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Children with feeding tubes often become reluctant to try oral feeding. In a few cases your child may be nil by mouth entirely, but in most children caregivers are encouraged to continue to offer oral tastes and stimulation to help ease the transition back to oral feeding when the feeding tube is no longer required, however they often find their child is completely disinterested, or even distressed by oral feeding.
After a period of tube feeding the interest in meals is lost. Tube feedings are controlled by volume and timings and sometimes the rest of the family also loses their interest in meals. You may start to fear your child will never enjoy a normal diet, especially if your child develops tube dependency.
Most children have been tube fed from an early age and have never learned to eat.
Before starting a tube weaning program our parents worry about what they can feed their child once weaned. Concerns about weight loss and ill health, worries about what their child can and cannot chew or swallow and they are worried if they will be able to feed their child once weaned. Part of our program is to help build up parents’ confidence and give them information to empower them to help their child to lean to eat.
What food you give your child depends partly on their age and fine motor skills. In a young infant you may wish to start with pureed homemade or pre-packaged foods. One of the best solutions is to blend the same meal that the rest of the family is having. You can gradually increase the coarseness of the texture as your child gets used to eating.
As soon as possible add in finger foods (this is possible even from 6 months old). Consider rusks, potato-based puffed snacks, and other finger foods that will dissolve in the mouth. Keep your child in an upright position and let them have a selection in front of them at mealtimes. They may choose just to play with the food and will sometimes choose to have a taste.
Self feeding really helps with development of fine motor abilities.You can encourage use of utensils by using thick mashed food or rice dishes, such as risotto, and pre-loading a spoon. This stage is messy but lots of fun. If you can bear the mess let your child play with pasta and sauces, they will enjoy it (plastic sheeting under their chair makes cleaning up a lot easier) and it makes for some memorable photos.
It is important to offer a variety of tastes, colours and textures. Remember your child is an individual and may have their own preferences for flavours. We have come across children who have turned their noses up at mild chicken and potatoes, only to be found munching merrily away on garlic salami or olives. Do not be afraid to offer strong flavours.
Some children will develop hearty appetites and eat anything in front of them; others will be more discerning in their food choices. As professionals we find that this is down to the child’s taste and texture sensitivity.
A lot of children will show a preference for starchy foods like potatoes, pasta and rice. These provide needed energy as carbohydrates but make sure your child is getting adequate protein and fats.
Proteins are the building blocks of our bodies and are present in meats and eggs. Vitamins A,D E and K need fat to be absorbed, and our body uses fats to make new cells. Some foods that are higher in fat allow children with small appetites to get more calories in before they feel full, and and in fact at this stage the children can enjoy fried and creamy food, full fat milk, butter and ice cream as it will help to keep their weight stable.
As your child gets older and more able, try to get them to eat the same as the rest of the family as often as possible. This helps give them encouragement without pressure, allows them to share their meal with everyone else. This makes life easier on you as parents without having to prepare extra foods. Let your child see you preparing food and help with peeling, washing, mashing or stirring as this encourages them to be curious about trying the food.
As caregivers you control when and what foods are offered, but your child is free to refuse the food. It is important to have food available at any times. This allows the child to learn to recognise their own appetite and satiety signals, and encourages trying new tastes. On the long run, please resist the temptation to offer food as a reward or to offer rewards for eating, instead encourage lots of activity to help your child build up an appetite, and eat alongside them as a positive example.
All this advice applies to any child learning to eat; there are no limitations on the food your child can try after weaning. If you join one of our weaning programs our team of therapists and doctors will also be at hand after the wean to offer advice.