Severe Feeding and Swallowing Issues in Infants (S2:E37)

Feeding is a primary concern for families of preterm and low birth weight babies. Many of these infants have severe gagging, vomiting and swallowing concerns. Intense feeding aversions are common, too. Some babies don't seem to experience the sensation of hunger. Each of these symptoms makes feeding meals an arduous task for parents and caregivers.

After a baby leaves the NICU, feeding a preterm baby can become even more complicated. New parents no longer have the same level of support they did at the hospital. Maintaining a predictable and consistent schedule is difficult. Fortunately, primary care providers (PCPs) can help families establish a feeding rhythm.

Listen to two pediatric experts discuss how to care for babies with severe feeding and swallowing issues

In this episode, we talk with returning guests Laura Pickler, MD, and Nancy Creskoff Maune, OT. This duo first joined us earlier in season two of Charting Pediatrics. If you missed their informative episode on general infant feeding and swallowing problems, be sure to listen later.

To add to our previous discussion, Dr. Pickler and Nancy share their approaches to diagnosis and treatment options for infants with severe feeding and swallowing issues. We also discuss diagnostic tests and therapies that pediatricians can use.

Dr. Pickler is the Chair of Family Medicine and Medical Director of the Feeding and Swallowing Program at Children’s Colorado. Nancy is an occupational therapist in the program. She has an extensive background in the evaluation and treatment of feeding and swallowing problems.

In this episode, our experts explain:

• The importance of remembering that not all premature infants are the same
• The inconsistent ability of preterm babies to feed and the individual contributing factors
• Why eating is an incredibly complicated task for a very premature infant
• How to approach babies in the NICU
• Why it's vital to develop regulation and how a careful routine sets babies up for success
• Considering all the contextual factors to optimize a baby’s success with feeding
• Considerations when caring for a baby with sensitivity around the mouth
• The difference between vomiting and gagging
• Why it's useful to view eating as a learned behavior and a developmental skill
• When supplemental feeding should be introduced
• How to choose the appropriate feeding tube
• Testing for aspiration, plus insights into why results are not always accurate
• When gastroesophageal reflux is a problem
• What to do when gastroesophageal reflux interferes with learning how to eat
• Why medication for reflux isn't always the best choice for children who have severe issues with feeding and swallowing
• The efficacy of lifestyle management strategies
• Different feeding options and what parents can do to prepare for successful feeding

Treating severe feeding and swallowing problems in infants at Children's Colorado

The pediatric feeding experts at Children's Colorado provide a comprehensive, family-centered approach to the assessment and treatment of feeding and/or swallowing-related difficulties. Our clinic team includes physicians, nurses, speech-language therapists, occupational therapists and social workers who work together to provide the comprehensive support babies and parents need. Refer a patient to Children's Colorado.