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When mealtimes become a nightmare. . .
- Why does my child refuse to eat?
- Why is my child a picky eater?
- Why does my child experience reflux?
Does my child have a feeding or swallowing problem?
Warning signs of Feeding and Swallowing Disorders
- Irritability or lack of alertness during feeding
- Does not explore with different food textures
- Takes more than 30 minutes to eat
- Hoarse, gurgly, vocal quality during and after meals
- Coughing/choking during & after meals gastroesophageal reflux
- Little or no weight gain
- Difficulty chewing food
- Significant amount of food spillage
- Difficulty coordinating breathing with eating and drinking
- Recurring pneumonia or respiratory infections
- Excessive drooling
- Hyperactive gag to foods and smells
- Picky eater or child refuses to eat
- Behavior (i.e. tantrum during mealtimes and purposeful vomiting
Common Causes of Feeding and Swallowing Disorders
- Conditions affecting airway
- Cleft lip or cleft palate
- Heart disease
- Premature birth/low birth weight
- Gastrointestinal conditions
- Neurological disorder (cerebral palsy)
- Sensory integration dysfunction
Long Term Effects of Feeding and Swallowing Disorders
- Dehydration, malnutrition
- Risk of aspiration (food or liquid entering airway)
- Pneumonia or repeated upper respiratory infections (which could lead to chronic lung disease
- Embarrassment or isolation in social situations involving eating
Normal Development of Feeding and Swallowing Skills
One Month
Positioning: On back with head slightly elevated; on stomach; or reclining at an angle of less than 45°; or side-lying
Swallowing: Tongue may protrude slightly through the lips while swallowing
Sequences: 2 or more sucks from the breast or bottle before pausing to breathe or swallow
Three Months
Positioning: Fed in a supported semi-sitting position, reclining at an angle of 45°
Sequences: 20 or more sucks from the breast or bottle. Swallowing follows sucking pauses for breathing are infrequent
Four to Six Months
Positioning: Child is fed sitting, with seat back at 90°; External support is required
Chewing: Munching pattern using up & down motion; infant gums thicker food with small lumps
Eight to Ten Months
Food Types: Child is given liquids, pureed foods, ground or junior foods, & mashed table foods
Chewing: Rotary chew may begin to develop; lateral movement of tongue noted
Sucking Soft Solids: lower lip draws inward
Consult your pediatrician about the possible cause of the feeding and swallowing disorder. At Melanie Massey Physical Therapy, we have ASHA certified Speech-Language Pathologists and registered Occupational Therapists who assess and treat feeding and swallowing disorders. The staff at MMPT work closely with parents, pediatricians and pediatric specialists to ensure the best overall quality care.
If you have questions or concerns regarding feeding and swallowing problems, please contact MMPT. We will be happy to talk with you and to discuss the different possibilities that may be available.
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