Feeding Evaluation Prep Kit
Bring a Clear Picture of Feeding to the First Visit
Check what you notice, jot a few notes, then print. The kit follows the 10 areas a comprehensive feeding evaluation covers, adds a 3-day feeding log, and lists questions worth asking.
Reviewed October 24, 2026 · Free to use · Bookmark it for next time
Your answers stay on this device. Nothing is sent to Integrative Wellness & Therapeutics or anyone else.
What You Notice, by Evaluation Area
Check anything you see often. Leave the rest blank; the evaluation fills in the full picture.
What to Record at Home
A short phone video shows a feed the way it really happens at home. Helpful clips:
- A typical feed or meal from start to finish
- A side view of the latch or bottle position
- Your child working on a food or texture that feels hard
- Any coughing, gagging, or breathing changes, if they happen on their own
3-Day Feeding Log
Print this page and fill in a few feeds or meals a day for three days before the visit.
| Day and time | Breast, bottle, or food | Amount | How long | What you noticed |
|---|---|---|---|---|
Questions to Ask at the Evaluation
- Which of the things I noticed matter most for my child's feeding?
- What is the plan: therapy, a home program, a referral, or a combination?
- What can we practice at home between visits?
- Who else should be part of the care team, such as the pediatrician or a lactation consultant?
- What changes would tell us the plan is working?
When you're ready, learn about pediatric feeding therapy.
Sources and How This Tool Works
The checklist follows the 10 areas of the comprehensive feeding evaluation at Integrative Wellness & Therapeutics, as described by Dr. Samantha Heidenreich, OTD, OTR/L, IMSC: medical and feeding history, feeding comfort and efficiency, oral structures and movement, sucking and swallowing coordination, gross motor skills and postural control, fine motor skills, reflex development, sensory responses and emotional comfort, developmental feeding skills, and possible swallowing concerns. The checklist records what a parent notices; it does not score or diagnose.
- Integrative Wellness & Therapeutics — Tongue-tie insight: the 10-point evaluation (clinical review: Samantha Heidenreich, OTD, OTR/L, IMSC) Link
- Integrative Wellness & Therapeutics — Pediatric Feeding Therapy Link
General information for families, reviewed October 24, 2026. It does not diagnose, and it does not replace an evaluation by your child's own clinicians.
Questions about feeding, speech, or development? Our therapists can help.
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