Feeding disorders in children: taking an interdisciplinary approach.

Feeding problems are common in children with special healthcare needs, and inquiring about feeding skills should be a routine part of the developmental assessment. Failure to meet normal feeding milestones, the presence of swallowing problems, and the presence or history of placement of a nasogastric or gastrostomy tube are all reasons to refer a child for a feeding evaluation. An interdisciplinary approach that includes the pediatrician along with a feeding team that includes a speech pathologist, occupational therapist, feeding-oriented nutritionist, and often others, should be taken to diagnose and manage feeding disorders in such children as early as possible for the best prognosis. However, caregivers also play a critical role in intervention, and effective management of feeding disorders should always be seen as a partnership between the caregiver and the interdisciplinary team. The additional benefit is the feeling of competence by the caregiver who is properly trained in the feeding of his/her special needs child. Providing caregivers with proper training as well as realistic goals, regular instruction for home practice, and the expectation for periodic setbacks, can help the child and the caregiver reap the most benefit from feeding intervention.