When it comes to feeding and nutrition, parents often find themselves with countless questions about their child's eating habits, developmental milestones, and mealtime challenges. As a parent, you want to ensure your little one is getting the best nutrition possible while creating positive experiences around food. To help address the most common concerns we hear from Australian families, we've compiled this comprehensive guide featuring insights from paediatric feeding therapists.
Understanding Paediatric Feeding Therapy
What is paediatric feeding therapy and who provides it?
Paediatric feeding therapy is a specialised intervention that helps children who experience difficulties with eating, drinking, or swallowing. This therapy is provided by trained professionals, primarily speech-language pathologists (SLPs) and occupational therapists (OTs), who have additional training in feeding and swallowing disorders.
Speech pathologists focus on the oral motor skills needed for safe swallowing, whilst occupational therapists often address sensory processing issues that can affect a child's relationship with food. Both professionals work together to create a comprehensive approach to feeding challenges.
Common Feeding Concerns from Birth to Toddlerhood
Q: When should I start introducing solid foods to my baby?
Most paediatric feeding therapists recommend beginning solid foods around 6 months of age, when your baby shows signs of readiness. These signs include:
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Good head and neck control and ability to sit upright with support
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Showing interest in food by reaching for what you're eating
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Opening their mouth when food is offered on a spoon
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Loss of the tongue-thrust reflex (no longer pushing food out with their tongue)
Starting before 4 months isn't recommended as babies' digestive systems are still developing. If your baby is approaching 7 months and hasn't started solids, it's worth consulting with your child health nurse or GP for guidance.
Q: I'm considering baby-led weaning (BLW). Is it safe for my baby?
Baby-led weaning can be a safe approach when done correctly. BLW involves offering your baby finger foods from around 6 months, allowing them to self-feed rather than being spoon-fed purees. Research shows that when proper food preparation and supervision are in place, BLW doesn't increase choking risk compared to traditional weaning methods.
Key safety considerations include:
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Ensuring foods are soft enough to squash between your fingers
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Offering foods in appropriate sizes (finger-length strips for babies to grasp)
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Avoiding small, round, or hard foods that pose choking hazards
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Always supervising mealtimes
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Ensuring your baby is sitting upright during feeding
Q: What should I do if my baby is refusing to eat?
Food refusal is incredibly common and can be frustrating. Here are some strategies that feeding therapists recommend:
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Offer food when your baby is calm, not overly hungry or tired
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Create a calm, distraction-free environment during meals
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Try offering foods at different temperatures or in different presentations
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Don't force feed - this can create negative associations with food
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Continue offering refused foods repeatedly; it can take multiple exposures before acceptance
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Consider consulting a feeding therapist if refusal is persistent and affecting growth
Addressing Feeding Challenges in Toddlers
Q: My toddler is an extremely picky eater. Should I be concerned?
Picky eating is very common in toddlers and often reflects their growing desire for independence. Most children go through phases of food preferences and aversions. However, you should consider seeking professional help if your child:
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Eats fewer than 20 different foods
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Has lost foods from their diet due to "burn out"
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Refuses entire food groups or textures
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Shows extreme distress when non-preferred foods are presented
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Is experiencing poor weight gain or growth concerns
Q: How can I tell if my child's eating difficulties are sensory-related?
Sensory-based feeding difficulties occur when a child has difficulty accepting foods due to their texture, taste, smell, or appearance. Signs may include:
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Extreme reactions to certain food textures
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Gagging or vomiting when certain foods are presented
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Only eating foods of specific colours or brands
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Difficulty transitioning between textures (e.g., from purees to solids)
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Showing distress when messy during eating
Children with sensory processing difficulties often benefit from feeding therapy that gradually introduces new textures and flavours in a supportive environment.
Introducing Allergenic Foods
Q: When and how should I introduce common allergens like eggs and peanuts?
Current Australian guidelines recommend introducing allergenic foods around 6 months of age, but not before 4 months. Common allergens include:
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Eggs (well-cooked)
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Peanuts (as smooth peanut butter or paste)
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Tree nuts (ground or as pastes)
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Cow's milk (in cooking)
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Soy
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Wheat
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Fish and shellfish
Introduce these foods one at a time, waiting a few days between each new allergen to monitor for reactions. If your baby has severe eczema or existing food allergies, consult with your paediatrician before introducing allergenic foods.
Q: What are the signs of a food allergic reaction?
Food allergic reactions can range from mild to severe. Watch for:
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Skin reactions (hives, swelling, redness)
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Gastrointestinal symptoms (vomiting, diarrhoea)
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Respiratory symptoms (coughing, wheezing)
Seek immediate medical attention if you notice swelling of the face, lips, or throat, difficulty breathing, or if your child becomes very unwell after eating.
Mealtime Challenges and Solutions
Q: My child with autism has significant mealtime difficulties. How can feeding therapy help?
Children with autism often experience feeding challenges due to sensory sensitivities, need for routine, and communication difficulties. Feeding therapy can address:
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Sensory sensitivities to food textures, temperatures, and flavours
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Rigid food preferences and resistance to new foods
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Oral motor skills needed for safe eating
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Mealtime behaviours and routines
Therapy approaches often include gradual exposure to new foods, sensory play activities, and creating predictable mealtime routines that reduce anxiety.
Q: What role does the family play in feeding therapy?
Family involvement is crucial for successful feeding therapy. Parents and caregivers are encouraged to:
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Attend therapy sessions to learn techniques and strategies
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Practice recommended activities at home between sessions
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Model positive eating behaviours
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Maintain consistency with therapeutic approaches
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Provide a supportive, pressure-free mealtime environment
Q: How can I make mealtimes less stressful for everyone?
Creating positive mealtime experiences involves:
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Establishing regular meal and snack times
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Eating together as a family when possible
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Minimising distractions (TV, phones, toys)
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Offering small portions to avoid overwhelming your child
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Providing choices within appropriate options
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Focusing on the social aspects of mealtimes rather than just food consumption
When to Seek Professional Help
Q: When should I consult a paediatric feeding therapist?
Consider seeking professional help if your child:
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Shows persistent feeding difficulties affecting growth
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Frequently chokes, coughs, or gags during meals
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Refuses to eat or drink adequate amounts
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Has difficulty transitioning between food textures
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Shows signs of aspiration (food entering the airway)
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Experiences significant mealtime stress or anxiety
Q: What happens during a feeding therapy evaluation?
A feeding therapy evaluation typically includes:
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Review of medical and feeding history
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Assessment of oral motor skills and swallowing function
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Observation of your child eating different foods and textures
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Discussion of current feeding practices and challenges
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Development of individualised therapy goals and strategies
The evaluation helps determine the underlying causes of feeding difficulties and develops a targeted treatment plan.
Special Considerations
Q: My child has a feeding tube. Can they still learn to eat orally?
Many children with feeding tubes can successfully transition to oral feeding with appropriate support. Tube weaning programs involve:
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Ensuring medical stability before beginning
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Gradual reduction of tube feeds while encouraging oral intake
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Addressing any oral aversions or feeding behaviours
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Supporting the development of hunger and satiety cues
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Close monitoring by an interdisciplinary team
The success of tube weaning depends on various factors including the child's age, underlying medical conditions, and feeding readiness.
Q: What is failure to thrive and how is it related to feeding?
Failure to thrive (now often called growth faltering) occurs when a child's growth is significantly slower than expected. This can result from:
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Inadequate caloric intake
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Feeding difficulties or food aversions
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Medical conditions affecting nutrient absorption
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Increased caloric needs due to medical conditions
Treatment typically involves nutritional support, addressing underlying feeding issues, and close monitoring by healthcare professionals.
Building Long-term Success
Q: How can I help my child develop a healthy relationship with food?
Promoting a positive relationship with food involves:
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Following your child's hunger and fullness cues
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Offering a variety of foods without pressure
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Making mealtimes enjoyable and social
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Involving children in food preparation when appropriate
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Avoiding using food as rewards or punishments
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Being patient with food exploration and acceptance
Q: What are some strategies for introducing new foods?
Successful food introduction strategies include:
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Offering new foods alongside familiar favourites
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Providing multiple exposures without pressure
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Allowing children to explore food through play
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Starting with small amounts
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Considering different preparations of the same food
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Maintaining a positive attitude about new foods
Supporting Your Child's Feeding Journey
Remember that every child's feeding journey is unique. Some children may need additional support to develop healthy eating habits, and that's perfectly normal. The key is to remain patient, seek professional guidance when needed, and focus on creating positive experiences around food and mealtimes.
If you're concerned about your child's feeding development, don't hesitate to reach out to healthcare professionals. Early intervention can make a significant difference in addressing feeding challenges and supporting your child's overall growth and development.
At Joyfull Mealtimes, we're committed to supporting Australian families through their feeding journey. Our range of feeding tools and resources are designed to make mealtimes more joyful and successful for both children and parents.
Creating positive mealtime experiences takes time, patience, and sometimes professional support. By understanding your child's individual needs and working with qualified professionals when necessary, you can help your child develop a healthy, positive relationship with food that will benefit them throughout their life.