The following questions may be useful for assessing a child’s feeding skills:

• What types of foods does your child eat?
  • Describe the texture
  • Describe the consistency
  • How many times does your child eat each day?
• Do you have concerns about your child’s feeding skills?
  • Does your child feed himself? With fingers? With utensils?
  • Does your child have problems chewing or swallowing? Gagging or choking?
  • Are there specific foods or textures that your child has difficulty with?
  • Does your child choke while eating? If so, how often does this happen?
• Can your child clearly communicate hunger and thirst?
• How does your child respond when food is offered?

Asking a caregiver about a child’s feeding history can also provide useful information:

• When were solid foods introduced?
• What types of solid foods were introduced?
• When did your child learn to drink from a cup?
• What was your child’s reaction to solids? To finger-feeding? To utensils? To the cup?

These questions are summarized in a table available for download in pdf format.

When a problem with feeding or eating is suspected, referral to a practitioner (e.g., occupational, speech, or physical therapist) with experience with feeding problems and children with special health care needs is warranted.

If a problem is identified during this assessment, interventions are developed. Interventions can include:

• Proper positioning
• Therapy to improve oral-motor skills
• Modification of food types or textures (for example, thickened liquids)
• Adaptive feeding utensils (for example, a weighted spoon may help a child with motor problems to feed herself)
• Specialized feeding techniques

For a child with identified feeding problems, coordination between the RD and feeding therapist is critical…to ensure that the foods that are offered meet the child’s nutrient needs and are safe for the child to consume.

The Bright Futures: Nutrition materials include questions that can health care providers can ask, to get information about a child’s feeding skills. See the Resource section for more information.