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 the founder of two specialty dental practices - Fusion Dental Specialists, and NW Prosthetic and Implant dentistry and a leading expert on dining health for the elderly. As an accomplished international speaker, lead research investigator, assistant professor, and published author on dental implants, and sleep apnea, she is considered a key opinion leader for Dentsply Sirona, the world’s largest dental company. She is a founding member of PEERS (implant innovation council), and has received multiple awards for innovative research in implant dentistry. For 5 years she has assisted in the Department of Pulmonology and Critical Care at OHSU, with training of physicians in the value of cross discipline collaboration. Hearing personal stories from her patients of dissatisfaction with food because of side effects of surgery, or chronic illness, led to inquiry and discovery of the inadequacy of solutions for the elderly leading to loss of quality of life. With her passion for solving complex problems, a deeply rooted belief in multi-discipline collaboration and an earlier background in French Culinary Arts, she founded, Taste For Life, LLC in 2014. Working with Oregon State University and University of Oregon, she developed the Savorease product line – a unique solution to improving the dining experience in the senior market. Her focus on flavor profile, nutritional performance and textural enjoyment led to positive results in 3 clinical trials demonstrating Savorease as having a competitive advantage in the market place. With the commercial launch of the product line in December 2019, she is solely focused on driving innovation and company success with disruptive products and services in nutrition and dining enjoyment for people with chewing or swallowing issues. For more information, visit

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

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

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