Feeding Therapy
Our Feeding Therapy program is a non-invasive therapy that assists even the most difficult eaters to cope with the demands of eating. This is achieved through purposeful food play and education that supports your child in developing the necessary skills to engage with new foods.
Our feeding therapy program is unique and effective as it addresses the underlying issues causing your child’s feeding problem. We use a holistic approach to address skill deficits, food anxiety, the parent-child feeding relationship, boundaries, and other underlying barriers to feeding. This includes factors such as sensory processing challenges, oral motor skill development and nutritional deficits.
Feeding therapy uses a family approach. As such, you will be an active participant in helping your child overcome their feeding difficulties.
When should a child be referred for feeding therapy?
Mealtimes are a great opportunity to bond and enjoy new experiences as a family. Unfortunately, for some children, it can be a stressful and challenging time. If any of the behaviours below are affecting a child’s ability to safely eat, meet nutritional needs or enjoy the mealtime experience, they may benefit from receiving a feeding evaluation.
- Difficulty chewing foods, including swallowing food in whole pieces or pocketing food/drinks.
- Difficulty swallowing foods or refuses to swallow certain types of food consistencies.
- Refuses to eat certain food textures or has difficulty transitioning from one texture to another texture (e.g. from bottle feedings to purees, from purees to soft solids or mixed textured foods).
- Gags on, avoids or is very sensitive to certain food textures, food temperatures and/or flavours.
- Struggles to control and coordinate moving food around in the mouth, chewing and preparing to swallow food.
- Fussy or irritable with feeding.
- The child seems congested during or after feeds.
- Frequently coughs when eating or drinking.
- Gags and chokes when eating or drinking.
- Refuses or rarely tries new foods.
- Pushes food away.
- Has difficulty transitioning from feeding tube (nasogastric or PEG tube) to oral feedings.
- Refuses to sit at the tables when non-preferred foods are present or struggles to remain at the table for the duration of the meal (i.e. squirming, feet on chair or table, orbiting).
- Negative mealtime behaviours (infant cries, arches, pulls away from food; child refuses to eat, tantrums at mealtimes or “shuts-down” and does not engage in mealtime).
- Feeding time taking longer than 30 minutes for infants, and 30 to 40 minutes for toddlers or young children.
- Known to be a “picky eater” who eats a limited variety of foods or consistencies.
Feeding Assessment
The first step to effective feeding therapy is to identify underlying causes. A multidisciplinary feeding assessment, and comprehensive report, with our allied health team looks at:
- Oral motor skills and risk of swallowing problems (i.e. If your child’s mouth muscles are functioning the way they need to in order to eat all food textures safely);
- Sensory processing and motor skills (i.e. how your child’s body processes sensory information and if they are over or under reactive to any senses that cause an automatic defence reaction to perfectly safe foods);
- Nutrition adequacy, deficiencies, risks and growth patterns (i.e. if your child is still growing well and managing to get the nutrition needed for healthy development).
Following the assessment, we offer individual or group therapy to develop skills in learning about and trying new foods. The feeding program runs with a parent coaching component that helps families implement changes in the home to promote the trying of new foods in the home environment.
What skills are taught in feeding therapy?
During feeding therapy, therapists work with children to provide them with the skills they need to make mealtimes more enjoyable and nutritious. The skills taught to each child are determined based on the child's individual needs identified through the assessment process and may differ from those below. The most common skills taught include:
Oral skills: Some children may lack the skills needed to eat and/or drink due to developmental delays, illness, allergies and a variety of other factors. When this is the case, therapists work with each child to teach them how to control and coordinate chewing, sipping, sucking, swallowing and the like while eating and drinking. Therapists also work with your child to increase oral strength and tongue control.
Food exploration: Due to a range of issues, your child may need help to broaden the range and type of foods they are able to eat. Therapists work with children and their families to increase the amount and types of foods the child is willing to eat through a range of different therapy strategies.
Feelings towards eating: Whether a child has struggled to eat because of illness or allergies, a sensory aversion to food, and/or reduced oral skills, they may have developed negative feelings toward eating and mealtimes in the process. As a result, many children, and their families, benefit from learning how to create positive eating and drinking experiences.
Therapists work with patients and their families to improve the child’s overall mealtime routine and create positive associations with food. Therapists also help children gain self-feeding independence by teaching skills like drinking from a cup, eating with a spoon or fork or drinking from a straw. By teaching the child how to enjoy mealtimes and retraining the child’s caregiver on how to create a positive mealtime experience, meals and snacks may become easier for the entire family.
What roles do caregivers play in feeding therapy?
Caregivers play an important role in feeding therapy. While the child is learning skills in order to become a better eater, caregivers must learn the skills and strategies they can use at home in order to help the child progress. The child’s caregivers and therapist are a team, working together to make sure the child receives the therapeutic, physical, social and emotional support to improve their feeding skills and habits. In order to provide patients what they need at home, therapists teach the child’s caregivers:
- Feeding strategies and general advice for eating at home.
- Approaches for addressing negative mealtime behaviours.
- How to continue encouraging the child to eat the new foods introduced during therapy at home.
Based on the assessment findings, the parent and therapist work together to decide the goals for feeding therapy. These may include the types of food that will be targeted, strategies to be introduced at home, what oral motor skills will be taught and what changes may be made in the home environment to help create a better mealtime experience.