Feeding and Swallowing
Feeding is an umbrella term for any issue relating to eating and drinking. This can include swallow function issues, psychological issues surrounding mealtimes, picky eating, behavior issues, sensory issues, etc.
Examples of feeding problems can include:
refusing age-appropriate or developmentally appropriate foods or liquids
accepting a restricted variety or quantity of foods or liquids
displaying disruptive or inappropriate mealtime behaviors for developmental levels
failing to master self-feeding skills expected for developmental levels
failing to use developmentally appropriate feeding devices and utensils
experiencing less than optimal growth
Many people don't give a second thought to how we chew and swallow our food, however swallowing is an extremely complex function. Much like breathing, swallowing is an essential life function. Swallowing is the passage of nutrition from the mouth to the stomach while keeping the airway protected.
Swallowing happens in 4 phases, two which are voluntary and two which occur automatically. If there is any breakdown in coordination during these phases, aspiration can occur. Aspiration is when food or liquids fall down the trachea (airway) instead of the esophagus. If aspiration occurs, the child is at high risk for pneumonia, malnutrition, dehydration, etc.
Oral Prep: voluntary phase when food is manipulated within the mouth to form a bolus (ball) in preparation to swallow
Oral Transit: voluntary phase where the food is starting to get pushed back toward the back of the throat by the tongue. This ends the voluntary phase of the swallow process
Pharyngeal: involuntary phase where the food passes through our pharyngeal cavity. This is where the risk of aspiration is at it’s highest because the food is being directed near the entrance to the airway
Esophageal: involuntary phase in which the food is carried to the stomach via the esophagus.
Issues with the swallow function could be caused by numerous factors, including muscle weakness, nerve damage, poor musculature coordination, etc.