PFD FAQs
If you have concerns about your child’s feeding, please know that you are not alone. After reading the following FAQs, view our Family Support Resources for more information.
How should medical concerns be addressed with doctors?
If you have concerns about your child’s feeding, try not to wait until the next wellness checkup to bring them up. Make an appointment with your child’s doctor to discuss your concerns as soon as possible.
Consider keeping a food journal of your child’s eating and mealtime behavior to share with your doctor to help them direct you to the appropriate first referral. It may be helpful to share what your child is eating, how much your child ate at that mealtime and how you and they felt before and after mealtimes.
You can also fill out the Infant and Child Feeding Questionnaire® (ICFQ©) and either print it out or email it to your child’s doctor.
How do I find a qualified provider to help my child with PFD?
Finding the right provider for your family and child is important when looking for therapy services. It’s a good idea to interview the providers you are thinking of visiting. Ask questions to help you understand the skills or issues that will be addressed during therapy, your role as a parent and caregiver and the expected outcomes for your child.
Your child’s primary care doctor can help direct you to the necessary specialists for your child’s care.
You can also use our our Feeding Matters Provider Directory to find a qualified provider.
Which medical tests are necessary for my child?
Recommended tests are based on the child’s individual needs. Your child’s medical team will advise you on which tests are necessary.
Which doctors or specialists will my child need to see?
Several different types of specialists receive training in feeding and development. Your child’s primary care doctor can help direct you to the necessary specialists for your child’s care. In addition to your pediatrician, your child’s PFD care team may a combination of some of the following clinicians:
- Registered dietitian (RDN)
- Speech pathologist (SLP)
- Occupational therapist (OT)
- Physical therapist (PT)
- Behavioral therapist (BCBA)
- Psychologist
- Gastroenterologist (GI)
Will a provider trained in PFD be able to work with my family’s cultural preferences and dietary restrictions, such as kosher, vegetarian or gluten-free?
Yes, a provider should look at your family culture and work with you based on what your goals are, keeping in mind your cultural preferences and dietary restrictions.
How long will my child need support for PFD?
The length, cadence and location of treatment depend on your child’s medical needs, feeding challenges and readiness for intervention.
Where does my child access treatment for PFD?
Therapy can occur in a variety of settings and by different delivery models, including the following:
- Home-based
- School-based
- Clinic-based
- Outpatient intensive therapy
- Inpatient intensive therapy
- Teletherapy
Is there someone I can talk to about specific questions?
Yes! Leave a message at 623-242-5234 x306 to speak with a family support coordinator.
You can also get support through our peer mentoring program, Power of Two, or ask your child’s doctor about local support groups.
How do I know if my child is eating enough?
Your child’s primary care doctor will track growth at each wellness checkup. If you are worried about the quantity or type of food your child eats, contact them to discuss your concerns. They may recommend an evaluation with a specialist or you can ask for a referral if you still have concerns.
Mealtimes should be pleasant for both the child and caregiver. Possible signs of PFD include:
- Lack of energy
- Poor weight gain
- Dehydration
- Extreme picky eating
- Difficult behaviors, such as tantrums, during mealtimes
- Parents and caregivers feeling stressed or overwhelmed at mealtimes
Why does my baby fall asleep during feeding?
Sleep may be a sign of satisfaction and relaxation. It may be the baby’s natural way to end feeding. However, some babies may experience stress and discomfort with feeding. They fall asleep to avoid feeding or avoid pain caused by feeding. Moreover, some babies, especially those with medical conditions, do not have enough energy to finish a whole meal. They may fall asleep from fatigue.
If your baby cannot stay awake and enjoy their feedings, speak with your child’s primary care doctor. Mealtimes should be a time that everyone in the family can share and enjoy together.
Should I be worried if my child has a limited diet?
It’s natural to feel anxious if your child only eats a few foods. If your child refuses to try new foods or will only eat certain foods, do not force-feed them. This may end up causing a negative mealtime experience for both you and your child. Seek out the help of your child’s primary care doctor. They may refer you to an RDN, speech-language pathologist, and/or occupational therapist to discuss your child’s needs.
When is the best time and place to feed my child?
This will depend on the feeding schedule that is most realistic and least stressful for your family. Setting meal times that stay the same each day can help create a routine.
Why are consistent mealtimes important?
Consistent mealtimes help your child know what to expect. It also helps regulate their appetite so they are hungry at mealtimes but not overly hungry.
How can I help mealtimes be positive for both my child and me?
Working with a professional can help you understand how to model positive behaviors and keep the experience stress-free for both of you.
I’m told my child’s feeding issues are just behavioral; does this mean my child only needs to see a psychologist?
Not necessarily. Children with PFD benefit from a multidisciplinary team to look at all four domains. When there is a problem in one of these domains, it can affect the others. It is important to have a team of specialists look at the medical, nutrition, feeding skill and psychosocial domains.
How do I know if my child is just a picky eater or has PFD?
Start by taking the the Infant and Child Feeding Questionnaire. You can print it out or email it to your child’s doctor. They may refer you to an RDN, speech-language pathologist, and/or occupational therapist to talk about your child’s needs.
If my child is meeting oral motor milestones but not meeting gross motor milestones, are there any concerns?
Yes, gross motor skills, such as sitting up alone, are a foundation for fine motor skills, such as feeding oneself, chewing, and swallowing. Without good gross motor skills, sitting, breathing, and swallowing can be challenging.
My child does not chew food; it is swallowed whole. Is this a concern?
Yes, chewing skills prevent choking and help children safely eat foods with different textures. It is best to avoid foods that require chewing until the child has the needed skills. Work with a feeding therapist or talk to your child’s primary care doctor if your child is having trouble chewing.
My one-year-old is picky and refuses new foods. Is this a concern?
No, not at this time. Picky eating and refusing to eat some foods is common in young children as they try new foods and learn how to eat different kinds of foods. Slowly introduce new foods, offer new foods several times and give your child time to explore new foods at their own pace. If introducing new foods creates significant stress at mealtimes, speak with your child’s primary care doctor.
Will my child need a feeding tube?
Making the decision to get a feeding tube can be difficult and scary. However, this may be the best choice for some children and families because it will ensure a child’s growth and development. Don’t be afraid to talk to your child’s medical team about your options and concerns. Placing a feeding tube is always a team decision and should not be made without your input and agreement.
A feeding tube may be a short-term solution to helping your child receive the nutrition they need, or it may be a lifelong support. In any case, it’s important to talk about any concerns you have regarding a feeding tube with your child’s team. In addition, do continue to work on feeding therapy.
Learn more about feeding tubes in this blog.
Do I have to feed my child formula through the feeding tube?
No, formula is not the only option for tube feeding. Based on the type of feeding tube and your child’s nutritional needs and/or allergies, there are many options. For example, you could make homemade food in a blender or use a commercial product made from whole foods. Many of these products are covered by insurance. Discuss your options with your child’s GI Doctor and/or dietitian.
How do I know if it’s time to wean my child from a feeding tube?
You should only wean your child from the feeding tube when they are medically ready, not because of fears about the feeding tube. Click here for more information on weaning.
How do I approach my insurance to request reimbursements or make an appeal?
The ICD-10 code that made PFD an official diagnosis meant getting the green light from insurance is significantly more straightforward today. However, many families still face insurance denials.
Click here to read one experienced mom’s tips for overturning insurance denials, as well as a script to use for it. Access a sample appeal letter template for PFD here.
Is there financial assistance available for families of children with PFD?
Feeding Matters awards Financial Assistance grants each fall to parents or legal guardians of a child under 18 years of age with pediatric feeding disorder (PFD) or feeding difficulties who can demonstrate financial need. Make sure you are signed up for our newsletter for information on the program launch and deadlines each fall!
Do you have resources in other languages?
We currently offer material in Spanish. Click here to learn more.
Do you have ASHA-AOTA Accredited Courses, CEUs, Feeding Evaluation and Assessment Courses, Grant Opportunities and recommendations?
Yes! Our annual International Pediatric Feeding Disorder Conference offers groundbreaking access to the latest developments and research in the evaluation and treatment of pediatric feeding disorder. Click here to learn more.
Join our PFD Alliance to stay current on PFD developments and learning opportunities.
How can I volunteer?
There are many ways to get involved with Feeding Matters. The generosity of our volunteer lay leaders and clinical leaders contributes to more positive outcomes for children with PFD. Whether you’re looking to join an event, volunteer your time, or donate funds, click here to learn how to get involved.
We always welcome new volunteers to our peer-to-peer mentoring program, Power of Two.
Can I donate formula or feeding supplies?
The Oley Foundation has an enteral donation program. Click here to learn more.