Infancy (0–12 months)

  • Difficulty latching (breast or bottle)
  • Poor suck–swallow–breathe coordination
  • Weak or inefficient sucking
  • Excessive coughing, choking, or gagging during feeds
  • Frequent arching, crying, or distress with feeds
  • Signs of aspiration (wet voice, breathing changes, recurrent respiratory illness)
  • Reflux impacting feeding comfort
  • Prolonged feeding times (>30 minutes consistently)
  • Low endurance during feeding
  • Difficulty transitioning from breast/bottle to purees/solids
  • Oral aversion (turning away, refusing nipple, distress with anything in mouth)

Toddlers (1–3 years)

  • Delayed progression to age-appropriate textures (still on purees, refusing solids)
  • Difficulty chewing (poor rotary chew, pocketing food in cheeks)
  • Limited food repertoire (accepting <20 foods, refusal of entire food groups)
  • Strong texture aversions (e.g., refuses crunchy, wet, or mixed textures)
  • Difficulty self-feeding (trouble with utensils, finger feeding)
  • Excessive gagging or vomiting with solids
  • Difficulty drinking from a cup or straw
  • Overstuffing mouth with food
  • Behavioral mealtime challenges (throwing food, tantrums, refusal to sit)
  • Nutritional concerns due to restricted intake

Preschoolers (3–5 years)

  • Persistent picky eating beyond typical toddler stage
  • Extreme food selectivity (brand-specific, color/shape restrictions)
  • Difficulty expanding diet variety despite exposure
  • Prolonged meal times (taking over 30–40 minutes regularly)
  • Continued oral motor difficulties (chewing, tongue movement, jaw strength)
  • Difficulty with mixed textures (soups, casseroles, fruit with skins)
  • Fear/anxiety around new foods
  • Oral sensory seeking/avoidance (chewing on non-food objects or refusing foods with certain smells)
  • Transitioning to school environments with restricted diet (social/mealtime participation issues)
  • Persistent mealtime stress affecting family dynamics

Across All Ages (0–5)

  • Growth and weight gain concerns related to feeding
  • Medical or structural issues (tongue tie, cleft palate, chronic ear infections, respiratory issues) impacting feeding
  • Neurological or developmental delays (low tone, CP, autism, sensory processing challenges) influencing feeding
  • Parental stress and need for caregiver coaching in feeding strategies