What Is Feeding Therapy For Your Children?
and children with a wide array of feeding difficulties which may include one or more of the following:
Reduced or limited intake
Food refusal
Food selectivity by type and/or texture
Addressing feeding problems may be important for preventing or eliminating nutritional concerns, growth concerns including failure to thrive, unsafe swallowing which may lead to aspiration pneumonia and future poor eating habits/attitudes. Feeding therapy may be conducted in an outpatient clinic or hospital. Staff involved in conducting the initial feeding evaluation and any subsequent therapy will depend on the location of the evaluation and the infant or childs current concerns. The feeding team may include one or more of the following: a speech/language pathologist, occupational therapist, physical therapist, nutritionist, social worker or other medical professionals. Initially the evaluator will gather information about the infant or childs medical, feeding and developmental history. Measurements of weight, height, weight to height ratio, frame size and fat stores may be taken. An observation of a typical feeding then takes place.
The evaluator may then change some aspects of the feeding and note the outcomes in order to develop a plan to address the current concerns. The evaluation itself is looking at a number of feeding skills and behaviors Most importantly the evaluator is assessing oral-motor and swallowing skills to determine if the infant or child has a physical problem or lack of oral-motor skill that is interfering with the child's ability to eat an appropriate diet safely.
Many infants and children with GERD have delayed feeding skills because the pain they associate with feeding caused them to refuse feeding altogether or refuse certain types or textures of foods and they don't gain the needed oral-motor experience to develop the physical skills needed to safely consume the type of diet they should be consuming. These associations can also lead them to attempt to get the feeding process over quickly as possible so they do not take to the time to use the physical skills needed to eat safely. Some children with GERD may also require tube feedings again reducing their exposure to oral-motor experiences and effecting their feeding skill development.
Observation alone may not give the evaluator all the information they need in assessing the infant or childs physical skills for feeding. They may need to schedule a swallow study to gain more information. The swallow study will allow the evaluators to look for structural abnormalities in the swallowing mechanism and assess risk factors for aspiration (penetration in to the lungs) of foods and liquids. The associations that infants and children make between the pain of GERD and feeding can remain even long after the pain of GERD has subsided. Young children may also be taken off medication when the obvious symptoms of reflux disappear yet their reflux may continue silently (meaning that stomach contents go into the esophagus but does not result in vomiting) and cause continued feeding problems.
Therefore it is vital that the young child receive proper medical diagnosis and treatment of reflux, especially pain relief, before attempting a feeding therapy intervention program. Although feeding therapy can be effective in addressing many types of feeding difficulties, without effective pain management, oral-motor, sensory and behavioral feeding interventions may yield disappointing, ineffective results.
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