More than 2.3 million American children under the age of five suffer from pediatric feeding disorder (PFD), which is defined as “impaired oral intake that is not age-appropriate and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction.”
The feeding team at Pullman Regional Hospital has immense experience in addressing these types of issues, even if they are not diagnostically considered a true PFD. The team is comprised of dedicated professionals who develop specialized care plans to address all areas of growth, nutrition, and feeding.
“Our core team consists of the referring physician, a registered dietitian, a speech-language pathologist, and the family, of course. We do have additional team members we can bring in to work with us. That might include occupational therapy, physical therapy, a behavioral counselor, and a genetic counselor,” states Kelly Sebold, speech and language pathologist at Summit Therapy & Health Services.
Range of Feeding Issues Requiring Specialized Care
Pediatric feeding issues range from very straightforward in nature to highly-complicated cases. The majority of our patients are infants and toddlers, but we do see children in their middle and teen years. Common referrals include premature infants with feeding difficulties, oftentimes due to reflux. Some patients actually require a feeding tube so they can meet their nutrition needs.
The team also sees children with developmental delays or immature motor skills that make coordination for sucking and swallowing or the transition to solid foods more difficult.
“Some other types of children we might be working with are those who have sensory processing delays. This can interfere with their touch, taste, sense of smell, their ability to handle stimulation in general—so maybe eating food is more difficult. Food has a lot of properties, like taste, temperature, smell, and texture. This can lead to children sometimes refusing to eat or self-limiting to a really narrow type of food,” explains Sebold.
Sometimes, children develop behaviors during the meal that undermine the relationship they have with their parents. The parent might feel compelled to bribe them or beg them to eat. This can limit their access to nutrients and minerals.
Children with a fragile medical diagnosis right from birth may suffer with complex neurological functions, a respiratory illness, heart problems, or kidney problems. “These can all interfere with feeding and growth. Not always, but they can,” notes Sebold.
Even food allergies can lead to feeding complications. A negative reaction to eating certain foods oftentimes causes children to fear all foods.
What does a Feeding Therapy Appointment Entail?
With the COVID-19 pandemic, the Pullman team has been able to see patients via telehealth services, which is a viable option during this time. However, a typical visit would involve the family meeting the team in person—with an initial first session to see a registered dietitian and speech-language pathologist.
“We observe the child at play, develop some rapport with them, and review their medical history. The family has brought an example of what their day is like; they might track what they've been doing, what the child has been eating and any behavioral concerns they have,” shares Sebold. “We also ask parents to let us watch them feed their child. That allows us to observe their feeding skills, oral motor coordination, and swallowing. We can brainstorm a few ideas, give them suggestions to try at home, answer any questions the parents or children have, and schedule a follow-up visit to see how things are going.”
Pediatric Feeding Therapy Provides a Full Team of Support
Feeding seems like such a natural process, which often makes parents uncertain about seeking help when their child is experiencing troubles. Sebold encourages any parent who is witnessing feeding issues to reach out for help.
“It is a complex situation, and we don't want families to feel alone. We want them to know there is support here and that we can collaborate with their other providers. We also really want to encourage people not to wait too long, because feeding behaviors that start out subtle or simple can become habits and are often emotionally draining and frustrating,” cautions Sebold. “Eating is really social. It should be fun. We like to eat most of the time. If you have kids eating five and six times a day and they're not having fun and the family is not having fun, they need help. They need to come see us so we can make that difference.”