When it comes to food, babies and young children can be picky eaters. It could be a forkful of broccoli that is met with resistance or a whole meal that they push away, yet parents often expect these reactions when introducing new foods.
But what do you do if mealtime is a constant source of agitation for your child? For example, they refuse to eat anything except for one particular item, such as french fries. Or you have noticed that they are taking forever to chew and swallow certain foods. These reactions may not be related to their personal preferences. They could be signs of a problem that needs to be addressed by a feeding specialist.
What is a feeding specialist?
A feeding specialist is a trained medical professional who works with you and your child to determine whether the food issues you have noticed are a phase that your child is expected to outgrow independently or if this is something that requires intervention. Additionally, the specialist will help to pinpoint if feeding struggles are behavioral or if there is an underlying medical condition contributing to the challenges associated with eating or drinking. A specialist’s examination will help get to the root of the problem and establish next steps for treatment when necessary.
Beth Kraus, MS, CCC-SLP, Speech Language Pathologist and Senior Clinical Specialist at the Department of Pediatric Otolaryngology at the New York Eye and Ear Infirmary of Mount Sinai.
“There are certain medical conditions that place kids at a higher risk for a feeding issue,” says Beth Kraus, MS, CCC-SLP, Speech Language Pathologist and Senior Clinical Specialist at the Department of Pediatric Otolaryngology at the New York Eye and Ear Infirmary of Mount Sinai.
“In some instances, a feeding problem is one of the first red flags, and we discover the underlying medical condition through thorough examination.”
When should I see a feeding specialist?
There are several signs that a child may be experiencing feeding issues that go beyond picky eating. These signs differ based on age and stage of development.
For babies who are still being breastfed or bottle fed, look for:
- Arching of the back or general stiffness during feeding
- Constant crying or fussing during or after feeding
- Problems staying awake during feeding
- Few or no wet diapers
- Difficulty latching on the breast or bottle, spilling milk/formula from the mouth
- Generally refusing the breast or bottle
“Stiffness, arching, or fussing during or after feeding generally are typically signs of discomfort and may indicate digestive concerns,” Ms. Kraus says. “However, lack of wet diapers or weight gain is a strong indicator that a child is not receiving enough calories to grow.”
For children who have transitioned to solid food, look for signs such as:
- Refusing or turning their head away when offered food
- Agitation at the sight of food
- Choking or gagging when eating or drinking
- Struggling or unwillingness to chew their food
- Taking a long time to eat a meal
- Avoiding all but one type of food
- Frequent vomiting
- Lack of weight gain
- Changes in vocal quality during or after mealtime, such as a wet or phlegmy voice
- Nasal stuffiness when eating
- Pronounced drooling or significant food or liquid dripping out of the mouth
- Frequent respiratory infections
What do I do if my child has signs of feeding issues?
In cases where there is a safety concern, such as coughing, choking, gagging, persistent vomiting, or ongoing weight loss, you should immediately contact your pediatrician for an initial assessment. This will help rule out acute illness as a possible cause before you are referred to a feeding specialist for work-up of a chronic feeding problem.
Prior to meeting with a feeding specialist, Ms. Kraus also recommends keeping a daily log of food intake and behaviors during snacks and meals to get a better sense of both the issues that your child is experiencing and their frequency. This will help to provide concrete details during your child’s evaluation.
“Often times, parents can identify that something isn’t quite right during mealtimes, but they have a hard time quantifying the frequency or identifying specifics of the problem when they are in the office with the specialist,” says Ms. Kraus. “Having some data collected beforehand will help the specialist complete a more comprehensive assessment right from the initial encounter.”