Pediatric Feeding Disorder:
A Clinical Practice Guide (CPG) for Healthcare Professionals

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Pediatric Feeding Disorder (PFD)  A Clinical Practice Guide for Healthcare Professionals provides information, guidance and recommendations, to support healthcare professionals in making clinical decisions regarding the screening, assessment and management of children with pediatric feeding disorder. The guide was prepared for Alberta Health Services (AHS) by an expert clinical reference group under the auspice of the Maternal Newborn Child & Youth Strategic Clinical Network TM (MNCY SCN) and is aimed at achieving the best possible pediatric care throughout the province.

Key Principles

The guide reflects what is currently regarded as a safe and appropriate approach to the screening, assessment and management of children with pediatric feeding disorder (PFD). This document should be used as a guide, rather than as a complete authoritative statement of procedures to be followed in respect of each individual presentation. It does not replace the need for the application of clinical judgement to each individual presentation.

As in any clinical situation, and due to the heterogeneous nature of PFD, there are factors that cannot be covered by a single guide. Clinicians need to assess and develop individual treatment plans tailored to the specific needs and circumstances of the child and family. This guide should be read in conjunction with other relevant guidelines, position papers, codes of conduct, and policies and procedures, at professional, organizational and local levels.

Use of Guide

Senior Operating Officers and Directors should ensure:

  • This guide is adopted or local practices are developed based on Pediatric Feeding Disorder – A Clinical Practice Guide for Health Care Professionals.
  • Local practices are in place in all hospitals, facilities and community-based programs supporting children experiencing PFD.
  • All clinicians treating pediatric clients are educated and supported in the use of the locally developed pediatric practices.

Directors and Managers are strongly encouraged to inform relevant clinical staff treating pediatric clients of this guide.

Acknowledgements / Sponsors

We would like to dedicate this work to the patients and family members who we have the privilege of working with and caring for, and together are shaping quality healthcare for children with PFD across the province.

We would like to thank everyone involved in the PEAS project who contributed to this provincial effort. This includes members of the Project Team, Steering and Leadership Committees, various Working Groups, families, and key experts who reviewed the evidence and developed materials such as this Clinical Practice Guide.

We would also like to thank the MNCY SCN for ongoing support and resources through the Health Outcomes Improvement Fund II.


© 2023 Alberta Health Services – Maternal Newborn Child & Youth Strategic Clinical NetworkTM

This work, Pediatric Feeding Disorder (PFD) – A Clinical Practice Guide for Healthcare Professionals is adapted from the Office of Kids and Families New South Wales (NSW) document, Feeding Difficulties in Children – A Guide for Allied Health Professionals, and is reproduced by permission, (NSW) Health © 2016.

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International license. You are free to copy, distribute and adapt the work for non-commercial purposes, as long as you attribute the work to Alberta Health Services – Maternal Newborn Child & Youth Strategic Clinical NetworkTM and abide by the other licence terms. If you alter, transform, or build upon this work, you may distribute the resulting work only under the same, similar, or compatible licence. The licence does not apply to AHS trademarks, logos or content for which Alberta Health Services is not the copyright owner. To view a copy of this licence, see

This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. This material is not a substitute for the advice of a qualified health professional. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.

Revision History


Approved by

Amendment notes

Mar 31, 2020

AHS Maternal Newborn Child & Youth Strategic Clinical Network TM

New Clinical Practice Guide

Jun 6, 2020

PEAS Steering Committee

Minor additions: Table 9 and new Appendix on Early Infant Feeding Difficulties

Jan 19, 2021 PEAS Steering Committee Update to use Pediatric Feeding Disorder and oral sensorimotor terminology and minor updates to terminology in Table 8.

May 11, 2023

PEAS Steering Committee Jurisdictional scan and literature reviews completed. Updated sections related to relational feeding and the neurorelational framework, screening, assessment, facilitating safe swallowing, sensory processing, and enteral nutrition. New sections included surgical management, home blended feeding, enteral nutrition administration, tolerance, and weaning.

It is intended that this guide is updated every three to five years in order to reflect any changes in evidence related to the screening, assessment and management of children with PFD.