Many children with Down syndrome suffer from a Sensory Feeding Disorder. A Sensory Feeding Disorder is “a learnt  pattern of defensive behaviour in and around the oral and facial area. The child behaves as though the food is poisonous/dangerous, and thus exhibits a physical and emotional response.” (Hibberd & Taylor, 2000)

·         Avoidance of meals

·         Refusal of meals

·         Restricted range of tastes and textures

·         Fear of new food, eating in new places and eating with new people around

·         May have additional sensitivities, e.g. dislike teeth cleaning, brushing hair, face washing, messy hands, and food around the face.

When food is presented to a child suffering from SFD you may see some of the following behaviours:

·         Gagging on lumps, often leading to vomiting

·         Gagging when food is approaching

·         Vomiting for no physiological reason

·         Spitting of food

·         Pocketing of food in the cheeks

·         Facial grimacing

·         Clamping mouth shut

·         Turning away from the spoon/teat

·         Very limited range of tastes and textures are accepted

What causes a SFD?

The following predisposing factors have been identified in the literature:

1.       Medical

·         Prematurity

·         Respiratory difficulties

·         Cardiac condition (it can decrease endurance during feeding)

·         Food intolerance

·         Reflux

2.       Negative and Traumatic Oral Experiences

·         Intubation / supplementary oxygen

·         Regular deep suctioning

·         Long-term nasogastric tube feeding (NG tube through the nose)

·         Discomfort associated with feeding

3.       Developmental Factors

·         Delayed introduction to oral feeding - thus missing crucial periods to introduce skills (usually between 6-9 months of age)

4.       Neurological Impairment

5.       No Known Cause

·         Consult your GP to see if there is no underlying condition that can cause this behaviour, e.g. lactose intolerance, reflux, etc.

·         Do not force or pressurise your child to eat.

·         Allow your child to be ‘in control’ during mealtimes by letting him feed himself or finger feeding.

·         Allow for small meals.

·         Allow for snacks.

·         Consult your Dietician to ensure your child is getting adequate calorie intake.

·         Encourage finger foods, strips of soft boiled vegetables, bite-sized pieces of food.

·         Make mealtime’s fun: make faces on bread, cut food into shapes, and make meals colourful.

·         Encourage messy play / food play or pretend play with pretend food / tea set.

·         Ask your Speech-Language Therapist to teach you how to implement a Facial Massage Programme to build up your child’s tolerance to touch.

Got a question for Marinet vanVuren? If so, drop her an email here.