If your child experiences any one of the Red List symptoms, or one or more of the Black List symptoms below, you should consult with
your medical professional and request a referral for a feeding and swallowing evaluation. These symptoms indicate significant risks for aspiration, obstruction, malnutrition, and feeding problems that could impact your child’s growth - social and emotional development, physical development and overall health.
Red List
Indicates significant risk for aspiration, obstruction and severe swallowing dysfunction:
Indicates significant risk for aspiration, obstruction and severe swallowing dysfunction:
___ Choking, coughing, gagging during feeding
___ Color changes: eyes water or turn red, color change to blue
___ “Sleep feed” or “dream feed” (when you put your baby to sleep or your baby falls
asleep in order to feed easier)
___ Vomiting or reflux (especially during mealtime or observed pieces of food in vomit)asleep in order to feed easier)
___ Traumatic choking incident
___ Stressful feeding, mealtime battles, child is difficult for everyone to feed, caregivers
dread feeding time
dread feeding time
___ Fear of swallowing
Black List
Indicates significant risk for feeding disorder often accompanied by a swallowing disorder:
___ Unable to transition to puree at 7 months
___ Continues to need baby food at 16 months
___ Does not consume most calories from table foods at 12 months
___ Consume more calories in liquids than solids at 12 months
___ Still dependent on bottle at 15 months
___ Does not eat more than 20 different foods at 12 months or 30 foods at 2 years
___ Avoids foods of specific texture, color or food group
___ Spits out food instead of swallowing
___ Over stuffs (places too much food in mouth and doesn’t clear mouth before adding
more food)
___ Swallows food before completely chewing
If you have concerns, please ask your physician for a referral to evaluate your child’s feeding skills and behaviors. Early and effective intervention is key to successful eating skills and swallowing skills. Contact us or feel free to call with any questions at 919-877-9800.
