Physical RED FLAGS to look out for:
Ranked below the 10th percentile for growth
Dark circles under the eyes
Loss of skin color
Dizziness
Fainting
Dry skin
Cracking lips
Hair loss
Poor wound healing
Fatigue
Irritability
Sleep disruption
Underweight
Painful joints
Brittle nails
Shortness of stature for age
Mealtime WARNING SIGNS
Gagging
Coughing
Back arching
Disengagement - turns head away from the food source
Watering eyes
Difficulty initiating a swallow
The child changes in color
“Wet” or “gurgly” sounds after eating
Excessive drooling and unaware of it
Overstuffing
Strong preferences for the type of nipple or pacifier
Aspiration
Vomiting
Food refusal
Lengthy mealtime
Delay in texture advancement
Mouth breathing
Loss of appetite
Spitting out food
Throwing food
Causes of Feeding Disorders
Nervous system disorders (e.g., cerebral palsy or meningitis)
Stomach problems
Being born prematurely
Heart disease
Having a cleft lip or palate
Having breathing problems
Autism
Poor postural control
Poor muscle strength
Medicines that decrease appetite
Sensory aversions
Having a tube insertion
Signs of Food Allergies
Hives
Rash
Eczema
Itching
Swelling of lips, face, tongue, or throat
Stomach pain
Diarrhea
Vomiting
Anaphylaxis reaction (obstruction of the airways)
Signs of Silent Aspiration
Frequent colds
Coughing
Frequent congestion
Choking
Wet breathing sounds
Watery eyes during food consumption
Limits their liquid intake from "not feeling right"
*Silent aspiration is very hard to observe; the Modified Barium Swallow Study is the only thing that can determine if your child is aspirating their foods. Keep a log of concerns and symptoms as they occur to share with your pediatrician*
Note: Ensuring that the child’s weight, length, and head circumference correlates with a good growth curve is important (look at CDC.gov for growth curves for specific disorders)
References
American Speech-Language-Hearing Association. (n.d.a). Feeding and swallowing disorders
in children. American Speech-Language-Hearing Association. https://www.asha.org
/public/speech/swallowing/feeding-and-swallowing-disorders-in-children
/#:~:text=An%20SLP%20trained%20in%20feeding,moves%20their%20mouth%20and%20ton
gue
Fraker, C., Fishbein, M., Cox, S., Walbert, L. (2007, November 2). Food chaining: The proven
6-step plan to stop picky eating, solve feeding problems, and expand your child’s diet.
Hachette Books.
Marcus, S., & Breton, S. (Eds.). (2022). Infant and child feeding and swallowing: Occupational
therapy assessment and intervention (2nd ed.) AOTA Press.
Taylor, T., & Taylor, S. A. (2021). Let’s not wait and see: The substantial risks of paediatric
feeding problems. International Journal of Child & Adolescent Health, 14(1), 17–29.
Toomey, K. A., Ross, E. S., Kortsha, B. C., Beckerman, L., Fitzpatrick, K., & Lagerborg, D.
(2017, November). When Children Won’t Eat: Picky Eaters vs. Problem Feeders.
Assessment and Treatment Using The SOS Approach to Feeding.
Typical development of feeding skills - San Diego occupational therapy. San Diego
Occupational Therapy. (n.d.). https://sandiegooccupationaltherapy.com/wp-content
/uploads/2012/01/TypicalDevelFeeding.pdf
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