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

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