Infant Feeding and Swallowing

Infant Bottle Feeding and Breastfeeding

Infant feeding requires coordinated sucking, swallowing, and breathing to safely and efficiently obtain nutrition.  Disruptions in this pattern can impact feeding safety, endurance, and weight gain. 

Infants who may benefit from a feeding evaluation include those:

  • Whose feeding patterns are concerning for their family

  • Who were born prematurely

  • With history of tube feeding dependence

  • With a complex medical history

  • Who were NICU graduates

Signs and Symptoms of Infant Feeding Difficulties

The signs listed below are common indicators of feeding challenges.  The presence of one or more of these signs does not confirm a diagnosis but may suggest that a feeding evaluation would be beneficial.  If you have concerns, we offer complimentary consolations to help determine next steps for your child.

Signs and Symptoms of Infant Feeding Difficulties:

  • Clicking, shallow latch, or slipping off the breast/bottle

  • Milk leakage or poor seal

  • Coughing, choking, or breathing difficulties during feeds

  • Noisy breathing during feeds or wet vocal quality (during and/or after)

  • Prolonged or inefficient feeding sessions

  • Frequent spit-up with distress or suspected silent reflux

  • Poor weight gain or even weight loss

  • Persistent maternal nipple pain and discomfort, cracked or bleeding nipples

Feeding is a dynamic relationship between a parent and their infant.  When challenges arise, evaluating both sides of that relationship helps identify the most appropriate support.

At Thrive Pediatric Feeding and Swallowing Therapy, we want to support your journey by assessing your infant's feeding function to help determine if your baby's feeding skills are contributing to what you both are experiencing.  Therefore, we coordinate with IBCLCs and lactation consultants, otolaryngologists, your current medical provider(s), and other specialists to help support the dyad between you and your infant with both bottle and breastfeeding.

What to Expect During an Evaluation

A comprehensive feeding evaluation includes assessment of:

  • Parent concerns and observations

  • Review of birth, developmental, medical and feeding history

  • Oral motor structure, mobility and function

  • Oral reflex integration

  • Suck-swallow-breathe coordination

  • Respiratory stability during feeding

  • Swallow safety

  • Bottle system, nipple flow rate, and positioning

If Therapy is Recommended

Therapy may focus on:

  • Improving oral motor function

  • Supporting mature feeding patterns

  • Sensory-motor skill development

  • Safe positioning and bottle and/or nipple flow rate adjustments

  • Parent/caregiver education and collaboration

What about Tongue, Lip, and Cheek Ties?

Oral restrictions (commonly referred to as tongue, lip, or cheek ties) may impact feeding function.  At Thrive Pediatric Feeding and Swallowing Therapy, assessment is based on function, mobility, coordination, and feeding performance - not appearance alone.

As a speech-language pathologist and feeding specialist, we do not diagnose or perform tie releases. We work on improving function of the oral structures to improve oral skills for feeding and swallowing. When indicated, we refer to and collaborate with pediatric dentists, ENTs, and medical providers to support coordinated care.