Whether you’re at a family reunion, Thanksgiving or a life cycle event, so many gatherings center around food. For families with a child who has pediatric feeding disorder (PFD), these moments of celebration instead become overwhelming.

As a young speech and language pathologist, I was struck by the fact that some children can’t fully participate in food-centered occasions. In my large Italian family, all our celebrations and most memorable moments revolve around food. Food is my family’s way of expressing love and bonding.

This awareness led me to focus on feeding therapy and research in order to help more children participate in their families’ rich cultural traditions around food.

In the decades since, I’ve learned that our job as feeding therapists is to support skill-based feeding within the context of each family’s culture and goals. This requires deep listening and understanding a family’s story before setting goals and recommending step-by-step skills to achieve them.

This is especially true for parents of children with complicated diagnoses of PFD.

Supporting appropriate feeding milestones for children with PFD

As a parent of a child with PFD, finding the right goals for your child’s feeding development can help you support their growth while staying realistic about your family’s needs.

Typically, feeding milestones are broken down by age ranges. Still, this remains a little fuzzy.

Guidelines from the American Academy of Pediatrics (AAP) recommend children begin transitioning from exclusive breast milk or formula to solid foods at 6 months and eat a variety of table foods by the time they turn one. More research is needed to fully understand how most children transition to solids and why some children struggle with food transitions.

These guidelines from the AAP and age-based goals, in general, often don’t apply to many children with PFD.

Instead, a feeding therapist can help you set meaningful, achievable feeding goals supporting your child’s growth and development while aligning with your family’s values.

The following are five recommendations for setting age-appropriate feeding goals for children with PFD.

1. Focus on what matters to your family

One of the most important steps in setting feeding goals for your child is understanding what matters most to your family. Some families might focus on having family meals together at the table, while others may prioritize ensuring their child eats a particular food.

Communicate with your feeding therapist about what’s important for you and your child so they can tailor feeding goals to your child.

2. Set realistic, skill-based goals

Many parents of children with PFD experience anxiety when their child isn’t reaching milestones at the “right” time. While developmental guidelines exist, it’s important to remember that all children grow and develop at their own pace. This pace may be slower or look different for children with pediatric feeding disorder (PFD), and that’s okay.

Instead of focusing solely on developmental steps, consider setting realistic goals for your child’s abilities. Assuming your child is getting the nutrition they need to grow, take time to celebrate small steps like holding a spoon, touching a food with a new texture or showing curiosity about a new food.

3. Stay flexible

Setting developmentally appropriate and family-centered feeding goals means staying flexible. The best time to begin a time-consuming feeding therapy plan might not be when a parent or family has a lot going on.

The key is to balance your feeding therapist’s expertise with what’s realistic for your family. When you meet with your child’s feeding therapist or doctor, bring up what matters most to you. Don’t be afraid to say you feel overwhelmed or need help with certain aspects of your daily routine. Goals should reflect both what your child needs developmentally and what’s most important for your family.

4. Look for “just right” feeding challenges

Fostering new feeding skills means finding foods that are just the right difficulty level for your child. In one study, we found that children need to be offered foods that strike the right balance of safe, age-appropriate foods that are just challenging enough to help children develop feeding skills.

For example, children who eat easily dissolvable foods, such as graham crackers and puffs, need to exert little effort to chew and swallow these foods, while the hard texture of other foods require more chewing. In the study, it wasn’t until the children were given foods with a slightly challenging texture that we actually started to see some more mature skills.

With the help of a feeding therapist, find slightly more challenging foods that encourage your child to advance while still being safe.

5. Trust your instincts

As parents, it’s natural to worry about your child’s progress. But remember, you are the expert on your child. Trust your instincts when making decisions that feel right for your family with your feeding therapist. Your feeding goals should reflect your family’s circumstances, and there’s no “one size fits all” approach.

If you ever feel like feeding therapy is becoming too much or doesn’t align with your family’s priorities, it’s okay to speak up. Your healthcare provider should be willing to adjust the plan and focus on what matters most to you.

Remember, anything you can do to reduce that stress for yourself as a parent also goes a long way toward supporting your child and yourself.

Your child’s feeding development is just one part of the bigger picture. By setting meaningful feeding goals for your family, collaborating with your provider, and trusting your instincts, you can create a feeding plan that supports both your child and your family’s overall well-being.

Meg Simione, PhD, CCC-SLP, a research scientist at Mass General for Children, speech-language pathologist, and an assistant professor of pediatrics at Harvard Medical School.

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