Scenario 1 - continued

You present your concerns to Nicholas’s parents:

If Nicholas does have a swallowing problem, this should be addressed.

• You contact his primary care physician, and a referral for a feeding evaluation is scheduled with a local therapist. This evaluation will include a videofluoroscopic swallowing study (VFSS), which is a radiologic procedure to evaluate the swallowing mechanism.

While infants and children develop feeding skills at different ages, it is appropriate to expect a 13-month old (who can safely consume solids) to eat solid foods.

• First, the safety of an oral intake for Nicholas should be determined.
• Then, if no physical barriers to eating solid foods are identified, a referral to a feeding team is probably needed.
• You provide his family with some information about the development of feeding skills, and also suggest a referral to a feeding team.