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Developmental and Behavioral Pediatrics

Golisano Children's Hospital / Developmental and Behavioral Pediatrics / Condition Information / Feeding Disorders

 

Feeding Disorders

  • Behavior Treatment Services - Provides assessment and short-term treatment for children and teens with developmental delay or disability and challenging behaviors.
  • Pediatric Feeding Disorders Program - Provides assessment and treatment for children who have difficulty eating related to food selectivity, food refusal, and disruptive mealtime behavior.

Description

Pediatric feeding disorders (also termed avoidant/restrictive food intake disorders) are conditions in which a child avoids eating or limits what or how much he or she will eat. This leads to problems including weight loss, nutritional deficiency, need for nutritional supplements, or problems with daily functioning. These disorders often limit a child’s ability to participate in normal social activities such as eating with others, and disrupt family functioning.   

Causes

For most children, there is not just one thing that causes a feeding disorder. Most often, it is a combination of factors. Things that can contribute to the development of a feeding disorder include:

  • Child temperament (slow to adapt, easily over-stimulated)
  • Pain or discomfort with feeding (from things like reflux and allergy)
  • Negative experiences with feeding (pain, coughing, vomiting or gagging during feeding)
  • Negative experiences related to the mouth (history of NG tubes, oral procedures, being on a ventilator, surgeries)
  • Slow emptying of the stomach
  • Poor oral motor skills (dysphagia)
  • Low muscle tone or high muscle tone
  • Developmental delays
  • Certain developmental disabilities, such as autism spectrum disorder
  • Anxiety
  • ADHD
  • Sensory differences (hypersensitivity to taste, smell, texture)
  • Chronic health problems (ear infections, frequent respiratory infections, dental problems, seizures)
  • Parent-child conflict, parental anxiety

Diagnosis

Depending on the child’s history and current problems, the evaluation may include some or all of the following:

  • Review of medical history, growth pattern, developmental history, and current symptoms
  • Assessment of dietary intake by a registered dietician
  • Evaluation by a physician or nurse practitioner with expertise in feeding  and feeding disorders
  • Evaluation of feeding behaviors by a clinical psychologist
  • Evaluation of oral motor skills, chewing and swallowing by a speech-language pathologist
  • Special tests to evaluate swallowing, such as a barium swallow or endoscopic assessment
  • Evaluation by a pediatric gastroenterologist to determine if problems of the GI tract (GE reflux, constipation, delayed emptying, or other GI disorders) are contributing to feeding problems
  • Evaluation of motor skills, posture, and sensory issues by a pediatric OT or PT
  • Blood work to evaluate nutrition status or to screen for medical conditions that can contribute to feeding problems

Feeding Disorder Prevalence

Pediatric feeding disorders are common. 1 of every 4 children are reported to have some sort of feeding disorder. A smaller number have symptoms severe enough to cause big problems or need specific treatment. The rate of feeding disorders is much higher in children with developmental disabilities. As many as 8 of every 10 children with a disability has a feeding disorder.