The act of eating is a complex task that involves the entire body and its organs working as one seamless unit. It takes 13 paired muscles (26 total) and six cranial nerves1 working in perfect harmony to move food and liquid through the body. This process takes only seconds but is the single most complex and physically demanding task an infant will complete for the first few weeks, and even months, of life.
Who Can Help Assess And Treat
Primary care physicians are commonly responsible for identifying PFD and often need to facilitate referrals to other specialists. Pediatric feeding disorder is complex and typically requires several subspecialists working together.
Below is a list of some medical specialists who collaborate to deliver care for PFD. To find a professional in your area, visit Feeding Matters’ Provider Directory.
Allergists/Immunologists — Food allergies and intolerances may cause pain or discomfort throughout the gastrointestinal tract. This may lead to a refusal to eat, difficulty with digestion, irregular bowel movements, or frequent vomiting. Respiratory allergies may further complicate the feeding process, making it harder to coordinate feeding and breathing (see Pulmonologist below). Learn More
Cardiologists — Children who have cardiac conditions are often fatigued by daily activities, especially eating. These children may not have enough energy during mealtimes or throughout the day to be able to eat enough calories to sustain proper nutrition. Some cardiac conditions may have associations with genetic disorders that are associated with challenges related to feeding. Caregivers may see children with cardiac conditions as “fussy” and hard to feed, thus leading to feeding challenges. This is crucial because weight gain may be very important in determining readiness for surgical procedures. Learn More
Dentists — Children who struggle to eat are often sensitive in and defensive about their mouth, which can make toothbrushing and oral care very challenging. In addition, minimal chewing may delay the loosening of baby teeth. Bottle-feeding at night (often resorted to by parents concerned with limited amounts of daytime feeding) can cause cavities in teeth, which cause pain and further limit food intake. Learn More
Endocrinologists — Hormones help control a child’s metabolism, nutrition, growth, and energy. A child can experience feeding and nutritional issues associated with these conditions because of the body’s inability to process certain nutrients. Learn More
Gastroenterologists — Medical conditions of the digestive system can lead to constipation, irregular bowel movements, or vomiting. Also, they can affect motility or the ability to absorb or digest nutrients properly, which may cause pain or discomfort during or after eating. Gastroenterologists are important components of teams in determining safe and necessary feeding interventions and supports. Learn More
Geneticists — Genetic disorders may be associated with poor feeding or poor growth, which can affect a child’s overall development. In turn, this affects a child’s ability to progress through developmental feeding milestones or efficiently process food for energy. Learn More
Neurologists — Neurodevelopmental and neurological conditions may affect a child’s ability to coordinate a safe and effective swallow or to self-feed. Certain conditions affecting the central nervous system are highly associated with feeding challenges and require specific treatments. Learn More
Otolaryngologists (ENTs) — Problems with adenoids, sinuses, chronic ear infections, or tonsils often affect the swallowing process or even the desire to eat. Stuffiness, wheezing, and nasal regurgitation during or shortly after feeding are common symptoms associated with such conditions. Learn More
Pulmonologists — Medical conditions of the respiratory system can lead to increased fatigue, increased oxygen requirements, poor management of secretions, a decreased ability to coordinate breathing and eating, or a decreased ability to safely swallow and control food and liquids. Respiratory problems and illnesses often increase the body’s need for additional calories as a source of energy. Learn More
Radiologists — A radiologist commonly interprets many of the diagnostic tests and images used to evaluate underlying medical conditions that may be affecting a child’s ability to eat and maintain nutrition. In addition, a radiologist often assists in the placement or ongoing care of feeding tubes. Learn More
What They Do
- Identify when feeding needs further assessment.
- Provide medical evaluations and tests to determine any comorbidities.
- Partner with other professionals to ensure a comprehensive evaluation is conducted.