Feeding Disorders
A feeding disorder may or may not be accompanied with problems swallowing but typically include picky eating, behaviors disruptive to meal-times, aversions to certain food textures or types of foods, failure to use developmentally appropriate utensils, and less than typical growth or weight.
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Swallowing Disorders
Also called dysphagia, involves difficulties at the various phases of swallowing (e.g., oral, oral-pharyngeal, pharyngeal, esophageal) and can lead to aspiration pneumonia, if left untreated. Aspiration pneumonia refers to liquid or food entering one’s airway/lungs.
Causes of dysphagia may be delayed or disordered chewing, limited sensation, difficulties drinking. This could be accompanied by symptoms of gagging or vomiting and clients may also have a diagnosis of gastroesophageal reflux disorder (GERD) along with poor nutrition/malnutrition. Children with swallowing disorders also frequently develop extreme oral aversions as a result of untreated difficulties swallowing.
This disorder is also present in those receiving alternate nutrition, such as tube feedings. Treatment of swallowing is typically warranted in children who have received nutrition from a J- or G-tube to decrease oral sensitivities before removal of their tube and returning to oral feeding.
MY APPROACH
Swallowing disorders require careful and ongoing assessment to prevent aspiration pneumonia. In the presence of a swallowing disorder, it is likely that I will recommend my clients to get a swallowing study, which can either be a Videofluoroscopic Evaluation of Swallowing (VFSS) or a Fiberoptic Endoscopic Evaluation of Swallowing (FEES) to rule out swallowing disorders at the level of the pharynx (throat) or lower. The results of a swallowing study are very important to guide treatment but my clinical swallowing assessment will make the determination as to whether we need to do this.
Treatment of feeding and swallowing disorders in children frequently involves helping children learn to chew or drink and may involve making some modifications during mealtimes (e.g., cutting up foods, giving smaller portions at a time, avoiding certain foods, modifying textures, or changing up the structure of your mealtimes). The biggest thing I like to stress to families is — DON’T STRESS (easier said than done when mealtimes are 45+ minutes long and your child is screaming, I know, I know - You are NOT alone)! Eating should be a fun and enjoyable experience. If it’s not, let’s talk and figure it out together.
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