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Diagnosis and Treatment


Understanding typical feeding development and recognizing the signs of feeding difficulties or a swallowing disorder (dysphagia) are essential to early diagnosis and treatment. Understanding the underlying causes of your child's specific feeding issues allows for accurate diagnosis and for the establishment of an individualized treatment plan designed to support safe, and positive, feeding experiences.  





Signs and Symptoms of Feeding Difficulty
  • Back arching and pulling away from breast or bottle
  • Irritability or reduced alterness during feedings
  • Difficulty coordinating breathing and feeding
  • Refusal to eat
  • Unusually long feeding times
  • Frequent spitting up, vomiting or excessive drooling
  • Liquid or food spilling out of the mouth or nose
  • Cough, choke, gag or "wet/gurgly" vocal quality during/immediately after feeding

  • History of pneumonia or reccurent upper respiratory infections

  • Difficulty transitioning to solid foods or spoon feedings

  •  Limited intake with less than expected weight gain or growth

  •  Difficulty chewing

  • "Fussy eater" - resistance to eating foods of different textures, tastes, colors or temperatures


Common Causes (Etiologies)

  • Prematurity

  • Failure to thrive

  • Neurological disorders

  • Gastroesophageal reflux disease (GERD)

  • Genetic disorders

  • Complex medical conditions 

  • Developmental disorders

  • Structural abnormalities

  • Oral motor weakness

  • Sensory issues 

  • Behavioral 




Comprehensive Evaluation
  • Phone consultation to prepare for evaluation
  • Obtain developmental, medical and feeding history
  • Initiate feeding log - track intake, establish feeding patterns and monitor for clinical signs of aspiration (when liquid or food enters the lungs)

  • Clinical assessment 

  • Preliminary review of evaluation results

  • Report with impressions and recommendations

Individualized Treatment Plan 
  • Recommendations to support safe feeding and healthy growth/development.
  • Feeding/Swallowing Therapy

  • Determine Necessity of Diagnostic Testing- i.e. Modified Barium Swallow Study (MBS/VFSS), Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

  • Consultation with medical team (Pediatrician, ENT, Gastroenterologist, Pulmonologist, Cardiologist, Nutritionist etc.)

Counseling and Education
  • Provide ongoing support, guidance and education for the family.
  • Make  referrals to the appropriate professionals to meet your child's overall developmental needs. 
  • Coordinate a cohesive team approach to your child's care.





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