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Care and feeding for children with feeding difficulties

Global RCEL Addendum - Africa (Eng) (USAID Advancing Nutrition | 2023)
Care and feeding for children with feeding difficulties

Key Messages

  • Sometimes children have difficulties feeding, and they may require additional support to be able to feed well. It is important to consult a health care provider if you have any concerns about your child’s feeding.
  • Children with feeding difficulties are at increased risk of becoming malnourished. Regular growth monitoring and feeding a variety of foods at each meal is important for all children. Food such as oil, ghee, and butter provide extra energy. Other high energy foods include seeds,
    • Seek immediate care at a facility if your child is losing weight, or displays warning signs like frequent coughing or tearing while feeding, jaw tightening that prevents feeding, fast breathing or breathing becoming wet-sounding, excessive sweating or tiring quickly when feeding, or vomiting after feeding.


Difficulty controlling head or body:

  • A stable, upright position with support for eating and drinking is one of the most important factors for safe feeding. Make sure your child’s whole body is supported well, so that she can focus on eating.
  • If your child is floppy, provide support to his back and head using your body or a chair. Always keep his head upright while feeding to prevent choking or having food go down his airway.

Persistent difficulty chewing or swallowing:

  • Difficulty chewing and swallowing can cause choking and can lead to illness. Consult with a health care provider and ask for specific feeding strategies for your child.
  • Consider pureeing foods by passing soft foods through a sieve. It is easier for children to learn to control foods in their mouth and swallow if they are only one texture.
  • Water and other liquids are easy for children to choke on if they have problems swallowing. Never pour liquids into your child’s mouth. Consider thicker liquids like soft porridge or yogurt.

Difficulty self-feeding:

  • Spoons and forks with thicker handles are easier for children to hold. Attach a rubber tube or piece of wood to the spoon handle to make it thicker.
    • Plates with steep sides may make it easier for some children to scoop up food themselves.

Picky eating:

  • Wait until your child is hungry to give her healthy foods she has not liked in the past. She may be more willing to try them when she is hungry.
  • Let him feed himself. This will help him feel like he is in control of what he is eating.
  • Do not use food as a reward or as a punishment. Your child will eat when she is hungry.

Poor appetite:

  • Provide more frequent, smaller meals throughout the day.
  • Avoid juices or sugary drinks. Provide only breast milk and water instead.
  • Avoid distractions during mealtimes, and encourage routines of the family eating together to make mealtime fun.
  • A child is getting enough to eat if they are growing well.
  • Consult with a health care provider if you are concerned or if your child’s poor appetite lasts for several days.


    • Make sure there is a clear plan to visit the health facility to address the feeding issues. Summarize the session by asking the caregiver(s) to demonstrate or explain what they will go home and do with their child. Ask if the caregiver(s) see any barriers and problem-solve together how to overcome them. Agree on next meeting date.