Does my infant or child need a Feeding Evaluation for Dysphagia?

Knowing when to have a Feeding Evaluation for your infant or child is very important.
The most common symptoms of a pediatric feeding and swallowing disorder (pediatric dysphagia) may include, but are not be limited to:

• Failure to thrive.
• Failure to consume adequate nutrition to meet the required caloric intake to promote growth.  Commonly, children who experience reflux often fall into this category.
• Difficulty coordinating sucking and swallowing during breast or bottle feeding.
  
• Breathing interruptions or stoppage during feedings.
• Prolonged feedings (longer than 30 minutes).
• Increased oral loss during breast or bottle feeding.
• Episodes of gagging, coughing, or choking during mealtimes.
• Upper airway congestion.
• History of recurring pneumonia.
• Noisy or "wet" respirations' "gurgly/wet" vocal quality before and after swallowing.
• Presence of food nasally during or following the swallow.
• Previous diagnosis of penetration and/or aspiration.
• Change in feeding patterns or new problem with feeding.
• Significant drooling or oral weakness.
• Difficulty transitioning from breastfeeding to bottle/cup feeding.
• Difficulty transitioning from baby food consistencies (i.e. stage I, II, table foods).
• Difficulty transitioning from NG/G-tube to oral feedings.
  
• Refusing to eat food with texture (lumpy, chunky, crunchy) except purees.
  
• Unexplained food refusal.
• Irritability during feeding or meal times.
• Sleepiness during feedings.
• Failure to gain weight over 2-3 months.
• Maladaptive or disruptive behaviors at mealtime (temper tantrums, crying, food refusal, food throwing, etc.).
  
• Diagnosis of a disorder associated with feeding and swallowing difficulties.
• Does not achieve feeding milestones:
  • Not spoon feeding by 9 months.
  • Not finger feeding soft dissolvable foods by 12 months.
  • Not chewing table foods by 18 months.
  • Not cup drinking by 24 months.