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.