Feeding is the process involving any aspect of eating or drinking, including gathering and preparing food and liquid for intake, sucking or chewing, and swallowing. Feeding situations provide children and caregivers with opportunities for communication and social experiences that form the basis for future interactions.
Swallowing is a complex process during which saliva, liquids, and foods are transported from the mouth into the stomach while keeping the airway protected. Swallowing is commonly divided into the following four phases:
- Oral preparatory—This is a volitional phase during which food or liquid is manipulated in the mouth to form a cohesive bolus, and that includes sucking liquids, manipulating soft boluses, and chewing solid food.
- Oral transit—This is a voluntary phase that begins with the posterior propulsion of the bolus by the tongue and ends with the initiation of the pharyngeal swallow.
- Pharyngeal—This phase begins with a voluntary pharyngeal swallow that, in turn, propels the bolus through the pharynx via an involuntary contraction of the pharyngeal constrictor muscles.
- Esophageal—This is an involuntary phase during which the bolus is carried to the stomach through the process of esophageal peristalsis.
Feeding Disorders in Children
Feeing disorders are problems with a range of eating activities that may or may not include problems with swallowing. Pediatric feeding disorder (PFD) is “impaired oral intake that is not age-appropriate and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction. PFD may be associated with oral sensory function and can be characterized by one or more of the following behaviors:
- A child may refuse 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
Speech-language pathologists (SLPs) are the preferred providers of dysphagia services and are integral members of an inter-professional team to diagnose and manage feeding and swallowing disorders.
Modified Barium Swallow Studies
Dr.Hopkins conducts modified barium swallow studies at Springfield Hospital in Springfield, Vermont, to definitively assess swallow function. The Modified Barium Swallow (MBS) is a fluoroscopic procedure designed to determine whether food or liquid is entering a person’s lungs. Furthermore, it allows the SLP to observe the coordination of anatomical structures in the mouth and throat, as they are actively functioning when chewing, drinking and swallowing. An MBS may also identify the reason for aspiration and help the SLP to make diet recommendations that can make eating a safer and more comfortable experience.
Note: This information and more is available on the website for the American Speech-Language and Hearing Association: www.asha.org.