Pediatric Feeding Problems

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Pediatric Gastroenterology

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Feeding problems refer to infants and children having difficulty accepting foods into their mouth (feeding aversion), or problems with chewing and/or swallowing (dysphagia). 


Infants and children refuse to eat or only accept small portions of foods at a time. Some children seem to want to eat, but then have difficulties with certain textures, or they begin to cough or gag as they eat, or have breathing difficulties shortly thereafter.


For some infants and children, their feeding difficulties arise from negative experiences around eating, which lead to a child being uninterested or even afraid of eating. For others, they have inflammation or anatomic abnormalities in their mouth, throat, or esophagus (food pipe), which then lead to food being swallowed incorrectly.


We will take a very detailed history and do a thorough physical exam. In addition, we may request a specially trained pediatric occupational or speech-language pathologist (feeding therapist) to watch the infant/child eat to help get a better assessment. Special x-rays are sometimes used: upper GI series and videofluoroscopic swallow study. We may also perform an esophagogastroduodenoscopy to look into the upper GI tract.


Treatment for feeding problems depends on the age of the child and the underlying cause. Sometimes the type of feeds, the ways that the feeds are administered or prepared will need to be changed. In addition, most children will need ongoing feeding therapy with a trained pediatric occupational or speech therapist, focused on making swallowing easier and more enjoyable. For some children, feeding tubes are needed, which help to provide nutrition when oral intake is not sufficient.