Feeding problem

Many infants have minor food-related problems, including spitting up, avoiding new foods, or refusing to eat at certain times. These issues are usually normal and are not an indication that the baby is sick. Per the National Institutes of Health (NIH), 25% of normally developing infants and 35% of babies with neurodevelopmental disabilities are affected by some kind of feeding problem. Some, such as refusing to eat certain foods or being overly picky, are temporary and don’t pose any health risks.

However, problems such as food allergies, gagging, vomiting, and consistently refusing foods and liquids may indicate an underlying medical condition. It can have adverse effects on an infant’s health and may require medical treatment.

Infant feeding disorders may include problems with grabbing food, holding liquids and foods in the mouth, sucking, and chewing. For instance, babies who are unable to pick up food and get it to their mouths or are unable to close their lips to keep food and drink from falling out of may potentially have a feeding disorder/issue.

Swallowing disorders, medically known as dysphagia, can occur at different stages during the infant’s swallowing process, and include:

• Oral Stage: The oral stage is comprised of sucking, chewing, and moving foods and/or liquids to the throat
• Pharyngeal Stage: The pharyngeal stage is when the infant begins to swallow and move food down the throat, yet closes off the throat to prevent it from going into the airway, which prevents choking
• Esophageal Stage: The esophageal stages consists of relaxing and tightening the openings of the esophagus and pushing food into the stomach

Signs and Symptoms of Infant Feeding Problems and Disorders

Babies with feeding problems may exhibit a number of signs and symptoms, but keep in mind that signs and symptoms will vary according to each individual and the severity of the feeding issues.

Common signs and symptoms of infant feeding problems include:

• Arching the back and body while feeding
• Fussiness or lack of alertness while feeding
• Refusing to eat and drink food and liquids
• Refusing different textures of food
•  Excessively long feeding times
• Chewing problems
• The difficulty with a bottle and/or breastfeeding
• Coughing or gagging during feeding times
• Excessive drooling
• Difficulty in coordinating breathing with eating and drinking
• Increased nasal stuffiness during meals
• Hoarse, or breathy voice quality
• Frequent spitting up and/or vomiting
• Recurring pneumonia or respiratory infections
• Poor weight gain or growth

Infants with feeding problems may also be at risk for:

• Dehydration
• Aspiration
• Chronic lung disease
• Poor nutrition

Diagnosis of Infant Feeding Problems

If you think your baby is having difficulty with feeding, it’s important to contact your pediatrician immediately. Although feeding problems are usually minor, it’s imperative to seek medical treatment in case there is an underlying medical issue.

The pediatrician will generally start by examining the infant and addressing and diagnose any medical explanations for the feeding difficulties, including, if applicable, the presence of excessive reflux or metabolic disorders. A speech-language pathologist (SLP) who specializes in treating infants and kids with feeding and swallowing disorders may also check out your baby’s symptoms, and if applicable, recommend speech-language pathology early intervention.

Treatment Options for Infant Feeding Problems

Treatment varies greatly depending on the cause and symptoms of the feeding issues.

The following are among a few treatment options for babies with feeding problems:

• Medications
• Individualized feeding therapy
• Nutritional changes
• Promoting an increased acceptance of new foods and textures
• Food temperature and texture changes
• Postural or positioning changes
• Behavior management techniques
• Mouth exercises to make the mouth muscles stronger
• Tongue movement and chewing exercises
• Promoting different types of foods, including different textures
• Help with sucking improvement
• Altering food textures and liquid thickness to ensure safe swallowing

In emergency cases involving feeding disorders, hospitalization may be necessary. Your baby may also need a feeding tube while there in order to receive adequate nutrition.

However, most cases of infant feeding problems are addressed before hospitalization. As mentioned earlier, nutritional counseling and/or routine meetings with your baby’s doctor are enough to help with feeding A team approach between parents, caregivers, your baby’s pediatrician, and professionals such as dietitians, therapists, and speech pathologists is often the most successful way to conquer these problems. 

In some instances, an infant may place on a specific diet and prescribed nutritional supplements, most often when they are underweight, undergoing treatment, and experiences developmental delays. 

Causes of Infant Feeding Problems

The following are some causes of feeding and swallowing disorders in infants:

Medical Causes

• Traumatic birth injuries that lead to neurological disorders, such as cerebral palsy
• Cleft lip and/or cleft palate
• Autism
• Neck and head abnormalities
• Premature birth
• Low birth weight
• Respiratory problems
• Heart disease
• Gastrointestinal disorders
• Medications that decrease appetite

Non-medical Causes of Infant Feeding Problems

Non-medical reasons that may affect a baby’s feeding patterns include:

• The baby may be stressed or scared about something
• The baby isn’t receiving enough attention or emotional care from parents and/or loved ones (feels alone, anxious)
• The baby simply does not like the tastes, smell, and/or texture of certain foods

Infant Feeding Problems Prognosis and Long-term Outlook

If the feeding problems are addressed as soon as your baby starts to show symptoms of feeding problems, such as losing weight and refusing to eat, the prognosis is generally favorable and is typically resolved with no long-term health conditions or effect.  If left untreated, however,  infant feeding problems can lead to a myriad of problems, including delayed physical development, delayed mental development, learning disorders, and more. In fact, these developmental delays may stay with infant through childhood and into and through adulthood. 

When certain foods with high nutritional value are not a part of a growing infant’s diet, there is a chance that oral motor development will be delayed, which in turn can lead to a host of other delays, such as speech problems, poor growth, cognitive issues, and behavioral disorders.