Paediatric feeding - Western NSW LHD speech pathology

Overview

​Children can have a range of difficulties feeding, including with breast or bottle feeding, eating solids, and/or difficulties swallowing. Challenges can range from typical age expected behaviour such as fussy eating, to not being able to swallow.

If you have concerns about your child’s eating, drinking, or mealtime behaviour, talk to your GP or child and family health nurse. They may be able to answer your questions, or refer you to another health professional such as a speech pathologist for more advice.

There are various health professionals who may be involved in supporting your child’s feeding. Depending on the difficulties your child is experiencing you may see one or more of these health professionals.

Who you can work with

You can download the “Paediatric Feeding: Who can I work with? (PDF 274.16KB)” handout for information on health professionals who may be involved in supporting a child’s feeding.

Gagging versus choking

​​Gagging​

Gagging is normal and expected in the early stages of introducing solids. The gag helps bring the food forward in the mouth where the child has control of it, and can either spit it out or chew it more and swallow. The gag may initially look like choking but it passes in a few seconds and the child continues with the meal. There is no or only minimal change in the child’s colour. Ignore it if possible. Consider changing the food, reduce the amount of food on the spoon/fork, or mash it a bit more. Sometimes children will gag the first time but continue happily with the meal.

Gagging occurring every time food (or a particular food) is offered, or gagging becoming more frequent, is not expected and should be referred to a speech pathologist or occupational therapist for further assessment.

Choking​

Choking is where food or drink has entered or is stuck in the airway. When children are learning to drink water from a cup, sipper cup or straw they will sometimes have water ‘go down the wrong way’ and then cough. This is expected and should get better with practice. Talk to your child and family health nurse or speech pathologist if this is not getting better with practice or you are concerned.

Choking where the airway is completely blocked is often silent. The child will be unable to cough or make a sound and will change colour (white, blue, red or purple). This can be on food or small objects.

Administer first aid and call an ambulance immediately.

Fu​​ssy eating

Everyone has foods they like a​​nd don’t like. In children these food preferences can change rapidly and for no apparent reason.  There are a number of things you can do at home to minimise the impact of fussy eating for the child and family. Download the fussy eating (PDF 750.46KB) handout​ for more information.

When to refer to speech pa​​thology

If you have concerns about your child’s eat​ing or drinking, talk to your child and family health nurse, or GP. They might suggest a referral to speech pathology or another health professional.

If your child has frequent coughing or choking during eating or drinking you should contact a speech pathologist for an assessment.

More information​​​

• Introducing solids – why, when, what and how.
• ​Babies – breastfeeding, bottle-feeding and solids.
• ​Children learning to feed themselves.
• Fussy eating.
• Sydney Children’s Hospital Network also has information on fussy eating in toddlers​​.