Understanding Feeding Disorders in Children
A feeding disorder happens when a child struggles with eating, swallowing, or tolerating a variety of foods and liquids in a way that affects their growth, nutrition, or development. While occasional picky eating is normal, persistent difficulties may signal a medical or developmental issue that needs professional attention.
Pediatric dysphagia is the medical term for difficulty swallowing in children. It can involve challenges with chewing, moving food from the mouth to the throat, or safely swallowing without coughing, gagging, or choking.
At BreatheWorks, we help families identify when feeding challenges are just a phase—and when they are a sign of something more serious.
What Causes Feeding Disorders & Dysphagia?
There isn’t one single cause. Feeding issues may be related to:
- Oral motor difficulties (weak jaw, tongue, or lips)
- Orofacial myofunctional disorders (OMDs) such as poor tongue posture or mouth breathing
- Medical conditions (GERD, reflux, neurological disorders, structural differences in the mouth/throat)
- Sensory processing challenges (sensitivity to textures, tastes, or smells)
- Developmental delays or premature birth
- Trauma or surgery (e.g., after a tongue-tie release or airway surgery)
Signs & Symptoms Parents Should Watch
If you’re wondering whether your child’s feeding issues go beyond “picky eating,” here are red flags:
- Frequent gagging, coughing, or choking while eating or drinking
- Difficulty latching, sucking, or coordinating suck-swallow-breathe in infants
- Long mealtimes (taking more than 30 minutes to finish)
- Refusal of entire food groups (not just preferences)
- Trouble chewing age-appropriate textures
- Poor weight gain, growth delays, or frequent respiratory infections
- Excessive drooling or food/liquid escaping from the mouth
- Stressful mealtimes that cause frustration for the child or family
Normal Picky Eating vs Feeding Disorder: How to Tell the Difference
| Normal Picky Eating | Feeding Disorder/Dysphagia |
| Child prefers certain foods but eats from all food groups | Child avoids entire textures/food groups consistently |
| Mealtime lasts 15–30 minutes | Meals consistently last longer than 30 minutes |
| Growth and weight are within normal range | Poor weight gain or slowed growth |
| Occasional gagging on new foods | Frequent coughing, gagging, or choking |
| Parent stress is minimal | Mealtimes are highly stressful for child & parent |
How Feeding Therapy Helps
The good news: with the right support, many children overcome feeding and swallowing challenges.
At BreatheWorks, therapy may include:
- Oral motor strengthening – improving tongue, lip, and jaw function
- Swallow training – practicing safe and efficient swallowing patterns
- Sensory desensitization – introducing textures and tastes gradually
- Breathing and posture work – addressing mouth breathing and airway issues
- Parent coaching – strategies to make mealtimes less stressful and more successful
We take an interdisciplinary approach, often collaborating with ENTs, pediatricians, dentists, orthodontists, and lactation specialists to create a care plan that supports the whole child.
When Should Providers Refer a Child?
For referring providers (pediatricians, ENTs, dentists, orthodontists, naturopaths, MDs/DOs): consider recommending an evaluation if you notice:
- Failure to thrive or poor growth patterns
- Structural differences impacting swallowing (e.g., tongue tie ankyloglossia, cleft palate, enlarged tonsils)
- Chronic respiratory illness linked to aspiration or poor swallowing mechanics
- Concerns from parents about choking, gagging, or extreme food refusal
- Post-surgical recovery where therapy supports better outcomes
Local Care for Families in Portland, OR
BreatheWorks proudly serves families across Portland, Oregon, and surrounding areas. Many families are referred by local pediatricians, ENTs, orthodontists, and dentists who recognize the impact of swallowing and feeding on long-term health.
Whether you’re a parent concerned about your child’s eating, or a provider seeking trusted therapy partners, we’re here to help.
FAQs About Pediatric Feeding Disorders
Is picky eating the same as a feeding disorder? No. Picky eating is common in toddlers but usually improves with age. Feeding disorders involve persistent, severe challenges that affect nutrition, safety, and development.
How do I know if my baby is swallowing correctly? Look for smooth, coordinated sucking, swallowing, and breathing. Signs of trouble include coughing, gagging, or difficulty maintaining latch.
Can a child outgrow dysphagia? Some mild issues improve as children develop. However, untreated dysphagia can worsen over time or cause medical complications. Early therapy makes a big difference.
Does therapy replace medical care? No. Therapy is often part of a team approach that may include your child’s physician, ENT, dentist, or other specialists.
Next Steps
If your child struggles with eating or swallowing—or if you’re a provider seeking specialized therapy for your patients—BreatheWorks is here for you.
- Schedule a feeding evaluation with BreatheWorks today
- Refer a patient to our team
