Your pediatrician, your child’s preschool teacher, or even your neighbor has mentioned to you that they think your child may benefit from feeding therapy. But what is that exactly?
What is feeding therapy?
While it can sound intimidating, feeding therapy is simply a professional or a group of professionals using therapeutic strategies with a child and their family to support their eating needs and goals. The child could be an infant struggling to sufficiently breast or bottle feed. Or it could be a toddler who has growth concerns and is trying to learn to eat without the use of a tube feeding. It can be a preschooler or school aged child with sensory aversions to foods, smells, or even the loud sounds that often accompany mealtimes.
In all of these cases, the goal remains the same- to help the child become an independent and “functional eater”- one who can consume adequate nutrition in an age-appropriate way and in a reasonable amount of time (generally less than 20-30 minutes for a meal) without the use of bribery, coaxing, and other such methods of coercion.
Who is on the feeding team?
Any of the following professionals may be included in your child’s care, depending on their needs.
- Occupational Therapist (OT)– The OT works to help children successfully complete tasks that are essential to their daily life, including eating. Many factors affect a child’s ability to eat including their physical skills (holding a spoon, core strength for sitting at a table), attention, and response to sensory input (noises around them, smells at the table, texture of the food). The OT evaluates all of these factors and designs a treatment plan that is unique to your child.
- Speech and Language Pathologist (SLP) – SLPs are trained in all muscles of the mouth so they can evaluate if your child has any deficiencies in their sucking, swallowing, chewing, biting, etc. They can also evaluate if your child may have any language processing deficiencies that may affect their ability to understand the communication that happens throughout and surrounding the meal time.
- Registered Dietitian (RD)– The RD can evaluate your child’s current nutrient intake for deficiencies and areas of excess. The RD works closely with the parents and feeding team to suggest foods and food groups to focus on during therapy and at home to ensure the child’s needs are met. This may include ways to add calories, protein, or other nutrients to the child’s current diet.
- Certified Lactation Counselor (CLC)– The CLC is a healthcare provider with training in breastfeeding management and counseling. CLC’s have up-to-date training in the latest breastfeeding research and are ready to support you and your family on your breastfeeding journey. As a part of the feeding team, the CLC works together with the other providers to evaluate latch, feedings and provide you with recommendations and information you need to help you meet your breastfeeding goals.
- Applied Behavior Therapist (ABA therapist) – The ABA therapist is consulted as needed on feeding clients. Parents, the feeding team, and the ABA therapist work together to implement strategies to help decrease behaviors that are destructive and inhibit the child’s chance of success at mealtimes.
- Physical Therapist (PT) – The physical therapist is consulted as needed or children are referred to outside physical therapists depending on their therapy needs. The physical therapist works to help children increase strength and improve movement. A PT may be needed when a child’s inability to move appropriately affects eating/ feeding. Examples can include torticollis in an infant, cerebral palsy, developmental delays, or muscle injury.
- Therapy Aide – The therapy aide is a staff member trained in food exploration and exposure techniques who may assist the therapist in implementation of their therapy plan. The therapy aide may engage in food art or play with a child prior to the therapist conducting the meal routine.
- Families– Yes, that’s right! You are a crucial part of our team! We cannot succeed without your help, your input, and your commitment to our process. Kids experience the most success in feeding therapy when the parents or caregivers are heavily involved. This involvement may look different based on each situation. It can include conducting feeding sessions (with staff coaching you through it), watching therapy sessions on the monitor, and/or meeting regularly with the therapy team for a “care conference” (updates and discussions on therapy and your child’s progress).
What happens in a typical feeding therapy session?
Sessions are designed around each child’s individual needs, but there are some common patterns.
Infants– Sessions with infants will involve the parent or caregiver breastfeeding, bottle feeding, or offering table food with the support and supervision of the appropriate clinical staff. Staff will observe and provide direction and suggestions as appropriate. Various exercises may be demonstrated and recommended for home use to help with muscle tone, attention to feeding, positioning, etc. Frequency of sessions will depend on the needs of the infant and the comfort level of the parents/ caregivers in implementing the recommended strategies independently.
Toddlers/Preschoolers- Sessions always include meal or snack time under the direction of the therapist. Typically, therapy sessions in this age group will also include other routines to help with motivation and practicing transitioning the child to and from the table. Other routines may include gross motor (playing on the playground) to stimulate appetite, food art to engage all the senses in experiencing the food, or other activities as recommended by the treating therapist.
School aged children- Ideally, children at this age will participate in therapy with peers (although this is NOT group therapy). Therapy sessions tend to be structured more like an after-school program with homework time, outdoor play, and snack time. All of these activities are directed by the treating therapists and intentionally designed to help the child meet his/her therapy goals. For example, outdoor time before snack time increases hunger and the natural desire to eat. Therapists also use outdoor play to address gross motor concerns or speech concerns through therapist-facilitated conversation on the playground. Snack time often includes group engagement with a new food or recipe (i.e. making a recipe together and having a taste test). Children also pack their own snacks so therapists can help facilitate acceptance of foods offered at home.
Across all age groups, parents are always invited to watch sessions and/or participate in the way that is appropriate for their situation. We truly believe that children will make more progress at home the more parents engage in the therapy process.
How long does feeding therapy take to work?
Parents ask this question quite regularly, but unfortunately, we really don’t have an answer for it. Just like children don’t usually develop feeding difficulties overnight, they don’t typically go away overnight. We know that it can be daunting for parents to commit to this process, but our goal is to provide you with support every step of the way. We are committed to your family and your child’s success. Our goal is for you to know that there is a path forward through what can often be such overwhelming feeding challenges. We hope that by providing you with consistent support and objective updates on your child’s progress, we can help you celebrate victories- small and large and recognize change when it is happening .
Who can benefit from feeding therapy?
Feeding therapy is for children of all ages- from NICU or hospital discharge on.
- If your child is struggling to eat enough
- If your child is struggling to eat age appropriate foods
- If you are worried about the nutritional adequacy of your child’s intake
- If it is difficult to feed your child anywhere but at home (and still difficult sometimes there too!)
- If feeding/ meal time is a constant point of stress and tension in your house
We are here for you. Call us today to start a conversation and the evaluation process. Evaluation is the first step in us getting to know your child and discussing with you the ways we may be able to help. An evaluation is not a commitment, it is the start of a conversation. If you and your child are struggling with feeding times, please don’t feel you need to continue on alone. Call us today for compassionate and competent care.
