We care for infants, children and teens who have trouble eating and swallowing, and have chronic medical or developmental needs that include:

• Cerebral palsy
• Cleft lip and cleft palate
• Down syndrome and other genetic conditions
• Feeding tube dependency
• Gastroesophageal reflux disease (GERD) or other digestive conditions
• Heart conditions and lung conditions present at birth
• Medical or developmental differences linked to prematurity (birth before 37 weeks of pregnancy)
• Neurodevelopmental disorders, including seizure disorders

We provide:

• A team of pediatric specialists who work together to create a custom plan for your child.
• Evaluation of factors that affect feeding, including:
  • Chewing and swallowing coordination.
  • Medical conditions.
  • Gastrointestinal health.
  • Family stress and learned behaviors patterns.
• Support for your whole family, including a social worker to help with emotional, financial or social needs.
• Locations in Portland and Eugene.

Understanding feeding and swallowing disorders

Many young children need help eating and drinking. If eating and drinking problems are affecting your child’s health or social well-being, they may have a feeding or swallowing disorder.

Feeding disorders are often complicated by:

• A condition that affects chewing and swallowing coordination.
• A medical condition that makes eating or digesting harder.
• A health problem.
• A psychological challenge, such as learned patterns of refusal or avoidance.

Feeding and swallowing disorders are most common in children born early or with chronic (ongoing) medical conditions. A study found that:

• Between 2% and 4% of children under 5 in the U.S. have a feeding disorder.
• A third to a fifth of children under 5 in the U.S. who have chronic conditions also have a feeding disorder.

Signs and symptoms of feeding and swallowing disorders

• Coughing, choking or gagging at meals
• Not being able to eat foods typical for a child's age
• Low weight gain or growth
• Refusing to eat or drink
• Poor digestion, resulting in constipation, vomiting or diarrhea

Evaluating feeding and swallowing disorders

You’ll need a referral from your child’s provider to see us.

At your child’s first visit, we will:

• Discuss your child's medical history and your concerns.
• Weigh and measure your child.
• Have your child eat and drink, to learn about their feeding and swallowing skills and tolerance.
• Talk and play with your child, to learn what mealtimes are like in your home.

Tests for feeding and swallowing disorders

Sometimes we need more information to help us plan the next steps. After we evaluate your child, we may suggest tests outside our clinic:

Fiber-optic endoscopic evaluation of swallowing (FEES): This test uses a thin, flexible device (endoscope) to look at your child’s throat while they swallow. This test is done to check for physical problems.

• Endoscopy: This is done to check the health of your child’s esophagus.
• We may refer to other specialists:
  • Pulmonology, for lung care
  • Ear, nose and throat (ENT)
  • Gastrointestinal (GI), for care of the digestive system

Therapies for feeding and swallowing disorders

Therapy can help your child:

• Learn to eat more textures.
• Accept more types of food.
• Improve their nutrition.
• Gain confidence to try new things.

Sometimes we find medical problems that need treatment before we start therapy. If so, we’ll refer you to specialists at OHSU Doernbecher Children’s Hospital.

We may suggest these therapies:

Breastfeeding support: If your baby has trouble latching on to nurse or has other problems, a lactation consultant can help.

Feeding therapy: Most communities have feeding therapists nearby.  Sometimes a child has feeding challenges but does not meet criteria for a feeding disorder. A local occupational therapist or speech-language pathologist can help your child:

• Learn to suck, drink, chew and swallow safely and comfortably.
• Try new foods, drinks or textures.

Feeding tube: If your child uses a feeding tube, we can help manage feedings.

Nutrition services: A registered dietitian can help your child avoid nutritional deficiencies and, if needed, improve their weight gain.

Psychotherapy: A psychologist can help your child with mealtime behaviors and thought patterns that promote success with mealtime challenges.

Learn more

• Feeding and swallowing disorders in children, American Speech-Language-Hearing Association
• Swallowing disorders in infants and children, National Foundation of Swallowing Disorders