Feeding Problems

Feeding can become a problem when your child is losing weight or having trouble gaining the right amount of weight for their age. Your child or baby has feeding problems when:

• They can’t eat or drink anything.
• They can’t eat and drink enough of the right things to stay healthy.
• They choose not to eat or drink enough of the right things to stay healthy.

With a baby, you might have breastfeeding problems. Other baby feeding problems might come from your baby not being able to suck, chew, or swallow.

Eating disorders in young children are called feeding disorders. They might also be called toddler eating disorders. (Usually, the term eating disorder is used for pre-teens, teenagers, and adults.)

Sometimes problems with eating get better without treatment. Sometimes your baby or child will need to be seen by a doctor.

With treatment, feeding disorders can get better. Eating can turn into a safer, easier, and happier experience for your child and the rest of the family. Treatment can also help your child become healthier.

Sometimes feeding problems are due to a child not being able to suck, chew, or swallow. This might stem from a physical problem such as a cleft palate or tongue tie. When the cause is less clear, you can look for these signs:

• Not gaining weight well
• Coughing, choking, or gagging when eating or drinking
• Throwing up often
• Choking on food or drink once during a meal and not eating again
• Eating and breathing coordination problems
• Not eating baby food purees by 8 months old
• Not eating table foods by 12 months old
• Not using a cup by 16 months old
• Eating baby foods at 16 months old
• Avoiding foods with a certain texture or from a certain food group (such as fruits and vegetables)
• Eating fewer than 20 kinds of food, especially when they stop eating certain foods and don’t replace them with other foods
• Crying or arching the back at most meals
• Taking more than 30 minutes to eat meals on a regular basis

Other signs within your family can include:

• Arguing with your child about food and feeding
• When feeding your child is difficult for everyone
• Eating problems you have that your child may get from you

If your baby or child is losing weight or having trouble gaining the right amount of weight for their age, you should see a doctor. While some feeding problems can get better without treatment, it is best to make sure that the cause isn’t serious.

If your baby is very uncomfortable when eating or their spit up is green or bloody, you should take them to a doctor right away.

Feeding disorders are more than picky eating. Feeding difficulties in children are almost always caused by some other medical problem, including:

• Gastroesophageal reflux [GAS-troh-ih-SOF-oh-JEE-uhl REE-fluhks]. This is a condition where acid from the stomach flows back into the esophagus, the tube that connects your child’s mouth to their stomach.
• Eosinophilic esophagitis [EE-oh-sin-oh-fil-ik EE-sof-a-jai-tis] or inflammation of the esophagus
• Other stomach or intestine problems
• Seizures
• Nervous system problems
• Premature birth
• Sensory system problems
• Autism
• Craniofacial [CRAY-nee-oh-FAY-she-awl] syndromes or abnormalities of the face or head
• Heart or lung problems
• Face and mouth muscle problems
• Problems swallowing certain liquids and food textures

When a baby has a problem with breastfeeding, these medical problems might not be the cause. Breastfeeding doesn’t necessarily come easily for everyone. You may have difficulty with positioning your baby or have sore or tender nipples. Your baby might be spitting up. Some spitting up is normal for all babies. It happens when they eat too fast or swallow air. Remember that it takes practice and patience to find a pattern that works best for you and your baby.

Your child will have a clinical feeding evaluation at a therapy center. The feeding specialist (either a speech-language pathologist or an occupational therapist) will talk with you about:

• The foods your child eats
• Where and when your child eats
• Who feeds your child

The therapist will look at your child’s mouth and face. They will watch your child eat or be fed. By watching children eat, the specialist can learn how they move their mouths, think while eating, and control their bodies. They can also see a child’s general ability to eat. If the therapist thinks your child may not be swallowing safely, they will schedule another evaluation.

After the feeding evaluations, the therapist may recommend several ways to help your child, including:

• Putting your child in certain safe eating and drinking positions
• Giving your child certain drinks and foods that are safe for them
• Helping your child to eat a wider variety of foods, and drink assorted drinks
• Teaching you and your child safe feeding and drinking skills
• Coordinating services with other medical and therapy professionals

Most causes of feeding problems cannot be prevented. Some steps you can take to make eating a healthy time that your child likes include:

• Not arguing about food
• Making food fun
• Avoiding power struggles over food
• Being patient when giving your baby or child new foods to try

• Healthy Children

Your child or baby has feeding problems when they can’t eat or drink or when they can’t eat and drink enough of the right things to stay healthy. If your child is losing weight or having trouble gaining the right amount of weight for their age, they might have a feeding disorder. With treatment, feeding disorders can get better.