Pediatric Feeding Services

1 in 35 children are diagnosed with a feeding disorder.
This Program is sponsored by the Rotary Club of Chattanooga.

What is a Pediatric Feeding Disorder?

A Pediatric Feeding Disorder (PFD) is a condition of impaired oral intake that impacts a child’s medical status, growth and nutrition, social and skill development, and daily family functioning. Feeding disorders are different than common feeding challenges in young children that are typically short-lived and do not impact the child’s overall growth and development. For children with more significant feeding disorders, the child may not consume enough volume or variety of food/drink to gain weight and sufficient nutrition for proper growth and development. These mealtime challenges have a significant impact on school placement, social opportunities, and family routines.

What does a Feeding Disorder look like?


• Eating or drinking very little and not enough for weight gain; concerns about growth.

• Eating only certain food types or textures.

• Delayed oral motor skills like chewing, swallowing, and eating or drinking safely.

• Challenging mealtimes including tantrums, gagging and vomiting.

• Dependence on gastrostomy (g-tube), naso-gastric (NG-tube), or supplemental drinks when safe for oral feeding.

Who has Feeding Disorders?

There are a number of medical, nutritional, developmental/skill, and psychosocial factors that can contribute to the onset of a feeding disorder. Some common conditions that co-occur with feeding disorders include:

• Gastroesophageal reflux disease
• Palate defects
• Prematurity
• Esophagitis
• Duodenitis
• Motility disorders
• Food allergies
• Motility disorders
• Behavior challenges
• Developmental Disabilities including Autism Spectrum Disorders
• Failure to Thrive
• Avoidant Restrictive Food Intake Disorder (ARFID)
• Oral motor dysfunction (dysphagia, swallowing problems)
• Gastritis • Delayed exposure to variety of foods

Our Pediatric Feeding Team

The Pediatric Feeding Team consists of specialists in pediatric feeding from the disciplines of speech-language pathology, occupational therapy, and behavior psychology/behavior analysis. Our multidisciplinary approach and specialized experience brings a unique approach to child health services. We work closely with other specialists including Gastroenterology, Allergy/Immunology, Neurology, Developmental Pediatricians, and Primary Care Pediatricians to assess factors impacting feeding.

Our Approach

Siskin Children’s Institute provides Pediatric Feeding Services with a multidisciplinary approach to assess and treat feeding difficulties in children. Children referred to our feeding therapy service are evaluated by one or more of our feeding team members during an initial evaluation. We ask for consent to have active collaboration with other consulting professionals to ensure that the child is medically stable and safe for intervention. Following the initial evaluation, individualized recommendations for treatment are provided.
View All Pediatric Feeding Team

This is a single appointment to gather information related to the child’s developmental, medical, feeding, and social history and a family mealtime observation. This will allow us to better understand the current challenges your child and family are facing. We will connect with other relevant medical providers to develop a plan for feeding intervention. Many children will then subsequently receive ongoing therapy from one or more clinicians to work toward improved feeding.


Treatment goals are individualized to the child’s needs and family priorities. The team will work with you to identify clear and measurable goals for treatment that will allow you to objectively track treatment progress.

Common Goals for Treatment

• Decrease enteral tube feedings
• Increase oral intake of solids and/or liquids
• Decrease refusal or problem behavior at mealtime
• Increase variety and/or texture of solid foods
• Improve skills, independence and flexibility within the meal routine
• Caregiver coaching to develop a mealtime structure or routine

Outpatient Services

These services are typically 1-3 appointments per week that occur initially in the clinic for children whose mealtime behavior is challenging but not impacting the child’s nutritional status. These sessions involve a combination of direct therapy with the child to develop routines and skills as well as caregiver coaching/consultation. Telehealth services are may be incorporated following demonstration of treatment gains in clinic and completion of hands-on caregiver training.

Meet Letty and discover how Siskin is helping her reach her goals.

When Letty was first born she didn’t eat well. Her parents were worried and knew something was wrong.

At five weeks old Letty was diagnosed with pyloric stenosis. Letty would later develop erosive esophagitis which created a food aversion. By five months old Letty decided that it hurt too much to eat and she wasn’t going to eat anymore. Letty’s family was worried and needed to find help for the daughter.

Then they were referred to Siskin Children’s Institute. At Siskin, Letty’s parents worked with the therapy team to get the services they need. Now Letty is showing improvements everyday and has the support she needs to grow.

Not sure where to start?

The Feeding Matters Infant and Child Feeding Questionnaire may help you identify if there are potential areas of concern to discuss with your child’s pediatrician. Click the link below to download the questionnaire.

Questions? Call 423.490.7710

Ask you pediatrician about a referral to Siskin today.

For additional information about pediatric feeding disorders download the guide below or visit

Pediatric Feeding Disorder Family Guide