We have team members who have completed training in the world renown “SOS Approach to Feeding” Course, and Australian speech pathologist Sarah Starr’s approach to Infant Feeding and its associated difficulties. We are fully equipped to offer assessment and treatment for infants, toddlers and children who are experiencing feeding difficulties.
Eating isn’t as easy as it seems
Mealtimes and eating are not as simple as putting down a plate of food in front of you and eating it.
Eating can take up to 32 steps, from tolerating food within the same room, to touching it and interacting with it, to then finally placing it in your mouth. Feeding involves many aspects of daily functioning, including postural needs, sensory integration, oro-motor skills, and sequencing/cognitive planning.
A child can get stuck at any of these many steps or have trouble in these areas, resulting in fussy or problem eaters.
Services:
Our Team of Trained Therapists can help infants and children who are problem eaters or fussy feeders, in a range of areas.
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 10Myths about Feeding:
- Eating is your body’s number one priority
– No, breathing is our number one priority! If you can’t breathe, the body cannot function properly, and therefore won’t be able to eat. Eating is actually our third priority – postural stability (the ability to keep yourself from falling over) is our number two priority. - Eating is instinctive
– No, eating is only instinctive for the first month of life, where feeding starts as the reflex for suckling. Following this we have primitive reflexes that lay the foundations for developing skills needed to eat. Beyond 6 months of age, skills needed for eating need to be learnt and are intentional choices. - Eating is easy
– No, eating is one of the MOST complicated tasks a human being participates in. Eating involves every single organ system, every muscle in the body, and requires coordination of all of these elements at once! - Eating is a two-step process.
– No, there are up to 32 steps required during mealtimes, in the course of learning to eat. - Children should not play with their food.
– No, children need to build skills for feeding and learn about foods first before manners, which includes playing with food and making a MESS! - Children won’t starve themselves; they will eat if they’re hungry.
– No, for children that have feeding problems, eating doesn’t work and/or it hurts, and NO amount of hunger will overcome this. - Children only need 3 meals a day.
– No, children need to eat 6-9 times a day, to get enough nutrients and calories in! - If a child won’t eat, they EITHER have a behavioural or physical problem.
– It’s more than likely that a child with feeding difficulties has a combination of both behavioural and physical problems. If a child starts with a physical limitation to eating, it is highly likely that they will learn that eating doesn’t work and/or hurts for them and will develop behaviours to avoid it. Similarly, if a child starts with behavioural/environmental reasons for not eating, a lack of nutrition will quickly lead to physical/organic problems. - Specific foods should only be at eaten at specific times during the day, and only certain foods are good for you.
– Food is food, they are either a protein, a starch or a fruit/vegetable. While some foods may have more nutritional benefits than others, labelling them as “good”, “bad” or “only to be eaten at X time” does not help a child develop positive associations with food. - Children should “mind their manners” during mealtimes.
– The skills for eating need to be developed before children can have good manners. Children learn through making noises, being messy and playing wither their food!
Red Flags – When to be concerned:
- Ongoing poor weight gain (i.e., percentile rank fall) or weight loss
- Coughing, spluttering, gagging while feeding
- Ongoing problems with vomiting
- Difficulty coordinating eating and breathing, with possible ongoing respiratory issues.
- Coughing/choking on water/milk feeds frequently.
- Inability to transition to baby food purees by 10 months of age.
- Inability to accept table food solids by 12 months of age.
- Inability to transition from breast/bottle to a cup by 16 months of age.
- Toddler has not weaned off baby foods by 16 months of age.
- Aversion or avoidance of foods with a specific texture, colour, nutritional group
- Food range of less than 20 foods, especially if foods are being dropped over time with no new foods replacing them in the child’s food range.
- An infant who criers and/or arches at most mealtimes.
- Feeding battles and/or fights about food.
- Distress on seeing/entering highchair.
- Restricted types of utensils used during feeding.
- Child is difficult for everyone to feed.
- Child/infant takes a long time to eat/feed.
- Parental/Family history of an eating disorder, with a child not meeting weight goals.
Feeding Milestones
By the Age of 3-6 months:
- Efficient and effective suckling from breast or bottle
- Consistent weight gain
- Learning to control tongue movement to move purees around in the mouth.
By the Age of 6-9 months:
- Efficient feeding from breast or bottle – able to hold their own bottle.
- Able to actively strip food from a spoon using their top lip
- ‘Munching’ (up-down- chewing with lumpy, soft food).
- Some gagging on lumps and solid food is normal
- Able to messily drink from an open cup with support from adult
- Use of fingers in the mouth to move food and keep it in their mouth.
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
- Uses fingers to self-feed soft, chopped foods.
- More controlled biting (isolated from other body movements).
- Getting into pattern of main meals and snacks in between, with milk feeds decreasing in amount/frequency as solids increase.
By the age of 12-16 months
- Grasping spoon with whole hand.
- “Co-feeding” with an adult.
- Holds and tips bottle and cup with two hands.
- 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
- Emerging use of utensils
By the age of 18-36 months:
- Speed and efficiency of feeding develops.
- Chewing strength improves
- Chews with lips closed and circular jaw movements
- Better able to manage hard to chew foods.
- Increased utensil use including spoons and forks.
- One handed open cup drinking without spilling.
We are proud to have team members who are fully qualified to assess and treat infants, toddlers and children who have feeding 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.
