What Is Pediatric Feeding Disorder—and How Can ECI Help?

Helping children eat, grow, and thrive—one bite at a time!

By Erika Almazan, MA, CCC/SLP

For many families, feeding a baby or toddler is a bonding time filled with smiles, messes, and milestones. But for others, mealtime can be full of tears, food refusal, and worries about growth. If your child consistently struggles with eating, avoids certain textures, takes an extremely long time to finish meals, or is not gaining weight as expected, they may be showing signs of Pediatric Feeding Disorder (PFD).



PFD is more than picky eating—it's a condition that affects how a child eats, drinks, and gets the nutrition they need to grow. According to Feeding Matters, PFD includes challenges in one or more of the following areas:

1.   Medical – conditions like reflux (GERD), food allergies, or prematurity

2.   Nutrition – not getting enough variety or quantity of food to support growth

3.   Feeding Skills – difficulty chewing, swallowing, or using their mouth efficiently

4. Psychosocial – mealtime stress, oral aversions, or behavioral feeding issues

How ECI at Easter Seals San Antonio Can Help

Our Early Childhood Intervention (ECI) team includes speech-language pathologists and occupational therapists trained to support children with feeding challenges. We deliver services in the home, where children are most comfortable and where real mealtimes happen.



We partner with families to make feeding less stressful and more successful. Support may include:

1.   Assessing intake patterns and creating a step-by-step plan to introduce new foods in a supportive and manageable way

2.   Helping your child build feeding skills like chewing, tongue movement, and safe swallowing

3.   Offering strategies to make mealtimes more positive, such as reducing pressure to eat, building simple routines, and modeling enjoyment of foods-showing your child that trying new things can be fun and safe

4.   Coaching caregivers to recognize hunger and fullness cues, set realistic expectations, and celebrate small wins

A Peek Inside a Feeding Session 

Every feeding session in ECI starts with your family at the center. The therapist may join you during a regular mealtime or snack and observe your child in their natural environment—where they’re most comfortable. Together, you discuss what foods your child currently eats, what they avoid, and how mealtimes usually go.

Let’s say your toddler eats crunchy snacks like crackers but refuses soft foods. The therapist might suggest offering a new food with a similar color or shape—like a slice of soft cheese or banana. You might sit together at the table and explore the food through play first—touching, smelling, or stacking pieces without the pressure to eat.

The therapist models ways to keep the experience positive, showing how to make silly faces, narrate the experience (“This banana is squishy!”), or show enjoyment by taking a bite and smiling. Most importantly, they coach you in real-time—offering encouragement, adjusting strategies, and celebrating progress, no matter how small.

Over time, these small steps add up. Your child begins to feel safe and curious around food again, and you gain tools and confidence to support their feeding journey long after the session ends.

Mealtime Doesn't Have to Be a Struggle

If your child is having a hard time eating, you are not alone—and you don't have to figure it out by yourself. The earlier a child receives support, the more progress they can make.

If you have concerns about your child's feeding, reach out to Easter Seals San Antonio's ECI program. Together, we can help your child enjoy mealtimes, try new foods, and grow with confidence.

To learn more about Pediatric Feeding Disorder, visit Feeding Matters.



Goday, P. S., Huh, S. Y., Silverman, A., Lukens, C. T., Dodrill, P., Cohen, S. S., Delaney, A. L., Feuling, M. B., Noel, R. J., Gisel, E., Kenzer, A., Kessler, D. B., de Camargo, O. K., Browne, J., & Phalen, J. A. (2019). Pediatric feeding disorder: Consensus definition and conceptual framework. Journal of Pediatric Gastroenterology and Nutrition, 68(1), 124–129. https://doi.org/10.1097/MPG.0000000000002188