1. Feeding difficulties are common in typically developing children as well as those with developmental delay.   The high prevalence in typically developing children suggests that for many children feeding difficulties are in fact part of normal development.
2. The types of feeding difficulties experienced by children with developmental delays are similar to those of typically developing children.  However the number of problematic feeding behaviours, their extent and duration, may well be greater.
3. Learning to eat involves a complex interplay between a child’s social and emotional development, physical, sensory and oral motor development, communication and cognitive development and their mealtime environments.  Disruptions in any of these domains have the potential to contribute to the development of feeding difficulties.
4. Learning to eat generally parallels other areas of a child’s development.  This process may take 3-4 years to complete.  It is supported by:
   1. Repeat experiences that increase acceptance of new foods and provide opportunities for practising skills.
   2. Graded experiences that promote progression in skill development. 
5. Typical feeding development provides a framework for managing feeding difficulties ranging from mild to complex.  Children with developmental delays learn in a similar way to typically developing children however the acquisition of new skills is likely to take longer, requiring a greater number of repetitions and more slowly graded experiences.
6. Learning to eat and the management of feeding difficulties is also supported by a  mealtime environment based on a reciprocal feeding relationship where:
   1. Parents decide: the what, when and where of feeding and
   2. Children decide: how much they will eat or if they will eat at all.
7. The assessment and management of feeding difficulties considers the mealtime experience from both the child and parents perspective.  A goal for all children with feeding difficulties is that mealtimes be a time for social interaction and enjoyment.
8. The impact of feeding difficulties on growth is variable.  Adequate growth does not exclude the possibility of feeding difficulties associated with micronutrient deficiencies or mealtime behaviours that have a negative impact on child and family relationships.
9. Children with complex feeding difficulties may benefit from an interdisciplinary approach to management.  The health professionals involved will vary from child to child according to individual need and the contributing factors.
10. Factors contributing to the development of feeding difficulties vary for every child.  Typical feeding development provides the template for management but strategies will vary for each child and family.  No single approach or method can be applied universally to all children. 

Solutions to feeding difficulties lie in considering the whole child and their environment and the interrelationships between the two.