Feeding and Swallowing Program

The Speech-Language Pathologists in the Feeding and Swallowing Program are highly trained and experienced in working with infants and children who have feeding and swallowing difficulties.  Below is a list of some of the areas that we specialize in:

• Dysphagia, swallowing impairments, swallowing disorders
• Feeding difficulties
• Food aversion, oral aversion, food refusal, behavioral feeding issues
• Oral hypersensitivity, gagging
• Oral motor delay, oral motor disorders
• Suck-swallow-breathe discoordination, sucking difficulties, breastfeeding difficulties, bottle feeding, newborn feeding, infant feeding
• Introduction of solids, difficulty transitioning to solids, biting and chewing difficulties
• Feeding equipment, bottles, nipples, baby food, spoons, cups, teething toys
• Modified diets, thickened liquids, thickened fluids
• Non-oral feeding, tube feeding, tube weaning
• Oral stimulation, oral desensitization
• Tracheostomy, speaking valves
• Clinical feeding evaluation, feeding assessment, swallow assessment
• Modified barium swallow (MBS), video fluoroscopic swallow study (VFSS), fiberoptic endoscopic evaluation of swallowing (FEES)

We address feeding and swallowing issues in children who have:

Prematurity

• Low gestational age at birth
• Respiratory disease
• Bronchopulmonary dysplasia (BPD)
• Chronic lung disease (CLD)
• Low birth weight
• Comorbidities associated with prematurity

Respiratory and aerodigestive disorders that can impact feeding and swallowing

• Apnea of the newborn
• Laryngomalacia, tracheomalacia, bronchomalacia
• Laryngeal cleft
• Reactive airway disease
• Pneumonia/bronchiolitis

Cardio-pulmonary disorders that can impact feeding and swallowing

• Cyanotic heart defects, acyanotic heart defects
• Hypoplastic left heart syndrome
• Cardiac disease
• Congenital heart disease
• Ventricular septal defect (ASD)
• Patient ductus arteriosus (PDA)

Gastrointestinal and growth Issues that can impact feeding and swallowing

• Congenital diaphragmatic hernia
• Food allergies
• Food intolerances
• Esophageal strictures
• Failure to thrive
• Nectrotising enterocolotis (NEC)
• Gastroschesis
• Hirschprung’s disease
• Tracheoesophageal fistula (TEF)
• Esophageal atresia (EA) and long gap esophageal atresia (LGEA)
• Gastroesophageal reflux (GER)
• Eosinophillic esophagitis (EE)
• Short gut syndrome/short bowel syndrome

Neurological and neuromuscular disorders that can impact feeding and swallowing

• Intraventricular hemorrhage (IVH)
• Periventricular leukomalacia (PVL)
• Hydrocephalus
• Seizures
• Epilepsy
• Microcephaly
• Traumatic brain injury (TBI) and acquired brain injury (ABI)
• Brain tumors
• Hypoxic ischemic encephalopathy (HIE)
• Spinal muscular atrophy (SMA)
• Muscular dystrophy (MD)
• Multiple sclerosis (MS)
• Cerebral palsy (CP)
• Chiari malformation

Congenital abnormalities that can impact feeding and swallowing

• Cleft lip, cleft palate
• Pierre Robin sequence
• Other cranio-facial syndromes
• Moebius syndrome
• Micrognathia

Medical treatments that may impact feeding and swallowing

• Tube feeding (OG, NG, NJ, PEG, gastrostomy)
• Respiratory support (e.g. ventilation, high-flow, CPAP, oxygen)
• Tracheostomy, nasopharyngeal (NP) airway
• Some medications

Ingestional injuries (e.g. swallowing detergents or a battery)

Structural or airway complications

• Laryngeal cleft
• Tongue tie
• Chronic tonsillitis
• Vocal cord/vocal fold paralysis
• Subglottic stenosis
• Laryngomalacia
• Tracheomalacia
• Tracheostomy
• Choanal atresia

Genetic disorders that can impact feeding and swallowing

• Down syndrome
• CHARGE Association
• Rett Syndrome
• Prader-Willi syndrome
• Cornelia de Lange syndrome
• 22q11 deletion (DiGeorge or velocardiofacial syndrome)

Sensory processing disorders (SPD), autism spectrum disorders (ASD)

Behavioral feeding difficulties (e.g. food aversion)

Please note: this list is not exhaustive.