Sometimes specializing within your field requires more than taking a class or two in college. Speech-language pathologists (SLPs) who want to work with children with feeding disorders need continuing education.

"Conferences and workshops are available nationwide and often in the Twin Cities area, providing clinicians who work with children with feeding and swallowing disorders the opportunity for continuing education," said Mary Huschle, an SLP who specializes in treating pediatric feeding disorders at Hennepin County Medical Center (www.hcmed.org).

Organizations that stage the conferences and workshops include Continuing Education Programs of America (www.cepauniversity.com) and Professional Development Programs (www.pdppro.com). The American Speech-Language-Hearing Association (www. asha.org) has more information about becoming a speech-language pathologist. Feeding therapy jobs may be found in hospitals, nonprofit clinics or private clinics.

Why is this happening?

The reasons for feeding disorders may be complex, according to Huschle. Newborns may have trouble swallowing due to breathing problems. Older infants may have difficulty transitioning to baby food, table food or drinking from a cup. A diagnosis of cerebral palsy, Down syndrome or autism may cause or contribute to the problem, but often there is no diagnosis, Huschle said.

"Feeding is very emotional and if an infant or child is having trouble growing, that can be terrifying for parents," she added. "Parents may have a tendency to force-feed out of fear. That almost never works well."

If the problem is sensory, as in autism, the child may not even want to touch food or get their hands messy. SLPs then have to teach not only the children but the parents how to approach feeding without fear.

Liz Oesterreich, SLP, feeding clinic coordinator at the nonprofit Fraser Child & Family Center in Minneapolis (www.fraser.org), said she's decided to feeding issues because it's such a big part of a child's well-being and quality of life. She enjoys working with other professionals such as occupational therapists and psychologists to help an entire family with mealtimes and social interactions.

Must practice patience

Most of Oesterreich's feeding patients are children with autism ages 2 to 7, although some are preteens and teenagers. "It's typically a slow process," she said. "There are some kids who will progress very quickly, depending on how many foods they have in their diet and how many we're looking to add."

The program may last 12 weeks to a year, with indefinite follow-up. "We've found that it can take multiple exposures for a child to either accept a food or reject a food and that's based on how the brain wires for different pathways," Oesterreich said. "It's very dependent on the child. You're reading their signals constantly ... It's really rewarding when you see progress."