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Feeding Difficulties
in Neonates

Feeding difficulties in newborns and neonates may occur for a variety of reasons. Feeding difficulties can be very mild, and babies can grow out of them, or they can be more severe and lead to an actual feeding disorder as the child grows older. Most feeding difficulties get better with time but can cause stress for parents as they try to keep their child fed and happy.

Symptoms

Symptoms of feeding difficulties in a child can vary based on what aspect of their gastrointestinal tract is affected and if their difficulties are due to food textures, swallowing issues, or another physiologic condition. Symptoms may include:

  • Poor weight gain
  • Coughing or choking while eating
  • Not having interest in puree food by 8 months
  • No interest in table foods by 12 months
  • Avoiding foods with specific textures or avoiding entire food groups

Types of Feeding Difficulties

Feeding difficulties have a large spectrum of severity. Poor feeding is often the first sign that a child has difficulties with feeding and may even have a true feeding disorder. Types of feeding difficulties can often be itemized into either texture or swallowing disorders.

  • Texture Disorders – Feeding difficulties in older children (toddlers and above) are often due to texture sensitivities. These children may seem like they have extreme pickiness, but in reality, have aversion to certain textures that lead to poor nutrition. Many toddlers are picky, which is very normal. However, if a toddler will only eat a handful of foods and are losing weight or have nutritional deficiencies, then their pickiness may be qualified as a texture disorder.
  • Swallowing Disorders – Swallowing disorders are common in many pediatric patients. In order to swallow food safely, you must use multiple muscles in your mouth and throat. Pediatric patients with poor muscle tone are at risk for also having poor muscular control/tone in their mouth and their throats. This can lead to gagging, choking and even aspirating what they eat and drink.

Premature infants also often have feeding difficulties, but their difficulties are often due to age. Infants develop the suck, swallow, breathe reflex at 35 weeks gestation, so babies born before this gestational age often have weak suck reflexes and are not able to maintain their oxygen saturations while they eat. This type of feeding difficulty improves overtime.

Reference Articles

Diagnosis

Feeding difficulties and disorders need to be diagnosed by a physician. If you feel like your child may have a feeding disorder, then make an appointment with their doctor. Their doctor will take a detailed history, do a physical exam, and may send your child to a speech therapist or occupational therapist for a feeding evaluation. Your child may also need certain tests to monitor their swallowing function.

 

Treatment

The treatment of feeding difficulties in patients can vary based on the child’s age and the severity of the difficulties. The main goals of treatment will be to allow the baby or child to safely swallow and get adequate nutrition from the food they can eat. Some babies may require external help to get appropriate nutrition. This can be anything from a feeding tube to intravenous nutrition.

Feeding therapy with a licensed speech therapist and a physician can also help many feeding difficulties and disorders. Feeding therapy is a great option for patients with poor muscular tone leading to poor swallowing skills, patients with food texture issues, and patients with gagging, choking or aversions to foods. Feeding therapy is a great treatment option for many children with feeding difficulties to help them learn how to safely swallow, keep food down, and try new foods in a safe environment.

Feeding difficulties can be very stressful for both patients and their parents. If your child has feeding difficulties, they may require some extra help to keep up their nutrition. Finding the right physician and the right feeding team can help your child thrive.

 
 
 

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