Signs it’s Time for a Feeding Evaluation
If your little one is having some difficulty with feeding, and you’re not sure if you should contact a feeding specialist for help, answering these questions should guide you! [Side note: It is always recommended to contact a specialist and ask questions if you’re concerned, since there is no harm in doing that!]
While each child is different, and these are GENERAL questions to help you, if you answer yes* to these questions, I recommend taking that next step and reaching out to a local feeding therapist.
*Answering yes to these questions does not necessarily mean that your child has a feeding disorder or underlying oral motor difficulty, as this is just a checklist to help you decipher where to go next! Further evaluation will be needed to determine the presence of oral motor difficulty.0-4 Months:
Does your baby have difficulty latching onto the breast?
Does your baby make gulping or clicking sounds on the breast or bottle?
Does your baby lose milk out of their mouth while breastfeeding or bottle feeding?
Does your baby have reflux that is not explained by allergies or other GI difficulties?
Does your baby drool consistently (e.g., wetting a bib or their shirt?)
Does your baby have noisy breathing or open mouth breathing at rest?
4-8 Months:
Does your little one dislike teethers?
Does your little one not enjoy solids or present with persistent gagging after multiple presentation of foods?
Has your little one had trouble learning how to close their lips on the spoon after several weeks of trying solids?
After several weeks of introducing the straw, has your little one not yet grasped how to suck from it?
Does your little one seem to need the pacifier to soothe when awake during the day (e.g., not just at night/naptime?) AND they present with open mouth posture at rest/while asleep?
Does your little one drool consistently (e.g., wetting a bib or their shirt?)
Does your little one have noisy breathing or open mouth breathing at rest?
8-12 Months:
Does your little one only accept lower textured foods (e.g., purees, mashed solids, dissolvable solids)?
Does your little one gag on higher textured foods that require more chewing (e.g., breads, noodles, veggies and fruits)?
Does your little one seem to use their tongue to mash foods instead of chewing them?
Does your little one refuse several foods or present with a limited diet of tastes/textures?
Does your little one seem to need the pacifier to soothe when awake during the day (e.g., not just at night/naptime?)
Does your little one drool consistently (e.g., wetting a bib or their shirt?)
Does your little one have noisy breathing or open mouth breathing at rest?
12-18 months:
Is your little one having trouble weaning from the bottle to a straw?
Is your little one having trouble managing harder textured table foods or mixed textured foods (e.g., lasagna, sandwich, meats)?
Is your little one gagging on any foods?
Does your little one continue to use the pacifier during the day or at night/naptime?
Does your little one drool consistently (e.g., wetting a bib or their shirt?)
Does your little one have noisy breathing or open mouth breathing at rest?
18-24 months:
Is your little one gagging on any foods?
Is your little one have any difficulty drinking from a straw or open cup?
Does your little one dislike a category of foods (e.g., wet and slippery foods, harder density solids)? (See Texture Hierarchy blog for more)
Does your little one continue to use the pacifier during the day or at night/naptime?
Does your little one drool consistently (e.g., wetting a bib or their shirt?)
Does your little one have noisy breathing or open mouth breathing at rest?
Between 24-36 months, it is expected that children develop a mature, adult-like chewing pattern and they should be able to manage foods similarly to an adult. If you notice that your child is approaching 3 years of age, and continues to eat softer, or easier-to-chew foods, and refuse harder textures or certain textures, it’s a good idea to contact a feeding therapist.
You will notice that drooling and open mouth breathing are listed under each age. That is because open mouth breathing and drooling are indicators of underlying oral motor weakness and should not be dismissed. If the tongue is not sitting up under the hard palate at rest, and a child is not breathing through their nose with their mouth closed, there is a reason for that! An evaluation is recommended to determine why those two patterns are happening.
A feeding evaluation can tell you A LOT about what is going on inside your child’s mouth. A feeding specialist (OT, SLP, IBCLC) assesses jaw strength, oral sensitivity, and management of foods and liquid. Trained professionals also evaluate for potential tongue tie/lip tie, which could be impacting your child’s feeding skills (as well as their speech production skills). An evaluation allows us to examine any weaknesses and provide you with what to do at home to help your little one! Feeding therapy can be very successful, especially if started early.
All in all, if you are concerned, it’s never a bad idea to reach out and ask questions! By asking questions, you’re doing what’s best for your little one!
If you reach out to a specialist, but the wait to get evaluated is long, or you’re looking for things you can do at home right away, book a consultation on our website. We are here to help!
