Some babies have trouble eating and drinking at first. They may spit up, avoid new foods or refuse to eat certain foods. They may have trouble holding food and liquid in their mouth. These issues are usually normal and temporary.

A child with a feeding problem or disorder will keep having trouble. Twenty-five percent of all children will experience feeding difficulties during infancy and early childhood that can affect their overall health and development.

When a baby doesn’t like solids, it’s easy to assume they are a “picky eater.” But poor feeding is different from picky eating, which doesn’t usually start until your baby becomes a toddler. A baby may have a feeding problem when they can’t eat or drink enough of the right things to stay healthy.

Feeding problems may include difficulty swallowing, called dysphagia. This is the inability of food or liquid to pass easily from the mouth to the throat, through the esophagus and into the stomach. Dysphagia can result in aspiration, which may cause pneumonia and/or other serious lung conditions.

How do you know if your baby has a feeding problem or disorder? Some common red flags include:

• Refuses to eat and drink
• Isn’t gaining weight or growing as expected
• Arches back or stiffens when feeding
• Cries or fusses when feeding
• Regularly takes a long time to eat (more than 30 minutes)
• Falls asleep or isn’t alert when feeding
• Avoids foods with certain textures
• Drools a lot, coughs or gags when feeding
• Has problems chewing and swallowing
• Has trouble breathing while eating and drinking
• Frequently spits up or vomits
• Has a hoarse or raspy voice during or after feeding

Feeding difficulties in babies may happen because of breastfeeding challenges. Lactation consultants can teach you how to feed your baby and help with latching difficulties, painful nursing, low milk production and other issues.

Poor feeding may also be caused by temporary illnesses, including ear infections and colds. These can make feeding uncomfortable for babies and will normally stop when the illness is treated. Other factors that may affect a baby’s ability to feed are stress, pain from teething and medication side effects.

Babies with certain health problems or conditions may also have feeding difficulties. Some possible causes for infant feeding and swallowing problems include:

• Prematurity, low birth weight
• Certain traumatic birth injuries (cerebral palsy)
• Structural abnormalities (cleft lip, cleft palate)
• Reflux or other stomach problems
• Lung or respiratory problems (asthma)
• Heart disease
• Nervous system or muscle problems (muscular dystrophy)
• Developmental delays or disabilities (autism)

If left untreated, feeding problems can negatively affect your baby’s health. Malnutrition is a top concern. Babies need to feed and digest the necessary nutrients to develop and grow properly. If they don’t get the necessary nutrition, it can lead to a condition known as failure to thrive.

Feeding issues can also put infants at risk for dehydration, aspiration, pneumonia or other lung infections, and delayed physical and mental development which can lead to speech, cognitive and behavioral problems.

The earlier the problem is addressed, the better the long-term outcome. Treatment for feeding disorders varies based on what’s causing the issue and the symptoms involved. A team approach, including the child’s doctor, dietitians and speech-language pathologists, is often the best way to treat these issues.

For instance, babies and children with dysphagia are often able to swallow thick fluids and soft foods better than thin liquids. A speech-language pathologist can suggest techniques for feeding that may help improve swallowing problems.

Treatment may also include medicines for reflux, trying different foods or textures, changing the temperature of food, changing the feeding schedule (e.g., smaller, more frequent meals), changing your child’s position while eating, and/or switching feeding methods. In severe cases, your child may need to get nutrition in other ways, such as through a feeding tube.

If you think your baby is having trouble with feeding, let your child’s doctor know right away. While feeding problems are usually minor, your doctor will want to rule out an underlying medical issue.

Some warning signs of feeding problems include wetting fewer than four diapers per day, infrequent or hard stools in the first month, your baby becomes more yellow instead of less during the first week.

If your baby shows any signs of emergency, such as a fever over 100 degrees, wheezing, bloody vomit or stool, or constant crying, get immediate medical attention. Signs of an allergy or digestive disturbance include vomiting after feeding, frequent loose or watery stools, blood in the stools or a severe skin rash.

The Edward-Elmhurst Health Pediatric Feeding Clinic takes a comprehensive approach to the full spectrum of feeding disorders in children of all ages and concentrates on feeding, nutrition and growth. Our multidisciplinary team includes a pediatric dietitian, pediatric speech-language pathologist, pediatric gastroenterologist and a pediatric nurse. For questions, please call 630-527-5409.

Explore children’s services at Edward-Elmhurst Health.

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