ASHA Shares Resources for Families on Feeding Development This Pediatric Feeding Disorder Awareness Month

(Rockville, MD) Many young children have difficulty eating in their first few years of life, but it isn’t always easy for families to differentiate between age-appropriate feeding challenges and those that could indicate a potential medical or developmental problem.

To help, the American Speech-Language-Hearing Association (ASHA) is sharing free resources for parents and caregivers this May, which is Pediatric Feeding Disorder Awareness Month.

Typical Feeding and Swallowing Development

Eating and drinking are among the most complex functions of the human body. Starting from birth, children learn to eat and drink in stages. Developmental milestones are the skills that most children demonstrate by a particular age range.

ASHA provides evidence-based checklists of feeding and swallowing milestones that families can expect their child to achieve between birth and 3 years. These milestones include the following:

• turns head toward nipple and opens mouth (birth to 3 months)
• brings hands to breast or bottle (4–6 months)
• brings food to mouth with hands and starts to feed self (6–9 months)
• begins chewing food on both sides of mouth—called “rotary chewing” (9–12 months)
• drinks from a sippy cup without help; can drink from an open cup with some spilling (12–18 months)
• chews all foods, including those with tougher textures, without gagging or choking (2–3 years)

The age range specified with each skill represents the time frame in which most children (at least 75%) will have mastered that skill. Not meeting one milestone doesn’t necessarily mean that the child has a feeding problem.

However, if a child is not meeting several feeding milestones, is not progressing in their skills, or is losing skills that they once had, then families should talk to their pediatrician and seek a feeding and swallowing evaluation from a certified speech-language pathologist (SLP).

Pediatric Feeding Disorder

Pediatric feeding disorder (PFD) is impaired oral intake that is not age appropriate; lasts at least 2 weeks; and is associated with medical, nutritional, feeding skill, and/or social–emotional challenges. More than 2 million children in the United States have PFD.

ASHA encourages families to not only familiarize themselves with feeding milestones but also to learn the warning signs of PFD. These warning signs include the following:

• arching back when feeding
• turning head away from food
• vomiting (more than the typical “spit-up” for infants)
• having breathing difficulties when feeding
• coughing and/or choking during or after swallowing
• crying during mealtimes
• losing food or liquid from the mouth when eating
• taking a long time to finish meals or snacks (longer than 30 min per meal—and less time for small snacks)
• losing weight—or having trouble gaining weight

Families can complete a six-question screener from Feeding Matters to determine if their child is at risk of PFD. Regardless of the results, if they have questions or concerns, families should trust their instincts and act on them quickly by obtaining a feeding and swallowing evaluation from an SLP. Taking that step is critical.

PFD can affect a child’s health and result in serious issues—including dehydration or poor nutrition; food or liquid going into the windpipe instead of the food pipe (when this happens, it is called aspiration); and pneumonia or other lung infections. Families should look for an SLP who specializes in feeding and swallowing disorders. A searchable database of these professionals is available at www.asha.org/profind.

SLPs can help with feeding problems in a variety of ways—beyond conducting a feeding evaluation:

• Helping the child learn how to breathe while sucking and swallowing (for babies only).
• Improving the child’s ability to suck from a bottle or drink from a cup.
• Changing food textures and liquid thickness to help the child swallow safely.
• Showing the caregiver a different way to hold their baby—or the way their child sits when eating.
• Helping children to chew foods.
• Encouraging children to try—and accept—new foods.

To learn more about feeding and swallowing development in children, visit ASHA’s website. Learn more about PFD from Feeding Matters.

About the American Speech-Language-Hearing Association (ASHA)
ASHA is the national professional, scientific, and credentialing association for 241,000 members and affiliates who are audiologists; speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology assistants; and students. Audiologists specialize in preventing and assessing hearing and balance disorders as well as providing audiologic treatment, including hearing aids. Speech-language pathologists (SLPs) identify, assess, and treat speech, language, and swallowing disorders.