What is Pediatric Feeding Disorder?
Pediatric Feeding Disorder (PFD) is a complex condition that affects a child’s ability to eat and drink normally. According to a recent definition published in the Journal of Pediatric Gastroenterology and Nutrition:
“Pediatric Feeding Disorders(PFD) is impaired oral intake that is not age-appropriate and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction.” (Goday et al., JPGN 2019;68(1):124-129)
In simpler terms, this means a child has significant trouble eating or drinking in a way that’s typical for their age, and this difficulty is linked to one or more of four key areas. Let’s dig deeper into each of these four areas:
1. Medical Factors
What does this mean?
Medical factors refer to underlying health issues that can cause or contribute to feeding problems.
Examples:
- Gastroesophageal reflux (GERD)
- Enlarged adenoids
- Genetic disorders
- Allergies
How we handle this as SLPs and OTs:
As speech therapists, we don’t directly treat these medical issues. Instead, we play a crucial role in identifying potential problems and referring children to the right medical professionals. Often, there might be overlooked issues like chronic constipation or undiagnosed enlarged adenoids. That’s why a thorough medical background history is important.
2. Nutritional Aspects
Why it matters:
Even if a child is gaining weight and following their growth chart, they might still have nutritional deficiencies if their diet is very limited. Pediatricians might not always ask detailed questions about a child’s diet if the child is gaining weight. But even if a child only eats a few things, getting all the necessary nutrients is crucial for proper development.
What we do as SLPs and OTs:
As speech-language pathologists (SLPs) and occupational therapists (OTs), we often recommend consulting with nutritionists or dietician. They can:
- Assess what nutrients the child might be missing
- Suggest ways to add important nutrients using foods the child already tolerates
- Help support overall growth and brain development through proper nutrition
3. Feeding Skills
Our area of expertise:
This is where SLPs, occupational therapists (OTs), and physical therapists (PTs) focus their efforts.
What we work on:
- Ensuring swallow safety
- Improving oral motor skills for safe eating and drinking
- Enhancing posture and fine motor skills.
- Trunk control is incredibly important for these children. It forms the foundation for many feeding skills.
- Addressing sensory issues to help with food acceptance
4. Psychosocial Factors
Why it’s crucial:
Mental health is deeply connected to feeding. The stress and fear associated with eating can have a significant impact on a child and their family.
What we consider:
- The child’s fear or anxiety around eating
- Family dynamics during mealtimes
- Parental stress and reactions to feeding difficulties
Our approach:
- We often recommend consulting with mental health professionals
- It’s important to address medical, nutritional, and skill-based issues first
- Once these are resolved, any remaining issues are often behavioral
- Mental health professionals can help develop positive strategies for use at home
A delicate balance:
Sometimes, parents might unintentionally increase a child’s stress around eating, especially if there’s an undiagnosed medical issue like reflux. It’s crucial to approach feeding difficulties with understanding and patience.
Conclusion
Pediatric Feeding Disorder is a complex condition that requires a comprehensive, multidisciplinary approach. By addressing all four components – medical, nutritional, feeding skills, and psychosocial factors – we can provide the best possible care for children struggling with feeding issues.
Remember, each child’s situation is unique. If you suspect your child might have PFD, it’s important to consult with a speech-language pathologist and other relevant healthcare professionals for a thorough evaluation and personalized treatment plan.