When It's Time for Therapy: Feeding

Image via huffingtonpost.com

Image via huffingtonpost.com

Many parents have trouble discerning whether their child is displaying typical behavior or when it's time to see a speech-language pathologist.  If this is you, first know that you are not alone!  The world of child development is big and sometimes confusing, which is why there are specialists to help you.  Sometimes family members, doctors, or others encourage parents to "wait it out" if they are unsure whether to seek help.  While this advice sometimes works, we always tell parents to seek help if they feel something is not "right" with their child; the earlier, the better!  (For more information on why it's important to treat early, see this article by The National Early Childhood Technical Assistance Center.)

To help parents know when they might want to consider therapy for their child, we've come up with some lists of factors to consider.  First in our series is feeding therapy.  Read on for signs that your infant, toddler, or older child might benefit from feeding therapy:

1.  Feeding has become a struggle

Feeding is a social activity and should begin that way from an early age!  If feeding your child is a struggle due to food refusal or unwanted behaviors, and if it's an activity that you dread, it could be a sign of underlying issues.

2.  Your child is a very picky eater

It is normal for some toddlers to be picky or quirky about food.  If your child's food repertoire is growing smaller instead of larger, or if it has not grown in several months, he or she might have a deeper difficulty.  The same goes for a child who tends to only eat foods of certain textures, temperatures, colors, etc.

3.  Your infant is having difficulty transitioning

You may want to consider therapy if your baby is having trouble transitioning from bottle to pureed food, or from pureed food to more solid food.  As a rule of thumb, babies are ready to eat pureed food at around 4-6 months and are ready for solid foods at around 10-12 months. 

4.  Your infant or child gags, chokes, or throws up nearly once a day

Although occasional gagging is not a concern, regular gagging may be a sign of sensory issues.  Regular choking and vomiting could indicate difficulties with the motor movements needed for eating and drinking, or could be a sign of reflux.

We hope this post will serve as a resource for parents who are wondering whether to seek a feeding evaluation.  Above all, if you feel something might be wrong, seek help for your child.  To find out more information on feeding evaluations and therapy, clickhere.  Thanks for reading!  As always, for more information, visit us on our website orFacebook page.

Pediatric Choking Information

As SLPs who work with many children who have feeding difficulties, we are very interested in information offered by the American Academy of Pediatrics on the subject.  Recently, they updated their policy statement on choking and introduced some new information about choking.  Here are some highlights from the American Academy of Pediatric's newest information and guidelines:


Image from   volginimage.com

Image from volginimage.com

  • From 2001 - 2009, approximately 112,000 children were seen in emergency rooms across the country as a result of food-related choking incidents.  The main culprit was hard candy (15% of cases).
  • Although hot dogs are traditionally thought to be a high choking hazard, they did not appear on the list of choking incidents requiring medical attention.  However, other types of meats were causes of choking.
  • The type of food choked on was directly related to the age of the child; infants are more likely to choke on formula, fruits and vegetables, and baby biscuits, while toddlers are more likely to choke on fruits, nuts, and candy.
  • In the year 2000, 160 children under the age of 14 died from choking causes.  41% of these cases were related to choking on food items, while 59% were caused by non-food related items.


  • Toddlers:  back teeth are not yet fully developed, and therefore, children age 1-2 have more difficulty completely grinding food to a consistency that is safe to swallow.  Children this age should not be fed foods that cannot be bitten into small pieces using the front teeth.
  • Preschoolers:  children age 2-4 have the capability to grind food using back molars, but may not yet have the knowledge required to do so.  With this in mind, it is important to teach children how to grind up food using their back teeth.  Additionally, children this age should always be fed in an upright, seated position with adult supervision.  If gum is offered to children at this age, it should always be safely removed by an adult before the child is allowed to get up from the table.
  • Older children:  children age 5 and older now have the anatomy and the knowledge required to safely consume most types of food.  However, it is still important to make sure the child is sitting at a table when eating, is not distracted during mealtimes, and is under close supervision when consuming foods that are more difficult to handle (e.g., peanut butter, tough meats, hard candy).

Eating should be a fun and social event!  We hope this information helps you share mealtimes with your child in a safe, enjoyable manner.

Thanks for reading!  For more information on feeding and how we can help, visit the "Resources" section of our website at www.slpcenter.com