the little ones:
newborns & babies

These issues may be in the full-term healthy baby or little ones who may have been born prematurely and had significant medical conditions. Early intervention is key for many kiddos of this age group. If problems are addressed as they unfold and the child “feels better”, there is a high likelihood that they will catching up with the feeding milestones they may be missing or were delayed in. Some of the problems that arise within this age group are the following:

• Poor bottle feeding/poor breast feeding following help from a lactation consultant

• Tethered Oral Tissue – anterior or posterior tongue tie

• Complications with reflux and constipation – crying, arching, vomiting, spitting up, excessive eating, hick-ups, breast of bottle refusal

• Poor weight gain

• Sleep feeding – only eating when they are sleeping

• Difficulty transitioning onto pureed foods or solid foods or not eating enough volume of these

• Medically complex cases may include little friends who are G-tube or NG tube dependent and are trying to learn to eat enough by mouth

the toddler years

As children advance in age they become more protective and determined in their avoidance of food and their behavior really starts to ramp up. They now have more anxiety and more learned negative behavior around food. Most children who exhibit this behavior do so because something is not right either medically or with the function of their mouth either from a motor perspective or sensory response or a history of such. Their refusal may very well be appropriate protective behavior. Here are some of the common feeding problems seen with this age group.

• Not advancing to solid food as the primary source of their diet

• Poor chewing skills

• Only eat select chewing foods

• Prolonged bottle or breast-feeding dependence or drink for the majority of their calories

• Consuming insufficient volume of food, may be losing weight

• More frequent temper tantrums around eating – crying, gagging, vomiting, throwing food

• Refusing to let others feed them but not feeding themselves enough

• Starting to refuse foods that they had been eating previously, begin to become increasingly “picky” and begin dropping foods or food groups.

• Becoming reliant on others to feed them – not feeding themselves with a spoon, fork or cup

For some medically complex children, this might be the first time that they are medically stable enough to begin eating by mouth. They may be toddlers chronologically but they’re feeding experience is that of a newborn.

preschool through school age

Often feeding issues as the child reaches school age are described as very “picky” or “selective” eaters. The child may have had feeding issues at a younger age and parents were hopeful or assured they would out grown them. Many children just grow up with this or the problem continues to grow. Now starts the parent panic- What will they eat in school? How will this affect them socially? What will be the long term effects of eating a poorly balanced diet? Here is what you may be seeing:

• Highly selective eater – brand, texture, presentation specific

• Will only eat select foods in certain settings/locations

• Demonstrate significant fear and anxiety when faced with new food or asked to try a new foods

• Are missing whole food groups in their diet

• Food refusal, gagging or vomiting when faced with new food

• Holding food or chewing for a long time

• Poor weight gain

• Excessive weight gain due to poor diet

• Unable or unwilling to attend social events