Understanding Feeding and Swallowing Disorders: Signs and Support

Feeding and swallowing are complex processes that involve moving food and liquid from the mouth to the stomach safely. The American Speech‑Language‑Hearing Association (ASHA) differentiates between feeding disorders, which involve difficulty getting food to the mouth or preparing it to be swallowed, and swallowing disorders (dysphagia), which involve problems moving food from the mouth through the throat and into the stomach. Swallowing has three phases: the oral phase (chewing and moving food to the back of the mouth), the pharyngeal phase (moving food through the throat while protecting the airway) and the oesophageal phase (moving food from the throat into the stomach).

Signs of feeding and swallowing disorders vary depending on a child’s age and the underlying cause. Infants may arch their backs or stiffen during feeding, cough or choke while feeding, show poor weight gain or be fussy and anxious when eating. Older children might take a long time to eat, refuse specific textures, cough or gag during meals, drool excessively or have wet or gurgly voice quality after swallowing. These difficulties can lead to inadequate nutrition, dehydration, respiratory infections and mealtime stress for families.

There are many potential causes of feeding and swallowing difficulties. Premature birth, neurological conditions such as cerebral palsy, cleft palate, heart conditions and developmental delays can all impact oral motor function. Gastroesophageal reflux, allergies and sensory processing issues may also contribute. Anxiety and negative feeding experiences can create behavioural feeding disorders, even when physical skills are intact.

Assessment and treatment should be conducted by a multidisciplinary team. A speech‑language pathologist evaluates the anatomy and function of the mouth and throat, observes how the child chews and swallows and assesses feeding behaviours. Occupational therapists examine posture, positioning and sensory processing. Dietitians ensure nutritional needs are met. Medical professionals address underlying medical conditions.

Treatment may include exercises to strengthen oral muscles, techniques to improve chewing and tongue movements, strategies to protect the airway during swallowing and recommendations for safe food textures and liquid consistencies. Therapists may also suggest mealtime routines, seating adaptations and parent training to make feeding more enjoyable. For some children, feeding tubes or specialised equipment may be necessary while oral skills develop.

If your child shows signs of feeding or swallowing difficulties, consult your GP or paediatrician for referral to a speech‑language pathologist who specialises in feeding. Early identification and intervention reduce the risk of complications and help children develop positive relationships with food.