Swallowing is one of the most complex movement patterns that people must use accurately throughout the day and night from the time they are born. These movement patterns are very closely integrated with breathing and movement of food through the aerodigestive tract. Malalignment or dysfunction in any part of these integrated patterns and systems can cause serious complications for successfully using or advancing skills involved in swallowing, breathing, and digestion. This then affects the breathing pattern and the shoulders and head, which influences the alignment of the oral and pharyngeal structures of swallowing and the abdominal muscles, affecting transport of the food through the digestive tract. Postural alignment is one of the first pieces of the feeding and swallowing puzzle that needs to be addressed. Often people don't fully understand the importance of this and end up asking how it relates to their child with feeding issues. Children with feeding difficulties compensate for weak trunk muscles by overexerting other muscles and developing compensatory patterns that are less efficient, making it difficult to build future swallowing skills. A typical presentation of a child with feeding difficulties may consist of weak abdominal muscles that are not able to stabilize the lower end of the rib cage or provide support for an upright posture and controlled, straight, and rotational movement patterns. Thus, the authors state that successful treatment of feeding problems must include an evaluation of posture, tone, and movement patterns that provide the basis of support for coordinated breathing, safe and efficient swallowing, and easy movement of food through the digestive tract. The treatment program must have a dynamic component to lengthen and strengthen structures for maximal alignment and control as well as a static component of proper seating to provide alignment and support during meals so that the refined patterns of the mouth and the swallow mechanism can be accurately practiced.