Early Childhood Intervention
This website is a place for families who are facing
challenges pertaining to their child's development and
It is a place to find answers and practical
suggestions. That's what Early Intervention Support is all
Whether a family has a child with a challenging behavior,
a disability or developmental issue, childhood is short - it
should be savored and enjoyed.
Ask a Therapist
We understand developmental milestones and the challenges
of Special Needs children. We spend a great deal of time
with families understanding the inner workings of childhood
routines and interactions. Ask us about your child today!
Ask a Therapist
Causes of Feeding Problems
What are the causes of Feeding Problems?
There are many factors which can contribute to problems feeding. They can
be medical, environmental, behavioral, nutritional, sensory related,
oral-motor related, or due to a child's particular diagnosis which may
encompass a few of the previously mentioned.
Some Medical Causes of Feeding Problems Are:
- Gastroesophageal reflux disease (GERD): A condition
often caused when the muscle at the bottom of the esophagus is weak,
which allows stomach contents to drift back up into the esophagus. It
can come from delayed gastric emptying or constipation or even muscle
spasticity. The acid that comes up into the esophagus causes the
esophagus to become inflamed which in turn makes swallowing painful and
difficult. The condition is often seen in premature infants and children
with neuromotor problems. Many children outgrow GERD, but some do not.
Most children are treated with medication. It is one of the most common
causes of feeding problems in children.
- Chronic Constipation: This is common in many
children with special needs. It can be caused by a lack of fiber in the
diet, or low/high muscle tone or motility problems (inability to move
food through the digestive tract). Some children have pain when having
bowel movements and therefore stop trying to go, leading to abdominal
pain and refusal to eat.
- Food allergies: Can cause rashes, vomiting,
abdominal pain and nausea which in turn can lead to a refusal to eat.
Some children outgrow food allergies, but others do not.
- Dysphagia: This is a difficulty with swallowing
foods, where swallowing is often painful. These children can be at risk
for aspiration (inhaling food into their trachea or lungs).These
children may gag or choke when eating and be prone to respiratory
problems and pneumonia. These children should be evaluated by a
- Motilty Problems/Delayed Gastric Emptying: This is
a problem with food being emptied from the stomach or problems with food
moving through the gastrointestinal tract. These children may have a
lack of appetite and constipation or vomiting.
These are just a few of the most common medical reasons related to
problem feeding, but there are many more.
A child should always be evaluated by medical professionals before starting
a feeding program. Some medical tests that may be ordered by a physician
- Allergy Testing: A doctor may perform either a
blood test or skin test to determine food allergies
- Upper GI/Modified Barium Swallow/Cookie Swallow:
This is an X-ray of the esophagus, stomach and duodenum. If the pharynx
and esophagus are evaluated this is called a barium swallow (also known
as a cookie swallow) since a child drinks barium to coat the structures
so they can be seen on film.
- Gastric Emptying Study: This study evaluates the
speed at which food empties from the stomach into the small intestine.
This involves the child eating a meal which includes a small amount of
radioactive material so the doctor can see the rate of emptying that
- Upper Endoscopy: This involves using a flexible
tube with a light that is inserted to examine the esophagus, stomach and
- pH Probe: This is the test used to diagnose GERD
(reflux). A tube is inserted in the child's nose into the esophagus.
This allows the doctor to assess the pH level of the esophagus over a
period of 12-24 hours. When the child has reflux and food backs up into
the esophagus, the probe records this.
Additional Issues Related to Feeding Problems
Behavioral Feeding Problems: Some children may have
aggressive or self-injurious behaviors related to feeding, which may require
professional intervention before the core issue of feeding can be dealt with
so that the child is safe. Some children may react differently to different
caregivers and may not eat for mom at home, but will eat for the day care
staff. Some children may have learned behaviors over time, such as if they
cry, vomit or gag, they will not have to eat. Sometimes there are even
parent-child issues such as maternal depression, a parent being anorexic or
other mental health issues of the caregivers which can impact feeding.
Environmental Issues Related to Feeding: Sometimes changes
in the child's environment will enhance his ability to eat. A child may need
a special chair in order to be properly positioned in order to chew and
swallow with ease. Some children will require special spoons or utensils,
cups or plates to eat with success. Some children may need less distractions
during mealtimes, such as turning off the TV or dimming the lights. There
are also many children for whom a lack of sleep or lack of a stable mealtime
schedule and daily routine affects their feeding skills/ability.
Oral Motor Problems: These problems are related to
difficulty with tongue, lip or jaw movement that make eating difficult.
These children may have trouble chewing, will take longer to eat, may tire
easily during feeding and may show a refusal to eat.
Sensory Related Problems: These problems can involve the taste, texture,
smell, appearance, type or temperature of foods. These children may have
difficulty accepting new foods due to the appearance (may gag on sight of a
certain food or due to smell of a food), may only accept hot or cold foods,
may only accept foods of one texture (ie smooth, pureed). They may not like
to touch foods with their hands or resist having their faces wiped after
Sources include: Autism and Feeding Problems by Elizabeth Strickland, RD,
LD; Pediatric Feeding Disorders by Kyong-Mee Chung and Sung Woo Khang;
Treating Eating Problems of Children with Autism Spectrum Disorders and
Developmental Delays by Keith E. Williams and Richard M. Foxx
Parenting Tips in Other Areas Include
Learn More About Early Intervention
Thankfully, there are many ways to deal with childhood developmental
delays and behaviors. These include in-home services, outpatient (you take
your child to a clinic), inpatient (following injury or surgery) and school
based services. Which type of therapy should you choose?
Visit our Therapy Options
area to learn more.
Return to Top