Author: Colin Rudolph, MD, Ph.D., and Dana Thompson Link MD, MS
Source: Pediatric Clinics of North America, Feb 2002, vol. 49, number 1, pages 97-112
This article provides an overview of feeding disorders in children. Normal feeding is broken down into the following phases: pre-oral (hunger), oral (manipulation of food in the mouth), pharyngeal (movement of food through the throat), esophageal (movement of food through the esophagus), and gastrointestinal (movement of food through the stomach and intestines). An extensive list of possible causes of feeding problems is listed and a team approach to care is outlined. The team approach can be helpful because of the complicated nature of feeding problems. Most feeding teams include specialists in- speech pathology, occupational therapy, psychology, nutrition, gastroenterology (physician who looks at the stomach and digestive tract), and otolaryngology (Ear, Nose and Throat physicians). An evaluation should include a good case history, observation of the child eating, a physical examination looking at muscle tone, posture, oral structures and function, efficiency of intake and motivation to eat. Further testing to evaluate swallowing and stomach issues may be necessary. Treatment may include oral-pharyngeal strengthening, behavioral intervention, and correction of medical problems. Some children may not be able to safely take all their nutrition by mouth. Caregiver support and follow-up oral stimulation is recommended.
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