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It is the natural instinct of a mother to feed her child from
birth to infancy and onwards. If a child refuses food or has
difficulty with eating, it can leave parents feeling very anxious,
helpless and frustrated.
The child may:
If your child is having problems eating, it is important you
seek help from a health professional who can check for possible
medical causes as well as provide advice on how to deal with the
Many new babies experience initial problems, and this does not
imply they have a long-term medical condition. Problems with
sucking can occur with certain conditions such as cleft palate and
cerebral palsy. This problem will be apparent very early on, and
staff on the maternity ward, the midwife or a health visitor should
all be able to offer suggestions.
This is the process when a young child moves on from drinking to
eating solid food. Some children find it harder to chew solid
foods, so moving from milk to semi-solids to solids is harder for
them. However some babies who find sucking difficult find eating
semi-solid food easier, so may thrive better when weaned. A health
visitor can advise on this.
This occurs during feeding when the child immediately 'locks'
the mouth onto anything that is introduced into it. The child is
not doing this deliberately. A speech and language therapist can
advise on techniques that may help, and a plastic spoon will lessen
the chance of injury to the mouth or damage to the teeth.
Regular choking can cause considerable anxiety for both the
child and the carer. A doctor, health visitor, physiotherapist or
speech and language therapist should be able to advise how to
prevent choking and what actions to take if it does occur.
This is when a child is unable to open his or her bowels. It can
be caused by an underlying medical problem, not eating enough of
certain types of food, not drinking enough liquids or the
consequence of reduced mobility. A health visitor, a paediatrician
or the child's GP should be able to help.
Difficulties in feeding can be because of the way teeth close
together or as a result of pain caused by a dental problem. It can
be more difficult to keep a disabled child's teeth clean. Frequent
check ups at the dentist are recommended, and it may be necessary
to go to a community dentist, who has experience of dealing with
disabled children and has special equipment.
This is when food that has been swallowed comes back up into the
oesophagus tube that goes into the stomach. This can cause
discomfort both during and after eating and may cause vomiting. It
should always be investigated by a doctor who can advise on
Frequent vomiting may be distressing for all concerned. Where
the child is physically disabled, this may be improved by changing
the child's position and avoiding lying down too soon after eating.
If it persists, seek advice from your health visitor or GP.
It can take longer for a disabled child to learn to feed
themselves, but as they get older most children prefer to be able
to do this and find depending on others frustrating. It may take
time and effort to help a disabled child to develop these skills,
but it will help them in other areas such as language development,
mobility and hand-eye co-ordination.
Most babies can be fed with the ordinary spoons designed for
young children and readily available in high street stores.
As children mature and begin to attempt to feed themselves,
there are a number of utensils that may help. Special plates,
bowls, cups, adapted cutlery and non-slip mats that help to keep
the dish in place are all available, as are specialist bibs to help
keep food off clothing. An occupational therapist can advise what
would be most appropriate.
A nourishing and well-balanced diet is important for staying
healthy. Health visitors and dieticians can advise on suitable
diets. If there is a problem in chewing and swallowing then a
speech and language therapist can advise on suitable food textures
and consistency. This should help increase the range of food the
child will take.
Sometimes it is necessary for babies and children who are not
able to suck or swallow adequately to get proper nutrition to be
fed by tube.
A Naso-gastric tube (NG tube) is inserted into
the stomach and is passed up the nose into the tube leading to the
A gastrostomy tube is placed through a small
incision in the abdomen directly into the stomach. This involves
Eating together as a family
Sitting down as a family to eat a meal together helps children
learn appropriate eating behaviour. It is particular helpful to
children who have problems learning or listening as they find out
about appropriate behaviour by watching others.
Parents can find it difficult to organise regular family meals,
especially if other members of the family are coming and going at
various times. Always make sure at least one person sits with the
child while they eat, and try to organise family meals whenever
Decide a place for the child to sit at meal times
Regular routine at mealtimes helps the child understand what is
being asked of them. Try to choose a table and chair in proportion
to the child's size. Some parents choose to sit their child in
front of the television or video so they can be distracted whilst
eating. This may be a difficult habit to break and cause problems
if eating out. It may be better to use a more mobile distraction
that can be more easily moved to the main table, for example a
favourite toy or book.
Get the child into the right position
If your child is physically disabled, they may need supporting
so they are sitting in the right position. It is very difficult to
eat or drink with the head tilted back. Seek advice from a
physiotherapist or occupational therapist.
Warn your child when the meal is nearly ready
If a child is engrossed in an activity, they might have temper
tantrums if suddenly told to stop what they are doing and come to
eat. Warn the child the meal will soon be ready by talking to them,
giving signs such as laying the table or showing them pictures of
When introducing new food, intersperse it with food you know
they like. Don't force them to eat food they dislike. If the child
has sat at the table for a short time and eaten a little food, then
praise and reward them.
If they find it difficult to sit for long periods, you might try
timing your child sitting down by using a large egg timer, and
allow your child to move once time is up. This will give them a
visual link for 'sitting down time'. Over time you can gradually
build up the sitting down period. Again, don't rush things and
don't expect instant change.
Possible causes of problems
Try to identify what might be causing problems. Here are some
If your child really plays up at the table and even resorts to
spitting food on the floor, try not to give them a reaction as this
will only reinforce their behaviour and may encourage them to do it
again. This is not an easy thing to do. Never try to force food as
this will create even more of a problem.
Try not to let your child sense it if you are feeling stressed
about his or her eating habits as this may create further anxiety
and make the problem worse.
It may sometimes feel that your child has hardly eaten anything
all day, so it is sometimes worth writing down what they have
eaten. It might surprise you that it is quite a lot, even if this
is chocolate, sweets and crisps! Take this with you when you go to
discuss their diet with a health professional.
There are times when parents need specialist help and support.
Don't struggle alone, but talk to your child's doctor, health
visitor or nurse. Try to get a referral for help from an
The dietician, community nurse, speech and language therapist
and occupational therapist all have particular skills that can help
you and your child.
Your health visitor can give advice on feeding, including breast
feeding, bottle feeding and weaning onto solid food. We can send
you a parent guide on this topic.
A doctor or health visitor might refer you to:
If your child is under five, a doctor or health visitor might