Specialized Pediatric Occupational Therapy, LLC
Ellen M. Venturella-Wilson, MS, OTR/L 314-368-0372
Does my infant or child need a Feeding Evaluation for Dysphagia?

Knowing when to have a Feeding Evaluation for your infant or child is very important.
The most common symptoms of a pediatric feeding and swallowing disorder (pediatric dysphagia) may include, but are not be limited to:

  • Failure to thrive.
  • Failure to consume adequate nutrition to meet the required caloric intake to promote growth.  Commonly, children who experience reflux often fall into this category.
  • Difficulty coordinating sucking and swallowing during breast or bottle feeding.
  • Breathing interruptions or stoppage during feedings.
  • Prolonged feedings (longer than 30 minutes).
  • Increased oral loss during breast or bottle feeding.
  • Episodes of gagging, coughing, or choking during mealtimes.
  • Upper airway congestion.
  • History of recurring pneumonia.
  • Noisy or "wet" respirations' "gurgly/wet" vocal quality before and after swallowing.
  • Presence of food nasally during or following the swallow.
  • Previous diagnosis of penetration and/or aspiration.
  • Change in feeding patterns or new problem with feeding.
  • Significant drooling or oral weakness.
  • Difficulty transitioning from breastfeeding to bottle/cup feeding.
  • Difficulty transitioning from baby food consistencies (i.e. stage I, II, table foods).
  • Difficulty transitioning from NG/G-tube to oral feedings.
  • Refusing to eat food with texture (lumpy, chunky, crunchy) except purees.
  • Unexplained food refusal.
  • Irritability during feeding or meal times.
  • Sleepiness during feedings.
  • Failure to gain weight over 2-3 months.
  • Maladaptive or disruptive behaviors at mealtime (temper tantrums, crying, food refusal, food throwing, etc.).
  • Diagnosis of a disorder associated with feeding and swallowing difficulties.
  • Does not achieve feeding milestones:
    • Not spoon feeding by 9 months.
    • Not finger feeding soft dissolvable foods by 12 months.
    • Not chewing table foods by 18 months.
    • Not cup drinking by 24 months.


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