What is Pediatric Feeding Therapy?
Pediatric feeding therapy is designed to help children who have difficulties with feeding, eating, or swallowing. Feeding challenges can arise from a variety of issues, including medical conditions like gastroesophageal reflux, developmental disorders like autism or cerebral palsy, sensory processing difficulties, or behavioral issues. Pediatric feeding therapists, often speech-language pathologists (SLPs) or occupational therapists (OTs) with specialized training, work with children to address these challenges and improve their ability to eat a variety of foods and drink safely and effectively.
Feeding therapy sessions are highly individualized, focusing on the child’s specific needs. These sessions may include exercises to improve oral-motor skills, strategies to increase the acceptance of different textures and flavors, techniques to reduce mealtime stress, and interventions to ensure safe swallowing.
What is Feeding Development?
Feeding development begins in infancy and continues through early childhood, encompassing the ability to suck, swallow, chew, and eventually self-feed. As with speech and motor skills, feeding development varies widely among children, influenced by factors such as oral-motor skills, sensory processing abilities, and exposure to different foods and textures.
Parents often worry about their child’s feeding progress, especially if the child is a picky eater, refuses certain foods, or has difficulty transitioning from breast or bottle feeding to solids as well as other drinking methods. While some variation is normal, persistent feeding difficulties can impact a child’s nutrition, growth, and overall health.
Pediatric feeding therapists assess both the physical and behavioral aspects of feeding, including the child’s oral-motor coordination, sensory responses to food, and mealtime behaviors.
Feeding Milestones and When to Be Concerned
Below are typical feeding milestones, along with indicators that may suggest the need for further evaluation:
| Skill | Normal Age Range | Concerned Time Period | Quality of Development |
| Sucking and Swallowing | Birth-3 months | Persistent difficulties after 3 months | Should be able to suck and swallow milk effectively without coughing or choking. |
| Transitioning to Solids | 6 months | Difficulty beyond 7 months | Should begin accepting pureed foods, with a gradual increase in texture tolerance. |
| Chewing Soft Foods | 8-10 months | Difficulty beyond 12 months | Should be able to chew soft foods like bananas or cooked vegetables. |
| Self-Feeding with Fingers | 9-12 months | Difficulty beyond 14 months | Should start picking up small pieces of food and feeding themselves. |
| Drinking from a Cup | 12-18 months | Difficulty beyond 18 months | Should begin drinking from a cup with minimal spilling. |
| Using Utensils | 18-24 months | Difficulty beyond 24 months | Should start using a spoon or fork to feed themselves, even if messy. |
| Eating a Variety of Foods | 2-3 years | Refusal to eat a range of foods beyond 3 years | Should be able to tolerate different textures and flavors, with a balanced diet. |
For more feeding milestones, visit the ASHA website here.
Other Red Flags That Feeding Therapy May Be Required:
- Persistent gagging or choking on food or liquids
- Refusal to eat certain food groups (e.g., all vegetables or proteins)
- Difficulty transitioning from liquids to solids
- Avoidance of foods with specific textures (e.g., crunchy or soft)
- Extended mealtimes (more than 30 minutes) or frequent mealtime battles
- Reliance on a specific type of food (e.g., only pureed foods) beyond an appropriate age
- Difficulty gaining weight or maintaining growth
While these milestones serve as a guide, it’s crucial to consider the quality of feeding and how it impacts the child’s nutrition and overall development.
If you, or your pediatrician, have concerns about your child’s feeding development, please click here to request an evaluation.
