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The Parent's Guide to Toddler Feeding:
Part 2: Unsafe Eating

Rogers Bridge » The Parent's Guide to Toddler Feeding: Part 2: Unsafe Eating

As a parent, ensuring that your child is eating safely is an important responsibility. But it can be challenging to recognize when your child is struggling with safe feeding skills if you are not a trained professional.

We all want to ensure that our toddlers receive proper nutrition for their growth and development. It’s important to remember that it’s not just about what our little ones are eating but also how they're eating it.


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In this blog post, we'll discuss the dangers of unsafe eating, including the signs of aspiration, and provide tips on how to prevent them.

Aspiration is the inhalation of foreign material, such as food or liquids, into the respiratory system. It occurs when the material is inhaled into the windpipe or lungs. Reoccurring aspirating events are concerning and if this happens the parents should seek a pediatrician’s referral for a feeding evaluation and/or swallow study. Feeding evaluations are conducted by an occupational therapist or speech therapist.

While most aspiration events occur in children that have other medical conditions such as prematurity, structural abnormalities, cerebral palsy, or down syndrome. But  there are times when the cause is unknown so all parents should be on the lookout for signs that their child is struggling with eating safely.

Here are some signs and symptoms of aspiration to watch out for:

  1. Avoiding certain textures or types of food: If your child is consistently refusing to eat certain textures or types of food, it could be because they are having trouble handling them safely in their mouth. This can be due to the food’s texture or your child’s inability to chew specific foods adequately.

  2. Taking a long time to eat or drink: If your child is taking an unusually long time to eat, it could be because they are having trouble managing the food or drink in their mouth. Meals and bottles should be completed within 20 minutes.

  3. Coughing or choking: If your child is coughing or choking while eating or drinking, it could be a sign of aspiration. A cough or choke that happens occasionally, is not concerning. However, coughing and choking that occur multiple times during a single feed is concerning.

  4. Difficulty breathing: If your child is having trouble breathing or is breathing faster than usual, during or after eating or drinking, it could be a sign of aspiration.

  5. Wheezing or wet vocal quality: If your child is wheezing or has a wet vocal quality after eating or drinking, it could be a sign of not swallowing safely, especially if it is accompanied by other symptoms such as coughing or difficulty breathing.

If you notice any of these symptoms in your child, it's important to speak with your pediatrician. If the symptoms are concerning, the pediatrician will refer you for a feeding evaluation by an occupational therapist or a speech therapist. These professionals can assess your child's feeding skills and provide guidance on how to help them improve them. They may also recommend additional tests to help identify the cause of the difficulty. Don't hesitate to seek help if you have concerns about your child's feeding skills – the earlier any issues are addressed, the easier it will be to help your child learn safe feeding habits.

Be sure to incorporate these recommendations into your child eating routine for a smoother and stress-free experience.

  1. Offer age-appropriate foods: Offering age-appropriate foods is crucial for preventing choking and gagging and toddlers. Young children are still learning how to chew and swallow their food, and their airways are smaller than adults. As a result, they are at higher risk of choking or gagging on foods that are too large, too hard, or too sticky. By offering appropriate food sizes and textures, parents can help their toddlers learn how to eat safely and avoid potential choking hazards. This can also help promote healthy eating habits and prevent negative associations with food.

  2. Introduce New foods slowly: When introducing a new food to your child, it’s important to do so slowly. Start with a small amount and gradually increase the quantity as your child becomes more comfortable with the food. This will help reduce the risk of choking or gagging.

  3. Cut food into appropriate sizes: Make sure to cut food into small, age-appropriate pieces to reduce the risk of choking. For children, it is a good idea to cut food into ¼ to ½ inch pieces.

  4. Offer a variety of foods: encourage your child to try a variety of foods by offering a range of textures and flavors. This will help them develop a diverse palette, improve their overall nutrition, and prevent problematic eating later.

  5. Supervise Meals: Therapists recommend that families participate in family style meals. This is an excellent opportunity for modeling safe eating habits and the consumption of different types of foods. By eating together, families can show their children how to chew their food properly and explore new items. This can help develop positive associations with food and promote healthy eating habits for a lifetime. If your family is unable to participate in family style meals, we recommend supervision for all snacks and meals. This will allow you to intervene if they start to choke or struggle with their food.

  6. Encourage self-feeding: As your child becomes more comfortable with solid foods, encourage them to feed themselves regardless of the mess. This helps to develop their fine motor skills and independence.

Remember, every child is different and will develop their feeding skills at their own pace. If you have concerns about your child’s feeding skills or nutrition, don’t hesitate to speak with your pediatrician or schedule a feeding evaluation with an occupational therapist or a speech therapist. 

If mealtime is a struggle for your child and you have tried the tips and tricks listed above, please talk to your pediatrician. You are welcome to contact us for a free consult to determine if your child should be evaluated.  

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"My daughter has been seeing Ms Jessie for about four years, since She was in the Babies Can’t Wait program. Ms Jessie has been kind, friendly, kid-centered, flexible, and has never given up on my daughter. To be able to serve a strongly oral averse child with health complexities for several years, to look into many different options so that my daughter would be okay with being in the same room where there was food, touch, smell, lick and so forth, to take a training course that would give her more tools to work with children like mine is the most incredible experience. My daughter is now feeding orally without the need for a feeding tube for  about eight months. Ms Jessie continues to help in increasing her food options with a fun, consistent and encouraging approach. We love having her as my daughter’s speech and feeding therapist. – Ana

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