Infants typically lose weight following birth and when learning the new skill of oral feeding. If weight gain is a concern from pediatrician, this may be a sign of difficulty with oral feeding. Infants need good nutrition to thrive, so it is important that they are safe and efficient with their feeding skills.

• Depending on the age of your infant, the expected volume intake varies. A newborn infant is expected to take less volume than a 5 or 10 month old infant.
• If you breastfeed, you may not know how much your infant consumes unless you are doing weighted feeds. If your child is breastfed and eating every hour, it is possible they may not be getting good volume when they eat. It is normal for infants to cluster feed, but there should be some longer stretches in between feedings.
• If your infant is bottle fed, likely your pediatrician has given you expectations about how much your infant should eat.
• If your infant has a persistent pattern of eating small amounts or quickly, then is seeming to want more 30 mins to an hour later, this could indicate that the infant is not efficiently eating during feedings.

Breastfeeding and bottle feeding for infants is an aerobic exercise. It is like adults getting on a treadmill and running. If an infant is feeding for longer than 30 mins, they will start to burn off more calories than they are consuming and possibly lose weight.

Infants typically feed about every 2-3 hours from the start of one feed to the start of the next feed. As infants mature, they can consume larger volumes, leading to longer spaces between feedings and sleeping longer at night. There are times when infants have growth spurts and increased feeding demand is typical. However, if a child is consistently eating every 1-2 hours, that child may have difficulties getting enough to eat in a timely manner and this can lead to poor weight gain.

Sometimes an infant coughs after feeding, this may be more related to possible reflux and should be brought up with the child’s pediatrician. However, if the child is coughing while they are actively engaged in feeding, this could indicate that the infant is having a problem coordinating sucking, swallowing and breathing while feeding and is a concern that should be addressed by a feeding specialist.

Loss of liquid on the sides or corners of the mouth while actively engaged in breast or bottle feeding. This could be an indication that the flow of the liquid is too fast, infant is too sleepy for feeding, or there is a weakness in the mouth.

During feeding- gulping, gasping for air, eyes widening, body stiffening, facial grimacing, pulling away from the nipple, coughing, gulping, eyes tearing up, face turning red or blue. Hiccups during or just after feeding can also be a stress sign that the feeding experience isn’t comfortable. Noisy drinking

We all have connective tissue in our mouths, sometimes these tissues are suspected to be too short and impact feeding. Often, there are other issues happening that are the actual problem with feeding, and a tongue tie release or upper lip release won’t help the feeding problems. To avoid unnecessary surgery, it is important that you seek a functional feeding assessment prior to surgical intervention.

Further, be careful with post-surgical stretching recommendations as these can lead to aversions to oral feedings.

Strong preference for only one texture (i.e. crunchy, chewy, pureed) or taste (i.e. spicy, sweet, salty, bland) of foods across all mealtime environments, no matter who is present

Increased sensitivity to temperature of foods, both cold (ice cream, popsicles, yogurt) or hot (waits for food to be room temperature before eating)

Difficulty tolerating sounds, lights, or smells impacting his/her ability to participate in mealtimes or interact with specific foods

Caregivers are the experts in care and development of their child. If there are any noted concerns above or seems atypical.