Practice Consideration
Developmental Milestones Related to Eating
Children with allergies should be evaluated to determine if they are reaching milestones that are related to eating behaviors. A summary of milestones is available from USDA as a My Plate resource.(1)
More can be learned about feeding disorders in food allergic children(2) and what the dietitian should consider in the assessment.
Symptoms associated with feeding disorders include:
- Difficulty swallowing
- Preference to drink rather than eat solid food
- Gagging before (at the sight or smell of food), during, or after meal times.
- Vomiting
- Oral motor skill deficit
- Oral sensory skill deficit
- Low variety of intake
- Excessive chewing
- Holds food or liquid in mouth (“pocketing” food in their cheek)
- Spits food out
- Food refusal
- Prolonged feeding time
- Low volume of intake
- Grazing
- Unstructured mealtimes
- Poor acceptance of new foods
- Requires prompting to eat
- Developmental differences: examples include speech-language delay, sensory-processing disorder, or motor skills (fine or gross) delay.
References
- Behavioral Milestones, My Plate, United States Department of Agriculture. Accessed 8 September 2024. Available at: https://myplate-prod.azureedge.us/sites/default/files/2020-12/behavioral-milestones%202-5%20yo.pdf
- Haas AM. Feeding disorders in food allergic children. Curr Allergy Asthma Rep. 2010 Jul;10(4):258-64. doi: 10.1007/s11882-010-0111-5. PMID: 20425004.
- Faltering growth: recognition and management of faltering growth in children. National Institute for Health and Care Excellence (NICE). 2017. Accessed 8 September 2024. Available at https://www.nice.org.uk/guidance/ng75
Updated September 10, 2024