Identifying and treating feeding difficulties in a child can be challenging. It is important to distinguish problems with an underlying organic cause from those due to a behavioral issue.
Signs and symptoms that may be indicative of a feeding difficulty:
(1) prolonged breast or bottle-feeding
(2) prolonged mealtimes
(3) food refusal lasting less than 1 month
(4) disruptive and/or stressful mealtimes
(5) lack of appropriate independent feeding
(6) nocturnal eating in a toddler
(7) distraction to increase intake
(8) failure to advance textures
Red flags for an organic disorder:
(1) failure to thrive or growth failure
(2) dysphagia
(3) apparent pain while feeding
(4) recurrent aspiration
(5) vomiting and diarrhea
(6) developmental delay
(7) chronic cardio-respiratory symptoms
Red flags for a behavioral problem:
(1) food fixation (extreme dietary limitations, selective)
(2) noxious feeding (forceful and/or persecutory)
(3) abrupt cessation of feeding after a trigger event
(4) anticipatory gagging
(5) failure to thrive
