Our pediatric services
Why would my child need a Speech-Language Pathologist if he has feeding problems?
Because the muscles and structures used for speech (lips, tongue, teeth, palate and throat) are also used in eating, a speech-language pathologist (SLP) may be needed to address feeding and swallowing difficulties (dysphagia). SLPs have specialty training in the assessment and treatment of dysphagia, and understand the anatomy and physiology of the swallowing mechanism. Feeding problems can be structural, functional, medical or behavioral/emotional.
Structural feeding problems such as a cleft palate or lip, or tracheoesphageal fistula (hole between the airway and the esophagus) can make eating very difficult for the child. Functional feeding problems such as weak suck reflex in premature babies or weak oral muscle tone can keep the baby or child from getting adequate nutrition. These children may have difficulty managing food, may be at risk for choking, and may aspirate food or liquid into the airway. Medical feeding problems such as gastroesphageal reflux can cause pain or discomfort after eating. In this case, the child may refuse to eat to avoid the pain. Once the reflux is resolved with the use of medication, the child may continue to have negative association with eating which leads to behavioral feeding problems.
Many children who have negative experiences around feeding due to structural, functional, or medical difficulties, will often develop behavioral feeding problems. Children who have undergone several medical procedures and surgeries from birth can become very defensive when a parent tries to feed them. Spoons, cups, and food appear threatening to these children. These children refuse anything offered by mouth and often do not mouth toys as young babies and children typically do.
For children who have been tube-fed from very early on due to medical/nutritional reasons, transitioning from tube feeding to feeding by mouth can take some time. These children have not been able to experience the tastes and textures of food in their mouths. Because of this, they can also be very defensive about trying foods and liquids. For children who are tube-fed, getting a speech-language pathologist involved from the beginning is key. The SLP can assist the parent or caregiver in providing oral stimulation along with each tube feeding. Providing oral stimulation and allowing experimentation with foods during the tube feeding will help the child to associate the feeling of satiation and fullness with oral stimulation. This will help to prevent the defensiveness that will occur if the child never experiences oral stimulation as typical feeders do.
All feeding problems should first be addressed by your child’s physician. Once the structural, functional and medical aspects of the feeding problem have been addressed, the Speech-Language Pathologist will work with the team of professionals treating your child to help your child become a functional, oral feeder. These professionals may include an occupational therapist, nutritionist, gastroenterologist, behavioral psychologist or other medical professional.
If your child has feeding and swallowing difficulties, a Speech-Language Pathologist can help to make meal time fun and functional for your child and your family.
