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Understanding Pediatric Feeding Disorders: Signs and Symptoms

Pediatric Feeding Disorders (PFD) can manifest in various ways, impacting a child's medical, nutritional, feeding skills, and psychosocial well-being. Early identification and intervention are crucial in addressing these challenges effectively. Here are some signs and symptoms across different domains:

Medical Signs:

  • Labored breathing with and without feeding

  • Color changes in lips or face when eating or drinking

  • Sweating when eating or drinking

  • Gurgle or squeaking sounds with and without feeding

  • Reoccurring upper respiratory infections

  • Crying, arching, coughing, grimacing when eating or drinking

  • Suspected food allergies

  • Multiple formula changes

  • Vomiting

  • Never seems hungry

  • Physical discomfort when eating or drinking

Nutritional Signs:

  • Unable to eat or drink enough to grow or stay hydrated

  • Insufficient or too rapid change in weight or height

  • Lack of a certain nutrient, e.g., iron, calcium

  • Need for nutritional supplements

  • Reliance on a particular food for nutrition

  • Need for enteral feeds for nutrition (NG, GT, TPN)

  • Constipation

  • Limited dietary diversity for age

  • Too few fruits and/or vegetables

  • Limited or no protein source

  • Too few foods eaten on a regular basis

Feeding Skill Signs (over 12 months of age):

  • Labored, noisy breathing or gasping

  • Coughing, choking, gagging, or retching

  • Gurgles or wet breaths

  • Loud and/or hard swallows or gulping

  • Unable to eat or drink enough for optimal growth

  • Excessively short mealtimes (< 5 minutes)

  • Excessively long mealtimes (> 30 minutes)

  • Need for thickened liquids

  • Need for special food or modified food texture

  • Need for special strategies, positioning, or equipment

  • Grazing between scheduled mealtimes

  • Refusal to eat, drink, or swallow certain food textures

  • Needs distraction to eat such as screen time

  • Needs excessive praise/threats/bribes to eat

  • Difficulty chewing age-appropriate foods

  • Unable to eat in new or unfamiliar situations

Psychosocial Signs:

  • Unable to come to or stay with the family at meals

  • Refusal to eat what is offered or to eat at all

  • Disruptive mealtime behaviors

  • Unable to eat with others present at mealtimes

  • Child stress, worry, or fear during meals

  • Caregiver stress, worry, or fear when feeding the child

  • Presence of bribes, threats, yelling at mealtimes

  • Need for distraction and/or rewards for eating

  • Unpleasant mealtime interactions between caregiver and child

Recognizing these signs and symptoms is crucial for early identification and intervention. If signs of PFD are present, it's important to refer early and often for proper assessment and treatment. Early intervention can significantly improve outcomes and support the well-being of both the child and the family. Let's work together to raise awareness and support children with Pediatric Feeding Disorders.

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