322 chapter 36
Successful feeding involves the whole child
The more difficult it is for a child to control his body movements, the more difficult
it will be for him to feed himself. A child with Down syndrome may have trouble
feeding because of weak mouth and lips and poor head control. But the feeding
cp problems of a child with cerebral palsy are more complex. They may include: lack of
mouth, head, and body control; poor sitting balance; difficulty bending hips enough
to reach forward; poor hand-eye coordination; and difficulty holding things and taking
them to his mouth. We must consider all these things when trying to help the child
feed more effectively.
It is not enough simply to put food or pour drink into the mouth of a child who has
difficulty sucking, eating, and drinking. First, we must look for ways to help the child
learn to suck, swallow, eat, and drink more normally and effectively. Here are some
suggestions.
POSITIONS FOR FEEDING
Be sure the child is in a good position before you begin feeding her. The position will
make feeding either easier and safer, or more difficult and unsafe.
Do not feed the baby while she
is lying on her back because this
increases the chance of choking.
Feed the baby in a half sitting
position with her head bent slightly
forward.
Do not let the head tilt
backward. It makes swallowing
harder and may cause choking.
cp
In a child with cerebral palsy, it often
causes backward stiffening, and
In a child with cerebral
palsy, to keep the head
makes sucking
from pushing back,
and swallowing
hold the shoulders
more difficult.
forward, keep
the hips bent,
and push firmly
WRONG
on the chest.
In a child with cerebral palsy,
avoid pushing the head forward
like this. It will cause the baby
to push
her head
back more
forcefully.
RIGHT
WRONG
Positions for feeding with a bottle, spoon, or finger are like those for breast feeding.
cp
If the baby does not suck and
swallow well, the mother may
Position the baby so that the head
is slightly forward, and the bottle
To avoid the backward stiffening,
bend the shoulders and back
think she should put a bigger
comes from in front, not above.
forward, keeping the hips and knees
hole in the nipple, tilt the baby’s
head back, and
pour the milk into
the baby’s mouth.
Pushing gently on the chest helps
stop backward stiffening
so the baby can swallow
better.
bent. Be sure
the head
bends a little
forward.
Place food
below and
in front
of child,
not above
WRONG
RIGHT
or behind
him.
But this
may choke
him, and
it does not
help him
learn to
suck well.
If
possible,
have baby
hold
bottle.
RIGHT
foot lift to
keep the
baby’s knees
higher
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