Transitional Foods for Pediatric Feeding Disorders: Updates on Behavior, Risks, and Benefits

April 29, 2021 2:30 pm

Transitional foods is a category found alongside the International Dysphagia Diet Standardization (IDDSI) pyramid and are defined as solid foods that rapidly change texture in the presence of moisture or temperature change. The limited literature supporting, or suggesting, the clinical use of this texture has been primarily focused on children’s development of mastication abilities with benefits of use shown with individuals with less mature or underdeveloped sensorimotor systems for mastication. However recently attention has been drawn to the variability in dissolvability and stiffness of transitional foods leading to a potential mismatch between the status of a young child’s oral anatomic and motor system and the functional demands of the food itself. Yet, while little is known about oral processing and swallowing across different classes of solids, even less is known about transitional foods. “First finger foods” which are frequently marketed to parents of toddlers, offer claims of safety due to them rapidly melting in the mouth and they are often presented to the public as a transitional food. However, when a variety of these products were tested, significant variability was found, with only a small proportion meeting all the safety criteria specified by the American Academy of Pediatrics. Ultimately, transitional foods have great potential to play an increased role in our therapeutic approaches to dysphagia management and also has been used in other applications such as tube feed weaning, and with picky eaters. The value of transitional foods is twofold: early development of the masticatory system which can have direct impacts on memory and cognition, and psychosocial impacts with access to foods for children with special needs that are desirable by all children. However, much remains unknown about the properties of these foods and the degree of variability that may exist between different marketed products, particularly under different oral environments which might be age and condition dependent. This presentation will define and categorize types of transitional foods. The potential benefits of improved choices, increased textures and ultimately improved dining enjoyment will be discussed. The IDDSI testing method for transitional foods will be discussed and the variation in results obtained with this test will be shown between known transitional foods. The purpose of this presentation is to expose the audience to a deeper understanding of this growing field of interest and provide them with the tools necessary to properly evaluate their patient’s potential risks and benefits of use of transitional foods.

Learning Objectives:

By the end of this session, attendees will be able to:

  • Define transitional foods and the role they play in PFD
  • Compare and contrast the differences between transitional food behaviors in the oral environment and on bench top, utilizing IDDSI testing criteria
  • Define and describe transitional foods and the relevance of the oral environment to this food category


  • Reva Barewal, DDS, MS

    Dr. Reva Barewal, is a practicing prosthodontist with 20 years of experience working in private practice with adults and children requiring oral reconstruction. Reva is a clinical assistant professor in the department of pulmonology and critical care at Oregon Health and Science University and plays a role as a dental specialist training medical fellows in sleep medicine. She serves as a member of the U.S. and Territories IDDSI expert reference group.

    As an international speaker, lead research investigator in clinical trials related to transitional foods, and oral reconstruction, as well as her background as a French culinary chef, she brings a unique perspective to the eating challenges found across the lifespan from PFD to adults with dysphagia and/or chewing related issues.

    Hearing personal stories of frustration and disappointment with food choices for people with dysphagia, she founded Taste For Life, a company that makes food products specifically geared to solve the nutritional and emotional needs to optimize dining health for people with dysphagia.

    Financial Disclosures: Receives intellectual property rights for Taste of Life and 100% Ownership Interest

    Non-financial Disclosures: Volunteers with IDDSI as a member of a task force in the US and territories

    Read more Show less