Feeding and Swallowing
The term feeding difficulties is a broad term used to describe a variety of feeding or mealtime behaviors perceived as problematic for a child or family.
This may include behaviors such as:
- Picky eating
- Food fussiness
- Food refusal
- Food neophobia
- Restricted variety of foods
- Food fads
- Limited, excessive, or variable appetite
- Prolonged mealtimes
- Disruptive mealtime behaviors
To some extent, these behaviors are all considered to be part of typical feeding development and are usually transient. Children displaying a significant number of these behaviors or displaying a behavior to a greater extent for a prolonged period may be considered to have a ‘Feeding Difficulty.’ In other words, it is not merely the presence of a behavior but the severity and duration of behaviors that signifies a problem.
Standard definitions of these terms are lacking; however, behaviors are generally considered to exist on a continuum from typical to more complex feeding and mealtime behavior problems.
The term feeding difficulties is also used to describe children with oral motor difficulties in ingesting & swallowing foods and/or fluids. This may be combined with other difficult mealtime behaviors.
Feeding Disorders are problems within the range of eating activities that may or may not include swallowing.
Swallowing Disorders can occur when there is disruption in one or more of the four stages of swallowing. This is known as Dysphagia.
Stage I:
Biting and chewing food takes place in the mouth. At this stage, lack of strength, control, or feeling in the mouth—due to stroke or muscle or nerve disease—may cause food or liquid to fall directly into the throat and cause choking.
Stage II:
The tongue pushes the food to the back of the mouth where a structure folds over the top of the windpipe to keep food out. At the back of the mouth, the presence of food triggers muscle contractions. At this stage, the muscle at the back of the mouth that opens to allow food into the esophagus may malfunction and cause aspiration (food passing into the windpipe), which results in choking.
Stage III:
Muscle contractions push food down the esophagus. At this stage, lack of or inadequate muscle contractions may cause food to stick in the chest.
Stage IV:
Food moves through the esophagus, and the lower esophageal sphincter muscle opens to let food pass into the stomach. At this stage, weakening of this sphincter muscle at the stomach opening may allow acidic stomach secretions to come back up into the esophagus from the stomach, a condition called reflux.
Causes
More than 15 million Americans have a swallowing disorder. They can occur at any age. Swallowing problems may be temporary, or they may be an indication of a serious medical problem. There are many causes, including nerve and muscle problems, head and neck injuries, and cancer. Or they may occur because of a stroke. Certain medications can also contribute to the disorder.