What are Feeding Developmental Delays?

How Common are Feeding Developmental Delays?

Feeding disorders are among the most common childhood developmental delays. Research has shown that up to 25-percent of children may demonstrate signs of a feeding disorder. In addition, as many as eight out of 10 children with a disability can have an accompanying feeding disorder.

What are the Signs of a Feeding Developmental Delay?

The signs and symptoms of a feeding developmental delay can vary widely. These signs range from mild (e.g. what many adults perceive to be “picky eating” or normal toddler behavior) to severe and alarming (such as gagging or vomiting when eating). In general, symptoms to watch include the following:

• Food refusal or fussiness
• Resistance to eating any solids or liquids (only requesting baby food or “mash”)
• Oral or sensory problems (e.g. inability to close mouth or chew); vocal cord dysfunction
• Throwing tantrums or other disruptive behavior when asked to eat
• Refusal to eat specific food groups or textures; resistance to a variety of foods
• Food neophobia (fear of trying new foods)
• Prolonged mealtimes
• Delayed attainment of self-feeding skills
• Choking, gagging, or vomiting while eating
• Gastronomy (g-tube) or naso-gastric (ng-tube) reliance
• Constipation or frequent stomachaches
• Difficulty gaining weight / chronic poor growth
• Malnourishment

What Causes Feeding Developmental Delays?

For most children, there is no one cause of a feeding developmental delay. Often, feeding disorders are the result of a combination of factors. Children with existing developmental or medical issues have the highest risk for developing a feeding problem. These children include infants or toddlers born prematurely, children with neurological diseases, or children with co-existing developmental delays.

Other common causes include the following:

• Poor oral motor skills (known as dysphagia)
• Palate defects
• Dental problems
• Abnormalities of the mouth, larynx, trachea, or esophagus
• Low muscle tone or high muscle tone
• ADHD
• Sensory processing and response issues (e.g. hypersensitivity or slow adaption to taste, smell, or texture; easily overstimulated)
• Chronic illness (ear infections, respiratory infections, or seizures)
• Anxiety disorders
• Gastrointestinal motility disorders (e.g. slow emptying of stomach) or short gut syndrome
• Severe food allergies
• Gastritis, duodenitis, and esophagitis
• Gastroesophageal reflux disease
• Environmental (e.g. delayed introduction to textured foods)

How are Feeding Developmental Delays Diagnosed and Treated?

One of the first steps to treating a feeding developmental delay is parental involvement. The parent or caregiver should report any signs of a feeding disorder to a pediatrician. Evaluation of a potential disorder will include a review of medical history, growth patterns, developmental history or disorders, and current eating habits.

The ongoing process may involve multiple steps, including dietary intake assessment from a registered dietician (RD), observation from a physician or nurse practitioner who specializing in feeding disorders, assessment from a clinical or child behavior psychologist, and evaluation of oral motor skills from a speech-language pathologist (SLP).

Special tests and evaluations may include a barium or endoscopic test to assess swallowing ability, gastrointestinal tests to rule out problems in the GI tract, and posture tests through a pediatric physical therapist (PT) or occupational therapist (OT). A doctor may need to conduct blood tests to determine nutrition status (such as vitamin levels and nourishment) or to screen for underlying medical problems that can contribute to feeding delays.

Treatment for feeding developmental delays includes feeding therapy, special skills training (SST), and occupational therapy. These treatments allow children to develop feeding skills through clinic activities, individual intensive feeding and swallowing therapy, and group feeding practice. Contact The Warren Center for more information on help with feeding delays.