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Does your child have difficulty with feeding or swallowing?

Updated: Jun 2, 2021

At first glance, eating seems intuitive, natural, and all-around very easy. But, upon closer inspection, the process of bringing food to the mouth, managing to swallow it, and participate in mealtime dynamics is a complex mixture of motor, sensory, and social demands.

Participating in mealtime requires gross motor, fine motor, visual motor, and oral motor skills. Before we even consider the mouth, it is important to promote a safe posture for feeding. Aside from proper etiquette, your parents may have taught you to sit upright while eating to maintain safety. For many of our little clients who are still building up strength, sitting upright with the head aligned over the torso helps prevent the food from moving back too quickly. For this reason, adequate head and trunk control are usually recommended prerequisites before offering solid foods.

The act of eating consists of 4 phases:

  • Oral preparation phase: The act of bringing food to the mouth. This may include finger feeding or using utensils. Feeding therapists often recommend encouraging your child to do as much of the oral preparation on their own as possible, as this gives them more control over the mealtime experience and often prevents picky eating and power struggles down the road.

  • Oral phase: Preparing the food to be swallowed. This includes biting off a piece, chewing it, and moving it toward the back of the mouth. These skills involve intricate movements of the cheeks, tongue, jaw, and lips.

  • Pharyngeal phase: The swallow. At this time, the food moves from the back of the tongue and travels down to the pharynx, a part of the throat.

  • Esophageal phase: To the tummy! The food continues traveling down into the esophagus, where it is transported down this tube-like structure to the stomach.

When each of these stages occurs smoothly, the food makes its journey to the stomach with ease.

Signs that something may be awry could include:

  • Coughing or gagging

  • Change in skin color or lip color

  • Wet vocal quality (sounds like there is mucus present)

  • Food residue remaining on the tongue, within the cheeks, or on the roof of the mouth

  • Teary eyes or a stuffy nose associated with eating

  • Resistance to accepting food, arching back

  • History of pneumonia

  • Difficulty breathing while eating

  • Low-grade fever following mealtime

  • Feeling of food being “stuck” in the throat

If you have noticed any of these signs or have any questions or concerns about your child’s feeding pattern, reach out to a pediatric speech-language pathologist or occupational therapist with advanced certification in feeding and swallowing disorders.

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