Pediatric Feeding Disorders
Pediatric feeding disorder (PFD) is impaired oral intake that is not age-appropriate and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction (Goday, 2019) The incidence of children of children with problematic feeding is on the rise. It is estimated that 2.3 million children five years old and younger in the United States (Manikam, 1996) are affected by PFD.
If you are in questioning if your child has PFD then take the short quiz on this document.
Primary care for these children generally includes Physician(s), Occupational and/or Speech Therapist, Nutrition/dietitian, and in some cases, Behavior support. The physicians monitor health status, medications, Western medical tests, labs, and possible surgery if a g-tube or other procedures are needed. Occupational therapists may work on seating, positioning, sensory processing, oral motor skills and adaptive equipment for feeding, as well as developmental skills in other areas. Speech therapy will work on oral motor skills, monitoring swallow, provide support for thickeners or food texture, and cognition and communication in general. Nutritionist/dietitian will provide diet education and support, (especially if special diets like Ketogenic, Atkins, allergen-free, etc are an issue), monitor the child’s weight, schedule oral and non-oral feedings as appropriate. Behavior intervention can be helpful in managing the psycho-social dynamics in the family related to eating. However, none of these professionals consistently look at the musculature involved with eating. This is where myfeedingcoach is different. We work on the model: the structure determines the function.
Using our approach we see improvement in:
- Reflux symptoms
- Limited movement or Range of Motion
- Dyspraxia, or impaired coordination
- Plagiocephaly, or of asymmetry of the skull
- Cervical (Neck) extension or torticollis
- Gains in all Developmental areas
Often babies with PFD, have “no neck”, especially if they had a difficult birth. Dysfunction anywhere in the cervical region affects the function in the other structures, including swallowing. Treating the baby’s neck for trauma can go a very long way to improving her feeding. Just as in adults, severe pain interferes with a baby's ability to concentrate and learn new things.
Wait a second, my kid has a serious problem, you are going to fix it with massage???
I have been interested in body work my whole career. I was fortunate to travel internationally extensively as a young adult. I always visited health clinics, special needs schools and traditional medicine practitioners on my travels. I was fascinated with the fact that all traditional cultures have versions of baby/child massage as medical treatment–they didn’t have much else to work with. But what was more interesting was the results! I met Westerns who migrated from their home country specifically to get traditional treatments, most of the time these treatments were based on massage or some body work. I met one woman that moved to Indonesian so her daughter with Downs Syndrome could be massaged everyday. WOW! The results were fantastic. The daughter had great muscle tone, her motor skills and language skills were the best I had ever seen in my pediatric practice in the USA.
I trained as a baby massage instructor and over the years did extensive training in massage and other hands-on therapies. I am now a teaching assistant for the Upledger Institute. Finally I trained as an Acupuncturist. Being an acupuncturist is a bit of a misnomer, because the medicine developed centuries before metal was extracted from the earth to make needles and needles are only a small part of a huge body of knowledge. It started as a massage techniques. Especially for children, it is still based on massage.
As I employed these skills in my work, I noticed that focusing on bodywork, I would get significantly better outcomes in all developmental areas for my clients with delayed milestones. These principles became the basis of my practice in general, but also for feeding issues specifically.
Most of my clients have had a LOT of treatment prior to starting with me. Consistently I see them improving with safe, easy to implement massage techniques.
Not using massage in therapy for children is an oversight in the healthcare system in my observation.
Bass, N.H. and Morrell, R.M. The neurology of swallowing. In: M.E. Groher (Ed.), Dysphagia, Diagnosis and Management. Butterworth–Heinemann, Boston, MA, 1992, pp. 1–29.
Callison, Matt. Motor Point Index: An acupuncturists guide to locating and treating motor points. AcuSport Seminars. 2007; 12-27 Fan Ya-li.
Chinese Pediatric Massage Therapy: A parent’s and practitioners guide to the treatment and prevention of childhood disease. Blue Poppy Press. 1994; 141-143.
Goday PS, Huh SY, Silverman A, Lukens CT, Dodrill P, Cohen SS, Delaney AL, Feuling MB, Noel RJ, Gisel E, Kenzer A, Kessler DB, de Camargo OK, Browne J, Phalen JA. Pediatric feeding disorder: consensus definition and conceptual framework. JPGN 2019;68(1):124-129.
Manikam R, Perman JA. Pediatric feeding disorders. J Clin Gastroenterol. 2000;30(1):34- 46.
Reau NR, Senturia YD, Lebailly SA, Christoffel KK. Infant and toddler feeding patterns and problems: normative data and a new direction. Pediatric Practice Research Group. J Dev Behav Pediatr. 1996;17(3):149-153.
Reau NR, Senturia YD, Lebailly SA, Christoffel KK. Infant and toddler feeding patterns and problems: normative data and a new direction. Pediatric Practice Research Group. J Dev Behav Pediatr. 1996;17(3):149-153. Nov 3, 2019 07:31am ·