Young children exhibit feeding disorders when they are unable or refuse to maintain an adequate oral intake of food. In most cases, feeding disorders have no single cause but arise from a combination of medical/physiological, developmental, behavioral, and psychosocial components.

Children may develop a repertoire of negative and aversive behaviors to avoid what they perceive as the unpleasant experience of eating. These behavioral aversions often persist well after an initial (underlying) medical cause has been treated. Furthermore, parents of children with feeding disorders may respond to their child’s negative behaviors and food refusal in a manner that unwittingly maintains, or even fuels, the negative behaviors and inadequate food intake.

Sources estimate that as many as 25% of children experience some type of feeding difficulties during infancy or early childhood. The incidence can be as high as 33% for children with developmental disabilities.

Children who do develop feeding disorders are at risk for weight loss, malnutrition, lethargy, impaired intellectual and social-emotional development, and growth retardation. In the most severe cases, children cease oral eating altogether, necessitating nasogastric or gastrostomy tube placement and feedings.

The Feeding Disorders Program team involves the following disciplines:

• Medicine
• Psychology
• Occupational
• Therapy
• Nursing
• Nutrition
• Speech/language therapy

Assessment
To provide the most cost-effective method of service delivery, a team assessment is ideal. Our assessment team considers the major issues interfering with oral feeding along with the most pertinent needs, resources, and limitations of the child and the family.

Treatment
The Cleveland Clinic Children’s Hospital for Rehabilitation delivers treatment for feeding disorders along a continuum of care, where patients can access varying intensities of treatment depending on their needs. At its maximum intensity, our Feeding Disorders Program provides treatment through the Robert O. Walton Day Hospital. In this option, initial treatment typically begins by separating the family from the feeding setting. The Feeding Disorders team initiates a prescribed feeding treatment plan. Then gradually and systematically as part of the plan, the team reintroduces the family to the feeding situation. For less severe feeding problems, the Feeding Disorders team may recommend treatment through individual outpatient therapy services and treatment sessions.

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