia related to aspiration (choking)

Nutrition

1. Malnutrition
2. Significantly restricted intake of nutrient-dense food
3. Limited diet
4. Reliance on supplements (e.g., Pediasure) to sustain nutrition and/or hydration

Feeding Skill

1. Need for texture modification of liquid or food
2. Use of modified feeding position or equipment.
3. Use of modified feeding strategies

Psychosocial

1. Active or passive avoidance behaviors by a child when feeding or being fed.
2. Inappropriate caregiver management of the child’s feeding and/or nutrition needs.
3. Disruption of social functioning within a feeding context.
4. Disruption of a caregiver-child relationship associated with feeding

PFD impacts 1 in 37 children under the age of 5 in the United States.

A feeding questionnaire from Feeding Matters can be found here: https://questionnaire.feedingmatters.org/questionnaire to help identify if your child may need intervention. Talk to your pediatrician about your concern with your child’s feeding skills. Call Sidekick Therapy Partners to schedule an evaluation with our feeding therapists.

Samantha Shaffer M.S., CCC-SLP

References:

Goday, P. S., Huh, S. Y., Silverman, A., Lukens, C. T., Dodrill, P., Cohen, S. S., Delaney, A. L., Feuling, M. B., Noel, R. J., Gisel, E., Kenzer, A., Kessler, D. B., Kraus de Camargo, O., Browne, J., & Phalen, J. A. (2019). Pediatric Feeding Disorder: Consensus Definition and Conceptual Framework. Journal of pediatric gastroenterology and nutrition, 68(1), 124–129. https://doi.org/10.1097/MPG.0000000000002188

https://www.feedingmatters.org/what-is-pfd/