Feeding Problems

Issues and symptoms of feeding problems include:

• Being a picky eater (eating only certain foods)
• Being a slow eater
• Eating only foods with certain textures
• Eating only solid foods or liquids
• Gagging and choking issues when eating

Sometimes, feeding problems are due to a child's dietary preferences. Other times, the condition might indicate another underlying medical problem such as:

• Anatomic abnormalities of the gastrointestinal (GI) tract
• Aspiration (when foods, liquids or secretions enter the airway or lungs)
• Inflammation of the GI tract
• Swallowing problems
• Gastrointestinal mucosal conditions such as:
  • Celiac disease
  • Delayed gastric emptying
  • Eosinophilic disorders
  • Gastroesophageal reflux (GERD)
  • Peptic ulcers

Prematurity and congenital conditions like cleft lip and palate, tracheomalacia and neurological disorders can cause feeding problems. Internationally adopted children who are born in an environment where they are only exposed to thickened liquids (e.g., China or Guatemala) may also develop feeding problems.

Diagnosis of Feeding Problems

If you answer "yes" to any of the following questions, your child may have a feeding problem:

• Does your child choke, cough or gag when drinking liquids?
• Does he or she play with the bottle or cup, taking a long time to finish it?
• Does your child limit the total amount he or she drinks per day?
• Does he or she sound congested or wheezy after drinking?
• Does he or she fight taking the bottle, turning his or her head away or pushing the bottle away?

If you are concerned about your child’s eating problems, you should discuss them with his or her doctor. If your child’s symptoms indicate certain feeding problems, a pediatric gastroenterologist will perform exams and tests to make a diagnosis.

Diagnostic exams and tests for feeding problems include:

• Keeping a four-day diet diary
• Fluoroscopy procedures such as an upper gastrointestinal (UGI) barium study or video feeding study
• An upper endoscopy

If your child's symptoms are severe, he or she will undergo a videofluoroscopic swallow study (VFSS) to make sure liquid or food is not going into the lungs. The Radiology & Imaging Department at Riley at IU Health conducts these studies. A speech pathologist will also take part in the study. A VFSS shows how well a patient drinks or eats and if he or she can swallow safely. If the study shows liquid going into the lungs (aspiration), this indicates a breathing or feeding problem. During the study, your child will sit in a feeding seat and drink formula with barium while a technician takes videos of the mouth, esophagus and breathing tube.