Nepean Speech & Occupational Therapy

Feeding

Services:

Our Team of Speech Pathologist and Occupational Therapist can help infants and children who are  trouble eaters and fussy eaters. Feeding difficulties can be due to a variety of reasons including  sensory – motor deficits. However, children who do not eat or are trouble eaters always have poor oral motor skills related to eating.

We provide the following feeding services:

  • Assessment
  • Individual and group therapy
  • Multidisciplinary management
  • Parent training, education and support

Misconceptions about feeding:

Eating is not as natural or as easy as we think. Below are 5 Myths about Feeding:

1. Eating is your body’s number one priority and children will not starve themselves

  • No, breathing is a human priority! And if you cant breath of have the skills to eat, you won’t eat.

2. Eating is an easy two step instinctive process

  • No, eating starts off as a reflex for suckling, however skills needed for eating need to be learnt and are intentional choices. Feeding is a complicated, multistep sequence needing coordination between motor skills, cognitive skills, sensory skills, social skills, biological stability and communication skills.

3. Children should mind their manners at mealtimes and not play with their food.

  • Children need to build skills for feeding first before manners, which includes playing with food and making a MESS!

4. Children only need 3 meals a day and specific foods should only be at eaten at specific times during the day.

  • Children need to eat 6-9 times a day! Your stomach doesn’t know what time it is!

5. A child who won’t eat is one that is behavioural

  • No, on most occasions there is an underlying reason for feeding difficulties.

Red Flags – When to be concerned:

  • Difficulty latching weak/uncoordinated suck
  • Significant fatigue with feeds
  • Coughing, spluttering, gagging while feeding
  • Frequent/large gulping swallows
  • Biting/chomping at breast or bottle
  • Biting and eating food with front teeth only
  • Not chewing food with back teeth and moving from side to side of mouth.
  • Dribbling milk frequently during feeds
  • Significant maternal nipple pain or damage
  • Long feed times
  • Gaging on nipple or teats
  • Persistent tongue protrusion with solids
  • Refusing to eat/gagging/vomiting on solids
  • Restricted types of utensils during feeding
  • Limited type of foods and liquids that can be consumed.
  • Feed refusal
  • Feeding battles
  • Distress on seeing/entering high chair
  • Coughing/choking on water/milk feeds frequently.
  • Mouthing more objects than food

Feeding Milestones

By The Age of 3-6  months:

  • Efficient and effective suckling from breast or bottle
  • Consistent weight gain

By The Age of 6-9 months:

  • Efficient feeding from breast or bottle
  • Learning to control tongue movement to side of mouth ‘munching’ (up-down- chewing with lumpy, soft food).
  • Some gagging on lumps and solid food normal
  • Able to messily drink from an open cup with support from adult

By the age of 9-12 months:

  • Continuing with breast/bottle feeding, moving towards increased cup drinking by 12 months.
  • Eating simple chopped table foods by 12 months, including easily chewed meats.
  • Clearing food off lips
  • Using more circular jaw movements for chewing
  • More controlled biting isolated from other body movement.
  • Getting into pattern of main meals and snacks in between, with milk feeds decreasing in amount/frequency as solids increase.
  • Starting to assert independence.

By the age of 12-16 months

  • Grasping spoon
  • Chews and swallows firmer foods without choking
  • Able to keep food in mouth during chewing
  • Efficient finger feeding
  • Moving chewed food around mouth with control
  • Uses tongue to gather shattered pieces

By the age of 18-36 months :

  • Speed and efficiency develops
  • Chewing strength improves
  • Chews with lips closed and circular jaw movements
  • Better able to manage hard to chew foods
  • Increased utensil use one handed open cup drinking without spilling

We have team members who have recently completed advanced training in Infant Feeding and it’s associated difficulties.

If you have any worries or concerns, please give us a call. We are happy to have a chat to see if an assessment may be beneficial.