Feeding difficulties for children are a more common problem than people may realize.

Feeding disorders are rarely an isolated problem, with many factors contributing, from oral motor and swallowing difficulties to sensory food aversions with food selectivity and resulting behavioral difficulties around the context of feeding. 

A child may experience some of the following:

• Poor oral intake of a variety of foods or refusal of some food groups
• Weight gain less than expected for age or failure to thrive
• Lack of appetite
• Oral sensitivity  with some gagging
• Fear and anxiety related to eating
• Sensory processing disorder (SPD): Reacts emotionally or aggressively to touch to hands, face, and within mouth
• Poor progression of food consistencies
• Biting or chewing difficulties
• Problems with airway protection and swallowing (aspiration), choking, and emesis
• Problems tolerating tube feedings
• Interactional or relationship difficulties around the feeding process

Feeding disorders are multi-factorial when a child has known or suspected medical and psychological conditions that are more likely to have associated issues around the feeding process.

Duke occupational therapists see children with some of the following conditions that may have associated feeding difficulties:

• Oral-motor or oral sensory dysfunction
• Dysphagia
• Gastroesophageal reflux disease (GERD)
• Gastrointestinal motility disorders
• Short gut syndrome
• Failure to thrive
• Prematurity
• Sensory food aversion
• Delayed exposure to a variety of foods
• Behavior management issues
• Food allergies

Duke occupational therapists are skilled in identifying risk factors, clinical presentations, and treatment of feeding difficulties.

An appropriate referral at an early age when a problem is first detected can produce a more favorable outcome for the child and their family. Evaluations are conducted each week by occupational therapists as a two hour process. Treatment is recommended as symptoms warrant following an evaluation.