Feeding Your Child with Special Needs

 

Recognizing Feeding Problems

Effective feeding requires coordination of sucking, swallowing and breathing. An infant or child must be willing to accept various taste and textures into his mouth. A child must have the ability to position in a sitting position that is stable and must have the attention span and appetite necessary for feeding. Various medical conditions such as gastroesophageal reflux, food allergies, the impact of certain medications on taste/appetite, oral sensory aversions and chronic constipation can impact a child’s eating.

Signs that your child may have a feeding problem include:

  • Choking or gagging when feeding
  • Having chronic respiratory problems or repeated pneumonias
  • Excessive spitting up or vomiting
  • Requiring a long time to feed
  • An infant becoming exhausted or excessively sweaty when feeding
  • Eating on a small amount during feedings
  • Having a poor appetite or not indicating when they are hungry (e.g. a baby frequently sleeping through feeding time)
  • Not progressing to baby foods, finger foods and table foods at expected ages or refusing to accept a variety of foods
  • Poor growth

What Can You do?

If you have concerns about your child’s eating, speak with your child’s health care provider. They can review your child’s typical diet, eating behaviors, growth pattern and medical condition. If there are concerns, your child’s primary care doctor may have some suggestions or may refer your child to a specialized provider such as a feeding therapist, gastroenterologist, dietician or specialized feeding program depending upon the specific concerns.

Feeding Challenges and Solutions

Your child refuses to eat what is offered at the family meal: Don’t become a “short order cook” for your child. Include within your meal plan something that you know your child will typically eat. Do not expect that your child will like everything at the table or that he should try everything that is on the table. You cannot make your child eat (do not offer your child bribes to eat), but you can set expectations with regard to how long your child stays at the table with your family, when the next meal/snack will be offered and what foods are available to your child between these meals and snacks (e.g. a fruit). If your child is generally well nourished and healthy, missing a few meals to learn that you won’t cook special items in response to their refusal to eat is something their health can tolerate. Most children will learn to eat with the family and will grow well. However, there are some children, such as those with severe sensory concerns, where this situation is more challenging and guidance from a feeding or behavioral specialist may be needed.

Your child only eats a few foods: This can be very challenging and can cause families to worry if their child’s diet is adequate in nutrition. Being role models of dietary exploration can be helpful. For some children, involving them in choosing foods and cooking may be helpful. It is not helpful to bribe the child to taste or try other foods. Nor is it helpful to restrict the child from the foods he/she likes beyond structuring family meal times which offer an appropriate selection of foods (see above). It is helpful to expose your child to a variety of foods by having the foods present at family meal time, having the child see others in the family eat and enjoy the food, and perhaps including a small amount of the food on your child’s plate with no specific expectation that they will actually taste or eat it. Including foods that are similar to what your child likes but slightly new/different will also encourage them to expand their diet. It is important for children to see foods over and over for them to accept them as opposed to trying everything in sight hoping your child will find something they like. In some situations, choosing “target” foods which will be in the family meal a couple times a week for several months may allow a child enough exposure to accept the item. Most children will broaden their diets with this approach; however some children can have very challenging eating situations and in these cases support of a feeding therapist may be helpful.

Meal times lack structure: It is important for a child to have set meals and snacks as opposed to grazing through the day. Grazing can be associated poor weight gain in some young children (because they are never hungry at meal time) or with excessive weight gain in others. It is also important to limit external distractions (e.g. TV, texting, games) during mealtimes. Eating while watching TV has been linked to excessive weight gain. Having regular meals with family allows for communication which has been shown to enhance outcomes. Set expectations for where your family will eat, how long children will join the family at the table (these expectations should be consistent with the child’s age and attention span) and what behaviors are acceptable during meal time (e.g. no whining, fighting). 

Find Support

Are you looking for someone to talk to about your child’s eating habits?

Visit the My Child Without Limits support community and talk to fellow parents and caregivers about what worked for their children.