What are pediatric feeding and swallowing issues?

The simple ability to consume food is one most of us take for granted.  But for some children, getting adequate nourishment is far from simple.  Feeding and swallowing problems (dysphagia) are extremely complex and surprisingly common in children.  Without appropriate treatment, these disorders can have lasting effects on a child's physical and emotional development, plus create anxiety for parents eager to meet those basic needs.  Parents and caregivers of children who will not eat are faced with a difficult and often puzzling challenge.  Because the relationship between weight gain and a child’s experience with food can be complicated, there is rarely an easy solution when a feeding problem arises.

 

Children of all ages may be affected by feeding and swallowing problems. The causes are numerous and include – but are not limited to – birth defects, genetic disorders, food aversions, gastrointestinal disorders, environmental issues, vomiting, respiratory problems, food allergies, trauma, injuries, or premature birth.

 

How do you treat swallowing disorders?

At smallTalk, we use a methodical and multidisciplinary approach incorporating the whole child.   Environment, cognition, sensory systems, oral-motor abilities, learning and behavioral personalities integrate with the muscles and organs associated with eating – the entire system must be assessed.  Each treatment plan is as individual as each child.

 

What about “picky eaters?”

Focus is placed on increasing a child’s comfort level by exploring and learning about the different properties of food.  This approach allows a child to interact with food in a playful, non-stressful way, beginning with the ability to tolerate the food in the room and in front of him/her, then moving on to touching, kissing, and eventually tasting and eating foods.

 

Children's nutrition doesn't have to be frustrating.  Consider these strategies to avoid power struggles and help the picky eater in your family eat a balanced diet.

 

Respect your child's appetite — or lack of one

If your child isn't hungry, don't force a meal or snack.  Likewise, don't bribe or force your child to eat certain foods or clean his or her plate.  This might only ignite — or reinforce — a power struggle over food.  In addition, your child might come to associate mealtime with anxiety and frustration or become less sensitive to his or her own hunger and fullness cues.  Serve small portions to avoid overwhelming your child and give him or her the opportunity to independently ask for more.

 

Stick to the routine

Serve meals and snacks at about the same times every day.  You can provide milk or 100 percent juice with the food, but offer water between meals and snacks.  Allowing your child to fill up on juice, milk or snacks throughout the day might decrease his or her appetite for meals.

 

Be patient with new foods

Young children often touch or smell new foods, and might even put tiny bits in their mouths and then take them back out again.  Your child might need repeated exposure to a new food before he or she takes the first bite.  Encourage your child by talking about a food's color, shape, aroma and texture — not whether it tastes good.  Serve new foods along with your child's favorite foods.

 

Make it fun

Serve broccoli and other veggies with a favorite dip or sauce.  Cut foods into various shapes with cookie cutters.  Offer breakfast foods for dinner.  Serve a variety of brightly colored foods.

 

Recruit your child's help

At the grocery store, ask your child to help you select fruits, vegetables and other healthy foods. Don't buy anything that you don't want your child to eat. At home, encourage your child to help you rinse veggies, stir batter or set the table.

 

Set a good example

If you eat a variety of healthy foods, your child is more likely to follow suit.

 

Be creative

Add chopped broccoli or green peppers to spaghetti sauce, top cereal with fruit slices, or mix grated zucchini and carrots into casseroles and soups.

 

Minimize distractions

Turn off the television and other electronic gadgets during meals.  This will help your child focus on eating.  Keep in mind that television advertising might also encourage your child to desire sugary or less nutritious foods.

 

Don't offer dessert as a reward

Withholding dessert sends the message that dessert is the best food, which might only increase your child's desire for sweets.  You might select one or two nights a week as dessert nights, and skip dessert the rest of the week — or redefine dessert as fruit, yogurt or other healthy choices.

 

Don't be a short-order cook

Preparing a separate meal for your child after he or she rejects the original meal might promote picky eating.  Encourage your child to stay at the table for the designated mealtime — even if he or she doesn't eat.  Keep serving your child healthy choices until they become familiar and preferred.

 

If you're concerned that picky eating is compromising your child's growth and development, consult your child's doctor.  He or she can plot your child's growth on a growth chart. In addition, consider recording the types and amounts of food your child eats for three days.  The big picture might help ease your worries.  A food log can also help your child's doctor determine any problems; he may refer your child for a feeding evaluation.

 

In the meantime, remember that your child's eating habits won't likely change overnight — but the small steps you take each day can help promote a lifetime of healthy eating.