The Occupational Therapists here at San Diego Occupational Therapy are experienced in treating children with feeding challenges related to organic and sensory disturbances. Our therapists watch your child eat, observing mealtime behaviors oral motor skills and reactions to foods. When feeding therapy is determined necessary, San Diego Occupational Therapy uses both the SOS approach to feeding as well as other behavioral, oral motor and medical management strategies.
For tips on feeding or if you would like to know the typical development of mouthing objects, food acceptance, etc., please contact us and we will provide you with educational resources.
Is my child a candidate for feeding therapy?
Yes-(if ANY of the following are present):
* Ongoing poor weight gain (rate re: percentiles falling) or weight loss
* Ongoing choking, gagging or coughing during meals
* Ongoing problems with vomiting
* More than one incident of nasal reflux
* History of traumatic choking incident
* History of eating & breathing coordination problems, with ongoing respiratory issues
* Inability to transition to baby food purees by 10 months of age
* Inability to accept any table food solids by 12 months of age
* Inability to transition from breast/bottle to a cup by 16 months of age
* Has not weaned off baby foods by 16 months of age
* Aversion or avoidance of a wide repertoire of tastes, temperatures and textures of foods.
* Food range of less than 20 foods, especially if foods are being dropped over time with no new foods replacing those lost
* An infant who cries and/or arches at most meals
* Family is fighting about food and feeding (i.e. meals are battles)
* Parent repeatedly reports that the child is difficult for everyone to feed
* Parental history of an eating disorder, with a child not meeting weight goals
* Child overstuffs his/her mouth with food
A child who exhibits these difficulties may be appropriate for a feeding evaluation. As part of the assessment, the parent and child will be observed eating a variety of preferred and non-preferred foods. An occupational therapist will observe the child for signs of oral motor difficulties as well as sensory defensiveness and/or hypo-responsiveness, which may contribute, to the child’s eating difficulties. Upon completion of the evaluation, a comprehensive assessment complete with findings and recommendations will be forwarded to the client, as well as the referring physician.
What is a feeding disorder?
A child with a feeding disorder has difficulties related to eating or drinking. There are many different types of feeding problems, and no two children have the same problem. For example, there are some children that do not eat food by mouth and may be fed by a tube. There are some children who do not eat enough or have a balanced diet because they only eat a few foods, then fail gain weight and grow. Sometimes, a child may have behavior troubles during meals, such as screaming or throwing tantrums, which cause the meal to be very stressful for the child and the family. Other children may have problems with chewing or swallowing. Finally, medical problems such as vomiting from GI issues, such as reflux, may play a role in a child’s feeding disorder.
There is no exact reason as to why children have feeding problems. We think that some children have feeding difficulties because they have medical problems (e.g., reflux disease) that cause eating to be painful. Some children who are premature or who are very sick as infants may not be able to eat orally at first, and they never learn how to eat or that eating is fun! Some children may have oral motor problems, and they do not seem to know how to eat; or they may have oral sensitivities or defensiveness, and they seem afraid of food or things coming near their face or mouth. Some children may have a decreased appetite and don’t care to eat! Regardless, children who do not eat enough or who do not eat the right types of food may be at risk for learning and behavior problems later on.
Over time, we have realized that parents feel very alone when it comes to their child not wanting to eat. In fact, food refusal is a growing epidemic in children. Recent statistics reveal that one in four children have some sort of feeding disorder. Food refusal can take the form of food selectivity, G-tube (gastrostomy tube) or NG-tube (Nasogastric Feeding Tube) dependency, bottle dependency, texture selectivity, or poor oral intake in general.
For more information on Feeding Therapy, please contact us.