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Feeding and Swallowing

Why do children need feeding and swallowing therapy?

Some children may exhibit difficulty feeding and /or swallowing.  Signs and symptoms that may indicate a need for therapy include:

  • Coughing and gagging during feeding
  • Difficulty coordinating breathing with drinking or eating
  • Hoarse or breathy voice quality
  • Excessive drooling
  • Loss of food/liquid from the mouth
  • Prolonged meal time (greater than 30 minutes)
  • Avoidance of food textures
  • Problems chewing
  • Frequent pneumonia or respiratory infections
  • Frequent spiting up
  • Arching or stiffening body during feeding
  • Failure to gain weight
  • Difficulty transitioning from bottle to food
  • Transition from tube-feeding to oral feeds


What does feeding and swallowing therapy involve?

Treatment may include:

  • Oral motor strengthening and range of motion
  • Chewing and biting skill development
  • Cup drinking
  • Oral motor stimulation and desensitization
  • Oral sensory skills
  • Positioning changes
  • Alteration of mealtime schedule
  • Utensil and/or bottle modifications
  • Assessing the safety of swallow


Is aspiration a common reason for needing therapy? Is this diagnosed by the videofluoroscopic swallow study?

A video fluoroscopic swallow is completed to see:

  • How the tongue is used to get food to the back of the throat
  • How the food is swallowed
  • If the food goes into the lungs instead of the stomach (Aspiration)
  • If different consistencies are handled better than others
  • If different positioning helps for feeding

To complete a successful study, the child should be able to accept 3 tsps. of liquid and another 5-7 bites of a semi-solid food.

If the child is found to be aspirating, follow up therapy is recommended to work with the child and family to develop a feeding/swallowing program based on the child's unique needs.

Meet our Feeding & Swallowing Team:

Children's Hospital:
Mary Cash, MS,CCC-SLP
Ann Kelly, OTD, OTR/L
Katie Lippincott, MS, CCC-SLP Lead SLP
Kimberly Norris, MS, CCC-SLP
Michelle Westengaard, OTR/L Lead OT
West Village Pointe:
Jaime Hill, MS, CCC-SLP
Heather Young, OTR/L
© Children's Hospital & Medical Center | In Affiliation with University of Nebraska Medical Center College of Medicine