Diagnosis and


Understanding the underlying causes of your specific feeding challenges allows for accurate diagnosis and for the establishment of an individualized plan designed to support safe, and positive, feeding experiences.


A dual certified feeding specialist and lactation counselor will help with all of your breastfeeding concerns. Commonly addressed topics include establishing and maintaining a strong latch, milk production and adequate intake, and nipple/breast pain. Compassionate care and support are provided for mothers struggling with breastfeeding challenges with concern for both baby and mother.


Guidance in bottle and nipple selection is provided with attention given to your baby’s individual feeding skills and needs. In addition to working collaboratively with you to establish successful bottle feedings of expressed breast milk or formula, we are knowledgeable about special formulas that may be prescribed by your medical care team.


When is my baby ready? Setting your child on a path for successful feeding experiences throughout their lifetime is our long term goal. We are here to help you understand your baby’s readiness for managing different solid consistencies and to provide strategies for any challenges you may encounter. Education is provided on self-feeding, cup drinking, and optimizing positive food exploration.


When oral feedings are not sufficient, or safe, for a child’s healthy growth and development, tube feedings may be established to meet those essential needs. Whether your baby is exclusively tube-feeding or receiving some of their nourishment by mouth, we are here to help you achieve your feeding goals. We will work closely in collaboration with your medical team to guide you through formula selections and feeding schedule decisions to maximize opportunities for safe and successful oral feedings.


Concerned About Your Child’s Feeding?

Signs and Symptoms of Feeding Difficulty

  • Back arching and pulling away from breast or bottle

  • Irritability or reduced alertness during feedings

  • Difficulty coordinating breathing and feeding

  • Refusal to eat

  • Unusually long feeding times

  • Frequent spitting up, vomiting, or excessive drooling

  • Liquid or food spilling out of the mouth or nose

  • Cough, choke, gag or “gurgly” vocal quality during/immediately after feeding

  • History of recurrent upper respiratory infections or pneumonia

  • Difficulty transitioning to solid foods or spoon feedings

  • Limited intake with less than expected weight gain or growth

  • Difficulty chewing

  • “Fussy eater” – resistance to eating foods of different textures, tastes, colors or temperatures

Common Causes (Etiologies)

  • Prematurity

  • Anatomical Anomalies (i.e. tongue-tie, cleft palate)

  • Gastroenterological Disorders (i.e. Reflux)

  • Complex Medical Conditions

  • Developmental Disorders

  • Oral Motor Weakness

  • Sensory Issues

  • Allergies/Food Sensitivities

  • Neurological

  • Genetic

There is a behavioral component to most feeding disorders. It is important to note that this behavioral component is often your child’s response to an underlying cause that has not yet been diagnosed. Once a proper diagnosis is made, all aspects including the behavioral component should be addressed in feeding therapy.

How Milk & More Feeding Therapy Can Help

Comprehensive Evaluations

  • Phone consultation to prepare for an initial evaluation

  • Obtain detailed medical, feeding, and developmental histories

  • Clinical assessment

  • Review evaluation results

  • Share impressions and provide recommendations

Individualized Treatment Plan

Recommendations may include:

  • Feeding/Swallowing Therapy

  • An objective swallow study – i.e. Modified Barium Swallow Study (MBS/VFSS) or Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

  • Consultation with a wider medical team (pediatrician, gastroenterologist, ENT, pulmonologist, cardiologist, dietician/nutritionist, etc.)

Counseling and Education

  • Ongoing support, guidance, and education for the family

  • Referrals to the appropriate professionals to meet your child’s overall developmental needs

  • Coordinate a cohesive team approach to your child’s care

Schedule an Appointment!

Working with Alisa in our pediatric clinic has been such a treat. She brings a high level of professionalism and huge breadth of knowledge to her work. She was adaptable, flexible, and collaborative. We all (staff and patients alike) benefited from her years of experience and consider ourselves lucky to have worked with her!

Pediatric Feeding Team Greenwich Hospital
For More Information…

Check out this questionnaire from our partners at Feeding Matters, "developed by internationally-recognized feeding experts to help you better understand your child’s feeding habits. By completing this questionnaire you will learn about typical feeding development, identify if there are any areas of concern regarding your child’s feeding, and be provided a method for discussing any concerns with your child’s physician."