Care and feeding of children with disabilities

Some disabilities can cause children to experience feeding difficulties:

• Children with feeding difficulties are at increased risk of becoming malnourished.
• Consult a health care provider if you have any concerns about your ability to feed your child, or if your child is having difficulty feeding, chewing or swallowing food.
• Seek immediate care at a health facility if your child is losing weight or displays warning signs, such as frequent coughing or tearing (crying) while feeding, jaw tightening that prevents feeding, fast breathing or wet-sounding breathing, excessive sweating, tiring quickly when feeding, or vomiting after feeding.
• Regular growth monitoring and feeding a variety of foods at each meal is important for all children, including those with feeding difficulties.

The following are solutions for three common feeding difficulties:

Difficulty controlling head or body

• A stable, upright position with support for eating and drinking is one of the most important factors for safe feeding. Make sure your child’s whole body is well supported so that she or he can focus on eating.
• If your child is floppy, provide support to her or his back and head using your body or a chair. Always keep the child’s head upright while feeding to prevent choking.

Persistent difficulty chewing or swallowing

• Difficulty chewing and swallowing can cause choking and can lead to illness. Consult with a health care provider and ask for specific feeding strategies for your child.
• Consider pureeing foods by passing soft foods through a sieve. It is easier for children to learn to control foods in their mouth and swallow if the foods have only one texture. Prepare foods in a texture that is easily managed by the child, matching the texture of the food to the child's abilities.
• Drinking water and other liquids may be difficult for some children, and pouring liquid into a child's mouth could lead to overfilling and/or coughing and choking. Start by offering small, single sips, pay attention to how the child is managing the liquid and follow the child's cues.

Difficulty self-feeding

• Spoons and forks with thicker handles are easier for children to hold and control themselves. Attach a rubber tube or piece of wood to the spoon handle to make it thicker.
• Bowls and plates with steep sides may make it easier for some children to scoop up food themselves. You can even create a special bowl from a clean plastic bucket.