Dysphagia looks at problems with chewing, sucking, and swallowing safely. This means that your child is unable to pass food or drink from their mouth to their throat and then through the oesophagus to the stomach during the process of swallowing.
Feeding is the intake of nutrition to help us grow and develop, it looks different at every age for babies and young children.
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Age: |
Feeding Skills: |
Diet: |
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0-3 Mon
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Latches onto nipple or bottle. Tongue moves forward and back for sucking. Suck-swallow-breathe pattern.
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Breast milk/formula – digestive system and muscle control is still developing so they should not be eating any solid foods. |
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4-6 Mon
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Shows interest in food. Opens mouth when a spoon approaches. Moves pureed food from front of mouth to the back. Hand on bottle during feeding.
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Breast milk/formula. Begins eating infant cereals and pureed foods. Smooth pureed food, like carrots, sweet potatoes, and pears. |
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7-9 Months
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Holds bottle when drinking in highchair. Chew toys for sore gums during teething. Shows a reaction to new smells and tastes. Starts to reach for food that is nearby. Preference of parents to feed but introduce finger feeding.
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Breast milk/formula Yoghurt Pureed foods Soft fruits Well cooked pasta Beans |
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10-12 M
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Finger feeding Eating a wider variety of food Begins using an open cup.
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Breast milk/formula Rice Scrambled eggs Beans Small pieces of meat Cheese Bread/toast Crackers Cooked pasta |
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13-18 M
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Self-feeding – either finger feeding or begin using utensils. Can use an open cup independently. Holding bottle with two hands and tipping Able to eat most foods. Eating a variety of chopped table foods.
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Milk Small pieces of fruit Bite-sized cooked vegetables. Mixed textures. Cereal Soft, small pieces of meat. |
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Reference: (Arvedson, 2006)
Arvedson, J. C. (2006). Swallowing and feeding in infants and young children. GI Motility online.
Made by Keira Boswell
Things to watch out for during your child’s feeds:
- Coughing and/or choking while eating or drinking
- Gagging
- Frequent respiratory illnesses
- Cannot latch onto breast/bottle.
- Sucks quickly and lightly rather than deep, regular sucks.
- Frequently spits up/vomits after feeding.
- Unusually long/short feeds
- Consistently rejects solid foods.
- Unable to keep food or liquid in mouth.
- Difficulty chewing age-appropriate foods.
- Refuses certain food textures.
- Appears hungry shortly after feeding.
What is sensory feeding? Selective eating
Your baby is only choosing foods or liquids that are specific to a singular texture or consistency, avoiding certain types of food usually due to their texture, taste, smell, or appearance.
Signs of possible sensory feeding difficulties:
- Continually refusing to try new foods.
- Strongly disliking textures, tastes, or food groups.
- Child is becoming more particular and restrictive with their foods.
- Will only eat a specific brand of puree/baby food.
- Refusal to eat items from other food groups.
- Not growing or developing as fast as their peers
- Having very strong likes and dislikes
- Takes a very long time to eat their food, child makes a fuss or finds it stressful.
- Underweight/weight loss
- Frequent colds and illness
Different food groups
All the senses are involved in feeding, how does each relate to sensory feeding difficulties?
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Sense: |
Impact: |
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Sight
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May reject food on appearance.
May insist food is not touching.
May only accept foods within a particular colour group. |
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Smell
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May be very sensitive to smells, gagging at the smells alone. Smells that you find pleasant or neutral could cause the child distress. OR Child may not pick up on the smell of food so could try eating non-food items. May lack sensitivity to smells that other people find offensive. May put food and objects closely to their nose to smell them. |
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Touch
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Strong likes and dislikes regarding texture.
May not even like to touch foods.
Become distressed if they have sticky hands, faces or clothes.
Texture preferences may include dry foods, purees, and single textures. |
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Hearing
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Some children are sensitive to noise meaning it can sometimes cause them actual pain or discomfort.
Examples of sounds in feeding – Metal cutlery clanging on teeth/plates. Crunching sounds made by chewing harder/brittle foods. Noisy dinner tables and dining halls. |
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Taste
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Smell, taste, texture and temperature all contribute to sensation of flavour.
Each of these are stimulated separately when food enters the mouth. |
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Strategy |
What is it? |
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Portion Sizes |
Larger portion sizes can be overwhelming for children and can put them off eating.
The Me-sized portions is an easy guide to use for portion sizes.
Imagine your child’s hand as a reference for their own portion sizes. |
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Mealtime management |
Positive environment and language.
Role modelling – having a negative attitude towards food can reflect onto your child, for example if you constantly reject new foods your child will too!
Create a structured mealtime routine – 3 meals a day with 1-2 healthy snacks throughout the day.
Pair new foods with safe foods that you know your child likes and will accept.
Laying all food out on the table so child knows that there is nothing else to eat. Encourages choice and control – they feel safe knowing they are choosing what they’re eating. |
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Messy play |
By using food in play away from mealtime there is no pressure for the child to eat the food. Sensory tolerance increases and children often become more willing to engage with target foods at mealtime.
Examples: Fill a plastic box or bowl with dried rice or pasta and bury toys for child to find. Place food items into a bag for them to touch. |
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Food chaining |
Explore foods with similar characteristics whilst increasing variety.
Idea is to chain together a variety of changes and combinations to taste and texture whilst keeping a ‘safe’ feature. |
