If your child has been tube fed for a long time, they may gradually transition to oral feeding (feeding by mouth). This transition can be long and challenging.
When your child’s health-care team tells you that your child is safe to feed orally, the following ideas can help make this transition easier.
Make mealtimes positive
Your child’s readiness to start feeding by mouth is an exciting time. Help your child develop trust around food by making mealtimes positive.
Every child is unique and will adjust to feeding by mouth at their own pace. At this stage, the goal is not about how much your child eats or how many calories they get from their feeds by mouth. Instead, aim for your child to enjoy the social aspect of eating with your family so that they will eat more and, in time, develop the skills they need to feed themselves.
Set up a meal schedule for oral feeds
Your child’s interest in eating will vary throughout the day and from day to day. They may also need time to learn what hunger and fullness feel like, as tube feeds can interfere with this.
- Set up a routine that includes three meals and two or three snacks a day.
- Start with very small meals.
- Offer food every three to four hours at consistent times every day.
- Limit mealtimes to a maximum of 30 minutes.
- While your child is still receiving some tube feeds, and if the feeding schedule allows, offer food by mouth before the tube feed.
Include your child in family mealtimes
- Eat with your child. Children learn from copying others.
- If your child can hold their head up and sit with minimal support, sit them in a highchair during family mealtimes (even if they are not taking anything by mouth).
- If the feeding schedule allows, run tube feeds during family mealtimes so your child is still included.
Let your child try self-feeding
- Let your child feed themselves instead of feeding them from a spoon. This gives them a sense of control that they have not had with tube feeds.
- A child often explores their food before they start feeding themselves. Let your child play with food by placing small amounts of purees on their highchair tray. It will be messy, but this is ok!
- Ask your occupational therapist (OT) for tips to help move your child from one food texture to another, for example from purees to soft pieces of cooked food.
Encourage healthy mealtime behaviour
- Praise your child when they try new foods and show good eating behaviour.
- Do not react when your child spits out or throws food.
- Minimize distractions: turn off the TV and put toys away.
Offer a range of foods
- Offer your child nutritious foods that are suitable for their stage of development.
- Offer a range of foods: salty, sweet, sour and spicy. Different flavours will spark your child’s interest in what they are eating.
Monitor your child’s safety
- Ask your child’s health-care team about when to start oral feedings and what foods are safest for your child.
- Be aware of any signs of distress such as coughing, refusal of feeds, difficulty breathing or choking. If your child shows any of these signs, stop oral feeding and talk to your child’s health-care team.