Children's Hospital Colorado

Feeding and Swallowing Problems

What is a feeding and swallowing problem?

Children's Hospital Colorado treats patients with feeding difficulties

A feeding or swallowing problem affects a child’s ability to eat or drink in a developmentally appropriate and safe way. Feeding difficulties may affect many aspects of a child’s health, development, growth, nutrition and overall well-being. The impact of a feeding problem can weigh heavily on a child’s family. A swallowing problem may affect a child’s ability to swallow foods and liquids safely, putting them at risk for choking.

What causes feeding and swallowing problems?

A wide range of issues can lead to feeding and swallowing problems including medical conditions, interruption in normal feeding development, developmental delays, pain, and abnormalities in anatomy.

Who can have feeding and swallowing problems?

Children with developmental or medical issues are at the highest risk for having a feeding problem. Examples of these children are infants or toddlers who were born premature, have had medical therapies interrupt normal feeding development, children with esophageal, gastrointestinal or aerodigestive disease, children with neurologic disease, and children with developmental delays or behavioral concerns.

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What are the signs and symptoms of feeding and swallowing problems?

  • Chronic poor growth
  • Compromised nutritional status or malnourishment
  • Food refusal/picky eating
  • Decreased variety and volume of oral intake
  • Choking, gagging, coughing and vomiting while eating
  • Inability to chew/swallow
  • Delayed attainment of self-feeding skills
  • Behavioral or learned feeding problems

Children who have been using a feeding tube for feeding may have difficulty developing or may even lose their oral skills needed for feeding without a feeding tube. Some children may have trouble transitioning back to oral feeding from the tube.

What are the signs and symptoms of a feeding and swallowing problem?

  • Coughing or choking while eating or immediately after eating
  • History of chronic lung problems (for example diagnosis of aspiration pneumonia)
  • Vocal cord dysfunction
  • Food being suctioned out of the child’s tracheotomy
  • Difficultly gaining weight thought to be the result of oral motor or pharyngeal dysfunction
  • Difficulty initiating a swallow

What tests are used to diagnose feeding and swallowing problems?

In order to diagnose a feeding or swallowing program, a clinician at Children’s Hospital Colorado will want to see your child eating. A feeding evaluation may be performed by a speech-language pathologist or occupational therapist with specialty training in feeding difficulties. Your child may also be seen by a larger team of feeding experts which includes a developmental pediatrician, dietician, speech-language pathologist and occupational therapist.

If there are concerns regarding your child’s swallowing, a radiologic or instrumental study may be performed with a radiologist, an ear-nose-and-throat specialist (otolaryngologist), speech-language pathologist, occupational therapist and a dietician to better assess your child’s swallowing mechanism with a variety of age-appropriate food consistencies.

How do clinicians at Children’s Colorado make a diagnosis?

Feeding and swallowing experts will meet with you and your child to take a thorough history and observe your child eating and drinking to make an assessment of the factors contributing to your child’s feeding difficulty. Further observation utilizing radiographic or instrumental tools may also be included to make a diagnosis regarding swallow dysfunction.

How are feeding and swallowing problems treated?

When eating doesn’t come easily for a child, the whole family can be affected. Children's Hospital Colorado’s Feeding and Swallowing Program provides a comprehensive, family-centered approach to assessment and treatment of children with feeding and or swallowing difficulties. Our clinic team includes physicians, nurses, speech-language therapists, occupational therapists and social workers to ensure we can provide all the support your child and family may need.

Program Options
At Children’s Colorado, we offer the following programs for the treatment of feeding and swallowing conditions:

Swallowing Disorders Clinic
The Swallowing Disorders Clinic provides a nutritional, oral motor/oral sensory and radiographic assessment when there is a concern regarding swallowing dysfunction and aspiration.

Pediatric Oral Feeding Clinic
The Pediatric Oral Feeding Clinic provides a medical, nutritional, oral motor/oral sensory and developmental assessment when there is a concern regarding limited oral intake, food refusal, picky eating, poor weight gain and/or difficulty transitioning off of tube or supplemental feedings.

Individual Feeding Assessments
Individual Feeding Assessments are available for children with specific oral motor, oral sensory and/or gross/fine motor difficulties that impact feeding.

Individual Intensive, and Group Feeding Treatment
Treatment is available to assist with a wide variety of feeding challenges. Speech-Language Pathologists and Occupational Therapists work with the family and other professionals from departments such as Nutrition and Gastroenterology for optimal success.

Why choose Children’s Hospital Colorado for your child’s feeding and swallowing problem?

Feeding issues usually involve many different aspects of a child’s health, development, growth, nutrition and overall well-being. Our program’s interdisciplinary approach utilizes experts from a variety of disciplines including developmental pediatricians, physiatrists, pediatric nurse practitioners, occupational therapists, speech-language pathologists and dietitians. The result is a patient-specific treatment program that considers medical status, nutritional status, motor skills, sensory systems, behavioral/emotional components and communication.

Access to and consultation with a wide variety of medical specialists is also a unique component of our program. In this way, we can treat both your child’s feeding or swallowing problem and any underlying developmental, emotional or physical problems that could be causing the issue. Learn more about the Growth and Parenting Clinic, Clinical Nutrition Department and Digestive Health Institute.

If you are interested in our feeding and swallowing treatments, please read through our patient questionnaire, available in English (.pdf) and Spanish (.pdf).

Individual and group feeding treatment is available at Children's Hospital Colorado throughout metro Denver.


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