Feeding therapy is a type of specialized support that is used to teach a child with sensory or motor challenges how to eat or improve how they eat. It focuses on building the physical, sensory, and behavioral skills they need for more successful mealtimes. It can be administered by a speech-language pathologist (SLP), an occupational therapist (OT), or both working together. While an SLP might focus more on swallowing and upper gastrointestinal dysfunction, an OT might take a whole-body approach that can also include swallowing difficulties and upper gastrointestinal concerns, as well as posture, sensory processing, adaptive equipment, and with advanced training, the evaluation and treatment of dysphagia.
Some children might need help feeling comfortable with new textures or building the coordination to chew and swallow safely, while others benefit from consistent routines and gentle encouragement. At its core, feeding therapy focuses on creating a calm, supportive environment where children can feel secure and build confidence around food.
To explore feeding therapy in more detail, we spoke with Joan Surfus, OTD, OTR/L, BCP, SWC, assistant professor of clinical occupational therapy at the University of Southern California’s Chan Division of Occupational Science Occupational Therapy, and owner of Surfus Pediatric Feeding and Occupational Therapy; and Marci Silver, MS, CCC-SLP, certified speech-language feeding pathologist and community outreach director at TheraPlay LA, and president/owner of Silver Speech. To get more insight from a funding perspective, we also spoke with Leslie Lobel, Undivided director of health plan advocacy; Lisa Concoff Kronbeck, Undivided public benefits specialist; and Lisa Carey, Undivided noen-attorney education advocate.
Feeding challenges can show up in different ways in children with disabilities. Some are noticeable early on, while others emerge as your child grows, and some feeding challenges go deeper and might need extra support. For more insights on what feeding challenges can look like in children with disabilities, what can be causing them, and other helpful tips for parents, head over to our article Feeding Challenges in Children with Disabilities.
When it comes to feeding therapy, there’s a whole menu of approaches — each designed to help children feel more confident and comfortable at mealtime. Here’s a look at some of the main types.
Medical and motor-based
This approach, as Dr. Surfus explains, focuses on helping children develop the muscle strength, coordination, and body awareness they need for eating to feel easier and safer. Therapy might include posture work, oral-motor exercises, or tools such as weighted utensils and supportive seating. It’s often playful and hands-on, helping children build those physical skills at their own pace.
Medically complex
If your child uses a G-tube, has trouble swallowing (dysphagia), or faces challenges with eating due to physical or sensory issues, feeding therapy can still help — though the approach might be more specialized.
A key early step, especially for children with G-tubes, is working with a therapist who understands the reason behind the tube feeding. Dr. Surfus recommends finding a provider with direct experience in this area so the therapy can be tailored to your child’s specific needs. She explains, “Depending on the reason for the G-tube, you want a therapist who can address the underlying feeding needs.” This might include slowly introducing tastes and textures, building oral strength, or simply supporting safe and positive mealtime routines.
Therapy might include:
As the saying goes, it takes a village. A strong care team — including your gastroenterologist, pediatrician, and therapists — can help build a feeding plan that supports your child’s growth, safety, and confidence.
Behavioral
These approaches focus on the why behind food refusal or avoidance. Sometimes what looks like a behavioral issue is actually a response to discomfort, fear, or sensory overwhelm.
Dr. Surfus says, “One really needs to look at why the behavior is there.” Maybe a child had a negative experience with a certain texture or finds food too difficult to chew. “Children are pretty savvy — we have to really tune in and listen to them to figure out the why.”
Some behavioral programs might incorporate techniques from Applied Behavior Analysis (ABA), using structured reinforcement strategies to support food acceptance. However, critics point out that these approaches aren’t always child-led, may overlook a child’s sensory needs and emotions, and might not align with neurodiversity-affirming practices.
Silver also notes the importance of environment and relationships: “We look at how long it takes to feed a child, what kind of chair they’re sitting in, and the relationship between the person feeding them and the child.” One gentle strategy is offering a “no thank you” bucket, so children can feel in control while still participating in mealtime.
Sensory-based
Many children struggle with how food feels, smells, or sounds more than how it tastes. Sensory-based feeding therapy aids children who are sensitive to textures, temperatures, or other sensory aspects of food. Sensory (and motor-based) work is often used to promote positive mealtime experiences. For example, helping a child feel grounded in their body or more comfortable with texture.
Silver uses what’s called a “sensory-behavioral” approach. “Touching the food can first be on their hands, on their arms, and working their way up to the mouth,” she explains. “It’s a process — we don’t skip steps. We move up when the child is ready and back down if needed.” She encourages caregivers to let children practice each step and stay there until they’re ready to take a leap to the next.
Dr. Surfus adds, “Smell is especially tricky — it’s tied directly to our brain’s safety system.” That’s why therapy might start far away from the table, using playful activities to gradually help a child feel safer and more regulated around food.
Therapists often blend specific methods into their work, depending on a child’s unique needs. Silver emphasizes that flexibility is essential, as some techniques work better for certain kids than others. Sometimes it takes a mix to find the right fit. “We are all wired differently and our oral and nasal cavities, sensory and nervous system are all unique,” she says. They are all useful depending on the needs of the client,” she explains.
Here are a few widely used approaches:
Developed by Dr. Kay Toomey, the Sequential Oral Sensory (SOS) Approach introduces new foods gradually in a nonthreatening way, starting with touching, then smelling, then tasting. This method is especially helpful for children who are very selective eaters, are anxious around food, or have sensory processing differences. Rather than jumping straight to eating, kids are supported in interacting with food through a series of manageable steps. It’s a slow and steady process designed to build comfort and reduce stress for both the child and the family.
This approach uses structured exercises to build strength and coordination for chewing and swallowing. A therapist guides the child through targeted movements of the lips, tongue, cheeks, and jaw to support oral-motor function. It’s often recommended for children with weak muscle control; for instance, if they drool frequently, have trouble managing certain textures, or show delays in both feeding and speech.
This approach combines tactile, visual, and auditory cues to improve oral-motor coordination. Specialized tools such as straws, horns, and chewy items (used in programs such as TalkTools) target specific muscle groups to help build strength and improve coordination. Because the same muscles are used for both eating and speaking, OPT is particularly beneficial for children with low tone, hearing loss, or motor planning challenges. Therapy might include blowing exercises, sucking through straws, or chewing with resistance tools — all designed to give the mouth the feedback it needs to build skills.
Motor-based tools
Silver uses tools such as vibrating devices, chewy tubes, and the Myo Munchee to build jaw strength and oral awareness. These, along with mirror work, provide sensory feedback and resistance to help activate the muscles used for chewing and swallowing.
Responsive feeding therapy is a child-led, neurodiversity-affirming approach that centers on emotional safety, trust, and autonomy. Instead of pressuring a child to eat, therapists and caregivers work together to support a joyful, low-stress relationship with food. As Silver puts it, feeding therapy is more like a dance than a straight path — a step-by-step process that follows the child’s lead.
This model meets children where they are, using positive language and celebrating small wins, such as being near food, touching it, or eventually tasting. Dr. Surfus explains that this also means understanding the reasons behind food refusal — whether it’s due to sensory sensitivities, past negative experiences, or motor difficulties — and moving forward at the child’s pace, without skipping steps. Families are also coached on creating a calm mealtime environment and responding supportively to their child’s cues, helping build lasting trust around eating.
Mealtimes can be tricky for many children, and safety is always a top priority. Feeding therapists aim to create a positive, stress-free environment that helps children feel both physically and emotionally ready to eat, says Silver, who frequently uses mirrors in therapy to help children connect with their oral movements. “It’s amazing to watch them see their own mouth movements while eating,” she tells us. Silver notes that since our face is the only part of our body we cannot see, it’s essential for the child to see their lips, tongue, and jaw working together.
From an occupational therapy perspective, posture and motor skills are key building blocks for successful eating. Dr. Surfus explains, “Lower muscle tone can make it tough to sit upright or handle utensils.” She also highlights the importance of helping children explore new foods by addressing sensory factors such as smell, texture, and temperature. Feeding therapy often starts long before a child sits down for a meal. Rather than jumping straight to the table, therapists use play-based activities such as climbing, rolling, or engaging in messy play to help ease mealtime anxiety, regulate the sensory systems, and build the strength needed for tasks.
So, what kinds of challenges can feeding therapy help with? According to both Silver and Dr. Surfus, quite a few:
Feeding therapy adapts as children grow, from infancy through adolescence. It uses strategies designed to support their ongoing developmental progress. Early on, infants work on foundational skills for feeding, whether through breastfeeding or bottle-feeding, setting the stage for later progress as they grow.
Infants
As Dr. Surfus explains, “From the infant standpoint, it’s often helping them coordinate with breast or bottle and looking at: is the nipple the right shape, the right flow rate? Sometimes, the moms need help when maybe they’re breastfeeding, maybe their milk hasn’t come in, and the baby’s getting really, really frustrated because they’re not getting enough. Or sometimes they need a nipple shield on their nipple to help form the nipple, and the baby can suck better. Also, sometimes babies can have a tongue-tie, which, especially in infants, can impact how they’re able to suck.” With attentive support, feeding therapy helps infants develop a comfortable feeding rhythm while giving parents peace of mind throughout the process.
Toddlers and young children
For toddlers and young children, feeding therapy is designed to encourage independence and address sensory needs. At this stage, challenges tend to shift away from physical coordination and toward sensory sensitivities or behavioral patterns. As Dr. Surfus notes, “If it’s a sensory-based problem, there’s probably going to be a lot of sensory play and prep. And for the sensory-based children, I will often tell parents we’re not going to work on the actual eating until we have a really nice rapport, and that doesn’t take very long.” A safe and relaxed environment, whether at home or in a familiar setting such as a park, can also make a big difference for toddlers who might be more comfortable when they feel safe and supported.
Adolescents
With adolescents, the challenges might shift more toward long-standing restrictive eating patterns or unresolved sensory issues. These might not have been addressed earlier, and by this age, many children have developed their own preferences and might be more resistant to trying new foods. Dr. Surfus states that using cognitive behavioral strategies — such as helping adolescents understand food science and the characteristics of different foods — can make the experience of trying new foods less intimidating. By linking familiar foods to new options, therapists, in turn, guide adolescents in discovering new flavors and textures at a comfortable pace.
While the specific techniques used in feeding therapy evolve by age, the core goals stay the same: supporting each child’s development, helping them eat safely and comfortably, and restoring mealtime as a positive experience for both children and caregivers.
Understanding whether feeding therapy is a good fit starts with observing your child’s unique experiences around mealtime. There’s no one-size-fits-all checklist; instead, the process is about noticing what’s working, what’s not, and where a little extra support might help. The goal isn’t to rush or push, but to make eating feel easier and less stressful for both you and your child.
Where do assessments take place?
Feeding therapy assessments can happen either at home or in a clinic setting. Dr. Surfus notes that home visits are sometimes ideal, since many children feel more relaxed and comfortable in familiar surroundings. In clinical settings, she advises families to bring preferred foods, utensils, or dishes—especially for children who are particular about how food is served or what they eat from. This helps create a more accurate and supportive experience for the child.
How to start the process
Silver explains that many families begin by contacting a private clinic directly. At her practice, the first step is a discovery call to discuss feeding concerns, daily routines, and family goals. From there, the team determines whether the child might benefit more from occupational therapy, speech therapy, or a combination — depending on whether the issues appear more sensory or motor in nature.
Silver also notes that families can choose whichever path feels most comfortable to them as the first step, such as:
Families are asked detailed questions about their child’s sleep, breathing, eating habits, and feeding patterns. Some clinics also request videos of mealtimes at home, since children often behave differently in clinical environments than they do in familiar ones. Silver emphasizes that seeing how a child eats at home provides valuable insight into their needs.
What happens during the assessment?
A full feeding therapy assessment might include:
Dr. Surfus shares that assessments vary depending on the child’s needs but typically involve observing how the child moves, eats, and interacts with different types of food. In clinic settings, she looks at how the child uses utensils, scoops food, chews, and swallows liquids or solids. The therapist might ask parents to bring a variety of foods and feeding tools to see how the child handles different textures and situations.
Silver adds that her team often introduces foods across a range of consistencies, such as purees, meltables, crunchy items, and proteins, to observe how the child responds. They look for signs of difficulty, discomfort, or avoidance and assess whether the child uses utensils, self-feeds, or shows physical signs of aversion (such as gagging or turning away). Seating and positioning are also considered, especially if the child has negative associations with specific environments due to past feeding challenges.
What happens after the assessment?
Based on what they observe, along with input from the family, therapists determine whether therapy is needed and what kind of approach may be most helpful. This might include motor-based, sensory, behavioral, or blended strategies.
If therapy is recommended, as Silver explains, the next step often involves setting individualized goals tailored to the child’s specific feeding challenges. For some families, this might mean regular therapy sessions. For others, it could involve home strategies with periodic check-ins. She adds that her clinic also offers feeding intensives when appropriate and when they fit the family’s schedule.
Each feeding therapy session is crafted around your child’s unique needs. As Silver explains, therapists meet the child where they’re at. For example, if a child is sensitive to smells, the therapist might begin with a goal (such as tolerating the food 12 inches away and using their nose to smell it). It’s a highly individualized process — everything is tailored to the child’s comfort level. The goal is always to work toward functional eating at a pace that feels achievable for them.
Silver shares what a typical session might include:
Therapists recognize that feeding challenges affect the whole family, so involving parents and caregivers is a key part of therapy. Dr. Surfus explains that sessions often include coaching parents on understanding the child’s unique feeding needs, helping parents and caregivers recognize that feeding difficulties are not simply picky behaviors but meaningful struggles. She encourages parents to be strong advocates for their child, even if initial medical advice downplays the issue.
Silver highlights that therapy respects family culture and preferences, working closely with caregivers to set realistic, individualized goals. Parents learn specific strategies and steps to support feeding progress at home, from managing sensory sensitivities to promoting positive mealtime routines. The therapist guides families on how to reinforce skills between sessions and adapt approaches as the child grows and changes.
To help track progress and adjust goals, Silver’s team requires families to keep feeding logs not only before the first session but throughout the course of therapy. These records help therapists understand how children are eating across different settings and over time.
Examples of goals might include:
Silver notes that parents, caregivers, and even daycares are a huge part of the therapy process. Feeding happens at home, school, and in the community, and children often eat differently with different members of the family. She adds that factors such as the physical environment, energy, and the use of positive, negative, or no reinforcement all play a role in feeding, attachment, and progress. If needed, tele-health sessions are also available to support families in continuing therapy goals outside the clinic.
By building this partnership, therapists help reduce stress and empower families with tools and confidence to support their child’s feeding journey outside the clinic.
Understanding how feeding therapy and nutritional support work — and how they differ — can help you get the most effective care for your child. Feeding therapy focuses on building the physical and sensory skills children need for successful and enjoyable eating. Nutritional support, on the other hand, centers around creating meal plans that meet your child’s specific dietary needs — especially if there are concerns about growth, weight gain, or nutrient intake, which is led by registered dietitians and medical teams.
Feeding therapists and dietitians bring different — but equally essential — expertise to the table. While feeding therapists focus on the how of eating, dietitians focus on what and how much a child needs to grow and thrive.
For infants, according to Silver, this teamwork might involve tracking ounces and adjusting feeding strategies based on growth. As children transition to solids, a dietitian ensures meals have the right balance of nutrients — which is especially important for children with conditions such as reflux, anemia, or food sensitivities.
Formula, tubes, and specialized diets
For children who rely on nutritional drinks such as PediaSure or receive tube or IV feeding, this kind of collaboration is even more important.
The method, amount, and type of nutrition are highly individualized, based on each child’s unique medical needs. Even when a child has a very limited diet or relies heavily on supplements, a coordinated care plan ensures both nutritional and developmental needs are addressed. With the right support, families can move forward confidently, even if progress takes time.
Building a safety net for formula delays and shortages
Storms, recalls, or paperwork slip-ups can pop up when you least expect them — but with a little planning, those surprises become easy to handle rather than last-minute mealtime stress.
Keep a little extra on hand. Many providers send only a month’s worth of formula at a time — but in some cases, you can request a bit more for emergencies. Lobel shares a helpful example: when she needed a backup supply, she reached out to the dietitian at her formula provider, got a prescription from her doctor, and was approved for an extra month based on health and safety for emergency supply. Just be sure to rotate your supply (first in, first out) so nothing goes to waste. Lobel notes that while some families consider ordering a day or two early each month to build a backup, many providers won’t allow a refill until a full 30 days have passed. Still, she says it’s worth trying if your coverage allows. She adds that families may also be able to request an extra month for natural disaster coverage through their pharmacy manager or DME nurse.
Graduating from feeding therapy is a milestone many children reach, though the timing and experience vary widely. For example, Silver notes that while some children progress in a few months, others benefit from years of support to feel comfortable with eating and achieve balanced nutrition. It’s important to understand that “graduating” doesn’t always mean a child is eating everything; rather, it means they’re getting enough nutrition and developing the skills to keep making progress. In other words, graduating isn’t about becoming a so-called “normal” eater — it’s about having the confidence, self-awareness, and support to navigate mealtimes in a way that works for your child.
Dr. Surfus points out that parents often learn techniques to expand their child’s diet, recognize manageable foods, and understand how to position their child optimally for feeding. In fact, one key sign of success is when families feel confident managing mealtimes on their own — without needing constant professional support. Feeding therapy isn’t just about the child making progress — it’s also about equipping parents with practical tools they can use every day. Feeding is a complex skill, Dr. Surfus adds, and each child’s progress can depend on a range of factors. Some children do move forward and leave therapy behind, but for others, feeding might always come with challenges. However, the goal isn’t to have everything “fixed” perfectly, but rather to build enough confidence and skills to navigate daily eating. Not every child “graduates” in a traditional sense, and that’s completely okay. That doesn’t mean progress isn’t happening — for some families, feeding therapy might continue over time or reappear at different stages of development.
Is it okay if a child doesn’t “graduate?"
When a child continues facing feeding challenges, it doesn’t necessarily mean they aren’t making strides. Some children, Silver notes, might always find feeding somewhat tricky, and that’s completely okay. Therapy can help them express their needs and find enjoyable ways to engage with food. In fact, some children even develop a passion for cooking or exploring new tastes, which can turn those feeding challenges into a personal strength.
Moreover, Dr. Surfus adds that ongoing feeding needs don’t mean a child is “stuck.” Many families reach a point where they feel equipped to manage feeding comfortably, even if some difficulties remain. In fact, Dr. Surfus states that sometimes, parents come back for a check-in or “tune-up” to review strategies or get advice on introducing new foods as their child grows. Not every child needs therapy every week, but having occasional check-ins can make a big difference in keeping up their progress. More than anything, feeding therapy is about giving families tools they can adapt as their child’s needs change over time.
Wondering if your child might need feeding therapy? Whether your child struggles with picky eating, has trouble chewing or swallowing, or just doesn’t seem to enjoy mealtimes, it can be tough to know where to start. Finding a feeding therapy provider can help you get clarity and create a plan that works for your child and your family. From low-pressure discovery calls to outpatient clinics and even in-home support, there are a range of options to explore. Here’s what to know as you take those first steps toward getting help.
A great first step is scheduling a discovery call with a feeding therapy provider, such as TheraPlay LA. These initial calls, says Silver, are low-pressure and give you a chance to talk with a professional about your concerns. They can help guide you toward the right next steps for your child, whether that’s an evaluation, occupational therapy, physical therapy, working with a nutritionist, or consulting a GI or ENT doctor. Their goal is to support you and help your family find the path that fits best.
Silver also notes that pediatricians do refer families to feeding specialists or other professionals such as occupational, physical, and speech therapists, as well as special educators and developmental pediatricians. However, some of these providers may not specialize in oral motor feeding or myofunctional therapy.
It can also be helpful to bring up feeding concerns with your child’s pediatrician. Sometimes, if a child isn’t underweight, doctors might brush off feeding challenges. But Dr. Surfus encourages parents to trust their instincts. You know your child best, and if mealtimes are consistently hard, it’s worth raising the issue again. Don’t be afraid to step into the advocate role for your child — asking questions and pushing for support is part of being a strong parent.
As you start exploring options, it’s completely normal to want to learn about a therapist’s background, their approach, and how long therapy might take. Keep in mind that feeding therapy is often a gradual journey, not a quick fix. Still, those small victories along the way can bring meaningful relief and hope. Finding the right therapist means balancing experience with a good fit — someone who clicks with your child and understands your family’s needs. Dr. Surfus encourages parents to ask questions and take their time finding someone who feels like the right match.
For families needing more comprehensive support, outpatient feeding clinics are a common option. These clinics are often part of children’s hospitals or rehabilitation centers. In addition to outpatient clinics, private therapy providers and early intervention programs are also common routes. Dr. Surfus recommends starting by consulting your child’s pediatrician for a referral or prescription if necessary. After compiling a list of providers, reach out to inquire about their qualifications, services, and wait times, especially if your child has specific needs such as swallowing difficulties. Families might prioritize faster access or choose to wait for a highly recommended provider.
In some cases, yes, as Dr. Surfus notes. This is especially common for young children receiving services through early intervention programs, though in many cases, services can continue beyond age three if the child qualifies. Availability can vary, and if an in-home therapist isn’t available, families might be referred to a local clinic instead.
Some private therapists also offer home-based services, depending on their practice model, your location, and your insurance coverage. While some providers regularly travel to clients’ homes, others might work only from their clinics. Telehealth is another option. While it’s not always considered the most effective for feeding therapy, it can be a valuable alternative for families without access to local providers. It’s important to ask early on about home visits, telehealth availability, and what insurance options are accepted.
Accessing feeding therapy through the school system can be challenging. As Concoff Kronbeck explains, “Schools are not really in a position to be treating medical issues.” While some feeding-related support might be written into a student’s Individualized Education Program (IEP) or 504 plan, full feeding therapy — especially for complex needs such as oral-motor or swallowing issues — typically isn’t available in most public schools.
Carey adds, “I’ve never heard of anyone getting feeding therapy at school. It’s not a service that I believe you can get at school, unless you’re in a specialized school.” Feeding therapy is generally a medical intervention, handled by external providers.
That said, schools can still play a supportive role. Concoff Kronbeck notes that practical help, such as opening containers, maintaining consistent mealtime routines, or assigning a trained aide during lunch, can make a big difference in a child’s daily experience, even without medical therapy.
Dr. Surfus suggests packing foods your child is most likely to eat, even if they’re not perfectly balanced. “There are good reasons for the foods parents pack,” she explains. “It’s about ensuring your child has something to eat, even if it’s not the most balanced option.” The goal is to provide some nutrition throughout the day while working on long-term support.
Supporting medically complex children at school often requires collaboration. Silver explains that while schools can help with daily feeding tasks — especially when a nurse is involved — specialized feeding therapy is typically provided by healthcare providers or private clinics. While schools might assist with tasks such as helping a child eat safely, more advanced feeding interventions are generally outside the scope of special education services.
Some schools have on-site nurses or dedicated nurses for individual students, but finding the right support can be challenging. Dr. Surfus advises having proactive discussions with the school about your child’s needs. If your child requires specialized care, be sure to ask who will provide it and what their qualifications are.
Concoff Kronbeck adds that school districts are responsible for ensuring the health and safety of students with medical needs, including those using G-tubes or other durable medical equipment (DME). If a student needs a licensed vocational nurse (LVN) for feeding, catheterization, or other medical tasks, these requirements should be included in the student’s IEP and health plan.
Lobel’s experience with her daughter offers a powerful example of how collaboration can make a difference: “Before my daughter used the G-tube, she was an unsafe eater, and during the years when she was an unsafe eater, what I put into her IEP was not that someone would work with her on swallowing, because that was not my goal. My goal was that the same person fed her at school every single day — the same person — because my daughter was nonverbal, so you needed to pick up on cues from her when she was finished eating. That way, you didn’t keep putting food in her mouth when she wasn’t hungry, and you didn’t put food in her mouth that she didn’t wind up swallowing and choking on later. So I put into the IEP that one special person would feed her every single day.”
Later, when her daughter transitioned to G-tube feeding, Lobel continued to work closely with the school. She brought in everything her daughter needed — from food to equipment — while the school nurse trained staff to feed her safely and on time. It’s a great reminder that open communication and teamwork can really make a difference in meeting a child’s individual needs.
If you’re considering adding feeding therapy to your child’s IEP, be aware that support varies widely by district. Silver notes that some schools don’t view feeding therapy as part of the educational experience, which can be frustrating for families navigating support for a basic daily function. Even when families succeed in getting an evaluation approved, finding a credentialed provider to actually deliver therapy within the school setting can be another hurdle.
Dr. Surfus emphasizes the importance of challenging the idea that feeding isn’t educationally relevant. As an occupational therapist, she believes feeding absolutely impacts a child’s ability to participate in school, citing effects on attention, behavior, and engagement. She encourages families to push back when school teams say feeding is “just a medical issue,” reminding parents that IDEA does allow room for interpretation and that sometimes informed advocacy can make a real difference.
Whether you’re navigating school-based support or seeking private services, it helps to know where to begin. Start by consulting your pediatrician, who can help with a referral or prescription, often a requirement for services. If you’re pursuing feeding therapy through insurance, Silver recommends asking for the appropriate Current Procedural Terminology (CPT), ICD-10 diagnosis, and procedural codes up front to clarify coverage.
When evaluating therapists, Dr. Surfus encourages parents to ask about experience and training, even if it feels awkward at first. “Some therapists, sometimes they’re put off by that. ‘Well, they wanted to know my background.’ Well, of course! If that were my child, I’d be asking about my therapist’s background too. So parents should feel empowered to ask those questions and make sure they’re comfortable and have a good fit for their child’s needs.” This kind of open dialogue helps ensure a strong match between the therapist’s background and your child’s specific challenges.
For children whose feeding needs involve medical safety or routine health care at school, such as tube feeding, dysphagia management, or severe food allergies, an Individualized Health Plan (IHP) may be appropriate. This document, usually developed by the school nurse in collaboration with families and providers, outlines how a student’s health needs will be supported throughout the school day.
Both Silver and Dr. Surfus acknowledge the importance of this kind of school-based support. Dr. Surfus notes that students with feeding tubes are often assisted by a school nurse or, in some cases, a private nurse who accompanies the child throughout the day. These arrangements, including who performs the feeding, how often, and under what safety guidelines, are typically detailed in an IHP.
An IHP might include:
Although not federally mandated like an IEP or a 504 plan, an IHP can complement those documents and offer an added layer of safety and clarity. For students whose feeding challenges impact their ability to safely access education, elements of the IHP may also be reflected in their IEP or 504 plan.
Families can request an IHP through the school nurse or district health coordinator. It’s helpful to come prepared with documentation from your child’s medical team and to ask how feeding-related accommodations can be integrated into existing educational plans when necessary. Every family’s journey looks different, but the goal is the same: to secure the right support and advocate confidently for your child’s well-being at school, at home, or both.
Finding the right feeding therapy can be complicated, particularly when it comes to determining what services are covered, where to start, and who provides them. As Dr. Surfus and Silver explain, there’s no universal approach. However, with the right information, you can navigate the system to find the best solution for your child.
Getting insurance to cover feeding formula can take some patience — it often depends on the child’s medical needs and the specific provider. Concoff Kronbeck explains that insurance is more likely to cover formula when it’s deemed medically necessary — especially if the child is being fed via a G-tube or has a condition that impacts growth or nutrition. Lobel adds that some insurance plans may cover medical foods delivered via G-tube, as well as specialty formulas deemed medically necessary for specific diagnoses. However, if a child is not fed via G-tube, coverage might require additional justification from a medical professional. Families might need to advocate strongly and work with their care team to demonstrate medical necessity.
Lobel expands on this by highlighting the importance of finding the in-network contracted provider for medical formula and supplies — often a specialty pharmacy, such as Coram (part of CVS). Insurance typically covers formula and related supplies through these providers, but there are challenges. Many insurance plans maintain a formulary (a list of preferred products), and if your child needs a formula not on that list, approval might require clear medical justification — such as an allergy to soy, which is commonly used in lower-cost formulas. In such cases, documentation from your doctor is essential.
In addition to the formula itself, accessories — such as tubing, syringes, extensions, feeding pumps, and pump supplies — might also be covered by insurance. This varies by plan, so families should confirm coverage for these “expendables” with their provider.
Note: for newborns who are in the NICU, some insurance plans may be willing to cover the rental of a hospital-grade breast pump, particularly if the child is tube-fed.
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