Eating drinking and feeding difficulties

We are specialist speech and language therapists (SLTs). We help babies and children who have trouble: sucking, chewing, or swallowing food or drinks safely. We can also support young children, under the age of 18 months, if they have difficulties accepting food (for example, if they avoid eating or dislike food around their mouth).
We’ll usually start by calling you on the phone. During this call, we’ll ask some questions about your child’s feeding and may give you some advice right away.

What happens at the first appointment?

The first appointment is often a home visit, especially for younger pre-school children.
We will:

• watch how your child eats and drinks
• check their feeding position
• look at what textures they can manage (like smooth or lumpy foods)
• see how well they can swallow and how their mouth and body work together during feeding

For school-aged children, we may visit them at school.
If we visit you at home, please have some food and drink ready for the appointment (we’ll tell you what to prepare in advance).

Where will we see your child?

Most children are seen at home, but we can also visit nursery, school, or childminders. For school-age children, we may see them at school. We’ll decide the best place for us to see your child with you.

After the first appointment

We may talk with other people who support your child (for example, doctors, health visitors, or other therapists). We will make a plan together to help your child eat and drink more easily and safely. Sometimes we may need to refer your child for more tests (for example, an X-ray to check swallowing)

How often will you see us?

We’ll agree with you how often your child will be seen. It depends on their needs and how they are doing. Follow-up appointments might be:

• in person
• over the phone
• on a video call

We’ll keep checking their progress and update the plan as needed.

Who do we work with?

We often work with other professionals, like:

• doctors and paediatricians
• dietitians
• health visitors (PHINS)
• GPs
• teachers and school staff
• physiotherapists
• occupational therapists

How can you help?

• Follow the advice and use the strategies we give you, this helps your child improve faster
• Make sure your child attends their appointments
• Let us know if your contact details or GP change

If you are concerned about your child’s eating, drinking or swallowing, please discuss with your child’s health visitor, GP, paediatrician or school. They will then be able to complete a referral to our team if this is appropriate

Useful websites

• Start for Life (NHS): Videos and tips on feeding babies and toddlers
• Infant and Toddler Forum: Nutrition and weaning help
• Bliss: Info on feeding premature babies
• Child feeding guide: Tools for fussy eating and happy mealtimes
• Royal College of Speech and Language Therapists (RCSLT): What is dysphagia
• International Dysphagia Diet Standardisation Initiative (IDDSI): Standards to describe food and drink textures for safety

Specialist speech and language therapists work alongside colleagues from the ICAN service.

We are specialist speech and language therapists (SLTs).

We help children with complex needs who attend a SILC who have trouble eating, drinking and swallowing safely.

We’ll usually start by calling you on the phone. During this call, we’ll ask some questions about your child’s feeding and may give you some advice right away.

What happens at the first appointment?

The first appointment is usually in school but could be at home.

We will observe your child having a meal in order to:

• watch how your child eats and drinks
• check your child’s feeding position
• look at what food and drink consistencies they can manage (like smooth or lumpy foods)
• observe how they pace their eating or drinking
• see how well they can swallow and how their mouth and body work together during feeding
• assess for signs of food or drink going down “the wrong way” towards the lungs (aspiration)

Where will we see your child?

Most children are seen in school, but we can also visit at home. We’ll decide the best place for us to see your child with you.

After the first appointment

We may talk with other people who support your child (for example, school staff, school nurses, doctors, or other therapists).

We will make a plan together to help your child eat and drink more easily and safely. Sometimes we may need to refer your child for more tests (for example, an X-ray to check swallowing). We usually write recommendations in a feeding plan or feeding mat for school or other settings to follow. We will also contribute to your child’s EHCP.

How often will you see us?

We’ll agree with you how often your child will be seen. It depends on their needs and how they are doing. Follow-up appointments might be:

• in person in school
• over the phone
• on a video call
• a home visit after school or during a school holiday

We’ll keep checking their progress and update the plan as needed. When your child’s feeding needs are stable and the feeding plan is in place, it may be appropriate to discharge your child from our service. However, it will be important that everyone feeding your child continues to follow the plan. Your child can be referred back to our service if there is a change to the way they eat, drink or swallow.

Who do we work with?

We often work with other professionals, like:

• teachers and school staff
• inclusion nursing service (school nurses)
• doctors and paediatricians
• dietitians
• physiotherapists
• occupational therapists
• GPs

How can you help?

• Follow the advice and use the strategies we give you to keep your child safe and well.
• Contact us if there is a change in your child’s feeding
• Make sure your child attends planned appointments
• Let us know if your contact details, GP or school change

If you are concerned about your child’s eating, drinking or swallowing, please discuss with your child’s school nurse, GP, paediatrician or school. They will then be able to complete a referral to our team if this is appropriate.

Useful websites

• Child feeding guides: Tools for fussy eating and happy mealtimes