324 chapter 36
cp
For the child who has
difficulty breast feeding (or
bottle feeding), as you apply
jaw control try bringing her
cheeks forward with your
fingers.
At the same time, push gently
against the child’s chest
with your wrist.
(This may help the child
who tends to stiffen
backward.)
If you bottle-feed the
baby, an ‘old-fashioned’
large round nipple
usually works best.
If the child still has
trouble sucking, try
making the hole in
the nipple bigger
and thickening the
milk with corn meal,
gelatin, or mashed food.
CAUTION: Jaw control helps in many children with developmental delay and
cp cerebral palsy—but not all. After trying it for 2 or 3 weeks, if the child still
resists it or shows increased problems, stop using jaw control.
Spoon feeding
The child who has no sucking-swallowing reflex needs to
be fed with a spoon.
YES
The best spoon is
rounded and shallow.
NO
RIGHT
Always
give the
spoon
from in
front,
not from
the side.
WRONG
WRONG
‘Tongue thrusting’
and not
from above.
Not deep because this
makes it hard for the
lips to get out the food.
NO
And not long and
pointed as this could
cause choking.
cp
A baby sucks by moving her tongue forward and backward. For this reason, when
the child begins to eat from a spoon, her tongue will at first push part of the food
out of her mouth. She has to learn to use her tongue differently—pushing the food
between the gums to chew, and to the back of her mouth to swallow. Children with
developmental delay or cerebral palsy may have trouble learning to do this, and
continue to push or ‘thrust’ the tongue forward for some time. Do not mistake this
for meaning she does not like the food.
Applying firm pressure on tongue,
and jaw control,
help prevent
‘tongue thrust’.
Jaw control, although helpful, may not be enough to
prevent this tongue thrusting. It also helps to apply firm
pressure with the back of the spoon on the tongue
as you feed the child. This helps keep the tongue from
pushing forward and lets the child use his lips and
tongue better.
CAUTION: Better to use a strong (metal) spoon and NOT
a thin plastic one that might break when you push down
the tongue.
Do NOT scrape the food onto the upper lip or teeth as
you take the spoon out. Instead, let the child try to get
the food off the spoon onto her tongue. To make it easier
for her, start by putting only a little food on the end of the
spoon. As you take the spoon out, make sure the mouth
is closed so that the tongue can move the food inside the
mouth and cannot push it out.
WRONG
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