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Feeding, speech disorders can indicate bigger problems

When a child struggles with eating, parents can grow frustrated and frightened as they worry about how that most basic need can be met.

Sometimes, help comes in the form of working with a speech therapist to address mechanical or sensory issues that can make feeding easier for all.

If your child is not meeting speech and feeding milestones, a referral to a speech therapist might be in order. Rachel Setzer, a speech-language pathologist with Pediatrics Unlimited in Spartanburg, said the mechanisms of feeding and speech go hand in hand.

“In feeding, we usually address working on the muscles of the jaw and lips and tongue,” she said. “Our jaw, lips and tongue are used for swallowing and feeding and also for speech. If you have jaw weakness or fatigue or your tongue isn’t moving back to swallow, it all really connects. If your lips aren’t coming together to eat, you may have trouble with ‘m’ and ‘p’ and ‘b’ sounds.”

Most of Setzer’s referrals come to her at around 12 months of age.

“Whenever they’re not transitioning from pureed baby food to some meltable solids by 10 – 12 months, or not transitioning from bottle to cup by 16 months, the doctor may refer them for feeding therapy,” Setzer said.

Parents usually have a feeling that there are problems with feeding, she said. If so, it is something that should be addressed with a pediatrician.

“If they have gagging or coughing, even a history of reflux or vomiting, weight loss is usually the big red flag for doctors to refer,” she said.

In feeding therapy, Setzer teaches different techniques for putting food in the mouth and also addresses rotating challenging foods with preferred foods, which may be especially important if children have sensory issues, such as wanting to eat only crunchy food.

“There is definitely a sensory component to feeding,” she said. “We look at that and get an inventory of the foods they will take. We use some sensory integration and an oral motor approach to feeding. Every child is so different. About 90 percent of the kids I see have other delays.”

If a child is struggling, parents should not rely on the hope that it is something the child will outgrow. Proper nourishment is about much more than gaining weight.

“Feeding is very crucial for brain development as well,” Setzer said. “It helps them develop and helps their height and weight.”

Parents should make themselves aware of some of the early speech and language milestones: saying p, m, b, h and w sounds at 12 – 18 months, saying k, g, f, t, d and n sounds at 2 – 3 years, saying first words and babbling at 9 – 12 months, and putting two words together at 15 – 24 months.

Setzer said a rule of thumb is for babies and toddlers to make sentences with the same number of words as their age: one word at 1 year of age, two words (“mama go”) at 2 years and three words (“where is it?”) at 3 years.

“Trust your instinct,” Setzer said. “If you feel like something is going on, reach out to the doctor and get some help.”