What Is Best Position for Feeding a Baby

Page Outcomes [edit | edit source]

When you lot have finished this workshop:

• You should understand some of the difficulties that a child with cerebral palsy may feel during feeding, and exist able to explain these to a family unit/customs member.
• If your child is non independent in eating then you should exist able to piece of work out how to brand feeding her easier and more than enjoyable for both of you.
• If your kid has some independence in eating then y'all should be able to teach her to eat more independently.
• You should know when to ask for help with feeding your kid, if needed.
• Yous should empathize the link between chewing and spoken communication development.

Feeding your child [edit | edit source]

Feeding is one of the showtime abilities that a kid usually develops to come across her needs. Merely many children with cerebral palsy have feeding difficulties, which tin can sometimes exist astringent.

List of feeding difficulties:

• Difficulty controlling her caput:

o Her head is floppy and she struggles to go on it upright
o Her caput is stiff and pushes backwards

• Difficulty controlling her torso

o She cannot sit down by herself and struggles to keep her trunk upright
o Information technology is difficult to concur her body upright when feeding her as she pushes back or
struggles to keep her torso still

• Difficulty decision-making her oral cavity/lips/natural language

o She struggles to close her mouth
o She struggles to chew her food
o She struggles to swallow / takes a long time before swallowing her nutrient
o She chokes / coughs a lot when eating
o She pushes the nutrient out of her oral fissure again with her tongue
o She struggles to eat what other children her age are eating and but eats soft food

• Difficulty eating on her ain

o She struggles to agree things and bring them to her mouth

Positions for feeding [edit | edit source]

Retrieve:

• Be certain your child is in a skilful position before yous brainstorm feeding her!
• The position yous use volition make feeding either easier and safer, or more difficult and unsafe.
• It is specially important that the head and cervix are in a good position for feeding to make swallowing easier and safer.
• You tin play with your child in these positions too – that fashion she gets used to the position before you effort feeding her, and yous besides go comfortable with using these positions.

Checklist for adept positions for feeding your child:

• Head and trunk: Directly and upright; dorsum of the cervix must be long
• Shoulders and arms: Forwards
• Legs: Hips bent

sitting on a chair, couch, or bed to feed [edit | edit source]

• Make sure that yous are comfortable, with a absorber behind your back and some other under your supporting elbow.

• Keep your upper arm firmly against the top of her head, and non behind her neck. Make sure you can run across your elbow.

• Agree your kid's bottom firmly betwixt your legs and so that she cannot push back.
• Raise your leg that is supporting her knees past putting a box nether your foot, and employ your other leg to make her back directly.
• Bring her arms forward so that her shoulders likewise come up forward.

If your child's back is very rounded, it may assistance if you enhance your leg that is behind her back even higher than the other leg.

sitting on the floor to feed [edit | edit source]

• Try to sit in a corner and so that you can rest your back and your supporting arm.
• Keep your upper arm firmly against the top of your child'south head – not behind her neck. Make sure you can run into your elbow.
• Her shoulders and arms are forward.
• Put a absorber nether your raised knee to proceed yourself comfortable and to keep her back straight.
• Make certain your kid'southward bottom is well betwixt your legs and then that you can keep her hips firmly bent.

For the bigger child, or for one who pushes back very strongly, try resting her bottom firmly on the floor and and then push her legs upwardly towards her breast. Place your leg firmly across her feet to hold them flat on the floor.

Extra hints for positioning in this style:

• If your child is sinking down also far between your legs, try putting a business firm folded towel nether her lesser
• Make sure her shoulders are really well back and supported. Recollect her back must be straight, non rounded
• If her back is however as well rounded, slip a folded towel over a piece of lath behind her back to give her something to lean against

 A buggy like this can requite your child all the trunk support thatshe needs, leaving you gratis to concentrate on your feeding technique. B ut brand sure she is correctly seated and positioned, as you have been shown. Information technology'due south no adept having equipment then not using information technology  properly. Positions for feeding the child on her mothers lap are probable to be very difficult with older/bigger children, and are more suitable for younger children.

For those older / bigger children, use of a proper positioning buggy will probably be the only way to accomplish a good feeding position.

Helping to swallow [edit | edit source]

Other than keeping her in a good position, swallowing tin also be improved by helping to shut her lips.

• First brand sure she is sitting with you in a good position every bit discussed before.
• Requite special attention to the position of her head and neck.The head is upright and straight with the back of her neck long.
• Now place two fingers, ane on her chin and one under it. To help close her lips when the food is in her oral cavity, roll her lesser lip upwards with your finger to meet her acme lip to assist her shut her mouth.
• The finger nether her chin is only there to stabilize your hand, then if yous find information technology hard to practise it similar this, you may also use just your thumb or index finger to close the lower lip with a rolling action (as demonstrated in the first two pictures)
• Be conscientious not to push her head dorsum, but go on it upright with the dorsum of her neck long, peculiarly when she swallows! This position makes it easier for her to swallow and helps to prevent choking.
• At first she may button against your manus, but once she gets used to it, information technology should help her control the movement of her mouth and tongue.
• Be sure non to push her head backwards, merely continue it bent forwardslightly.
• Try to go on your easily in this position for as long as possible during the feed. She volition reply better to constant, firm pressure than y'all putting your hands on and off.

Try this lip closure on yourself outset, to go your fingers in the correct positions. You may desire to effort information technology on someone else in your family unit before you endeavour it with your child. When you try whatsoever new feeding technique with your child, try the new style for 5 – x spoonfuls, and so go back to your usual way. This is until y'all and your child get used to the new way.

Spoonfeeding [edit | edit source]

• Brand certain she is in a adept position
• Make certain the nutrient is non too sloppy – it's easier for your child to deal with a pocket-size amount of firm food on the front end of the spoon
• Give the spoon from the front, not from above or from the side Keep the spoon flat and printing downwards firmly on her natural language
• Await for her to close her mouth, or help her to close her lips
• Remove the spoon chop-chop, keeping it flat. Don't pull information technology out against her summit teeth
• Maintain the force per unit area to keep her oral fissure closed, and permit her tongue practice it's job
• Let her enjoy eating and not be afraid of information technology

Chewing [edit | edit source]

Babies demand to learn to chew to help develop control of the movements of the tongue, cheeks, and lips, which is very of import for the evolution of talking. Lets look at tongue movements every bit an case:

• When drinking liquids and eating sloppy food the tongue only moves backwards and forwards to suck. This is the style a baby moves her tongue to eat. If an older child yet moves her natural language similar this to eat, information technology is considering she has never learned to make any other tongue movements.
• When eating solid food the tongue has to move sideways to movement the food to the teeth to exist chewed, and over again to the back of the mouth for swallowing. And then the child learns and practices much more than control over the movements of her tongue, which will help her when having to control different natural language movements needed for chewing, swallowing and talking.

HINTS TO TEACH HER TO CHEW

• Make certain you are both in a good position to beginning with Put a pocket-size piec

  

  e of solid food such equally a petty cube of cooked potato or other vegetable between her teeth and the side of her rima oris and toward the back.
• Arroyo with the food from the middle and below so that she doesn't throw her head back to look at the food.
• Practice not push the food into her mouth – pull the corner of her lip out, work your finger gently along her cheek outset, and then only slide the food in with your pollex.
• She may need help to proceed her oral fissure closed while she chews. Simply roll her bottom lip upwards gently to help her close her mouth. This will as well encourage her to consume.
• Practice not make chewing movements for her.
• Do non try to become her to open up and close her mouth every bit if she were bitter.
• Put food in one side, and adjacent time in the other.
• Once yous are managing with cooked vegetables, progress to a piece of brown breadstuff. Leave the crust on. Do non utilize white bread – it causes constipation.

This method of feeding is more than helpful than feeding with a spoon. It can go messy just is really a good way to help her learn to chew. Information technology may have a long time initially, but as she gets used to it and meliorate at it, feeding will begin to go more than apace.

Drinking [edit | edit source]

Cutting out a slice of the cup which will fit effectually her nose – this way she won't accept to tilt her caput back when drinking, especially for the last few sips. (Hint: Use a plastic cup, not paper or polystyrene. Endeavour to observe a plastic loving cup with no "bumps" on the sides, just a smoothen loving cup with a rim at the top.)
The almost important signal for drinking is to get the lips airtight. When drinking, if your child cannot close her mouth, assistance her past belongings your fingers equally discussed for swallowing, and gyre up to close her lips.

• Caregiver'due south right hand controls the liquid level in the cup.
• Because of the cut-out, the caregiver can meet the liquid level and the child's lips.
• Caregiver's left hand (with watch) is helping to control position of her head, and closing her lips equally needed.
• The caregiver does not remove the cup betwixt sips.
• She holds the loving cup firmly in place, only makes sure she gives time for a swallow between sips.

HINTS FOR DRINKING

• Make sure you are both in a proficient position to start with
• Give special attending to the position of her head and neck. The head is upright and straight with the dorsum of her neck long.
• Tilt the cup and then the liquid just touches her upper lip, and await for her to do the sipping movements.
• Help her to shut her lips, if needed.
• Don't have the cup away after each consume – this can cause her to push her caput back or her tongue out.
• Concur the mug firmly in place, just brand sure you give fourth dimension for a swallow betwixt sips.
• Don't exist in a bustle to give her normal liquids in the mug. Kickoff get her used to thickened liquids – like custard, soft porridge, fruit puree or yoghurt. These are easier for her to handle considering they flow more slowly and she is less likely to panic or choke.

Brushing teeth [edit | edit source]

We see that a child with cerebral palsy is very much at take chances of developing problems with her teeth and gums.
Therefore, yous should clean your kid'due south teeth carefully after every meal and after sugary snacks and drinks!

SPECIFIC HINTS FOR TEETHCLEANING IN A CHILD WITH CEREBRAL PALSY

• Make certain that you lot and your kid are in a good position earlier starting. Pay special attention to the position of her caput and neck.
• Rinsing is very difficult for many children with cerebral palsy. You could utilise a syringe to assistance rinse out the mouth.
• Yous may accept to bring her body forrad so that the water tin can run out.
• It is easier to use a small bowl for spitting out and rinsing, rather than a fixed basin.
• Giving firm pressure on the cheeks towards the lips could help the child to spit out.
• If in that location is whatever expanse with problems like pain or sensitivity, exercise those first and so it can get washed while your kid is even so relatively relaxed.

Confront cleaning [edit | edit source]

Some children with cerebral palsy need to take their faces cleaned often. This can be because of drooling or food spilling out of the rima oris when eating. We accept learned in this module how important it is for a child to learn to close her lips. It is important for swallowing and chewing.
It will help your kid to acquire to close her lips if cleaning her face up is washed in such a fashion that it gives her the feeling of a closed mouth. This can also assistance to teach your child to eat her saliva instead of letting it dribble out.

HINTS FOR Confront CLEANING:

• Use business firm pressure on the cheeks and lips using a dabbing motion –not wiping.
• Always dab towards the mouth. Information technology is as if you are helping to shut the lips.
• Dab from the left and right side of the oral fissure. And so the chin and lower lip. And then the upper lip.
• Tell your child to swallow when you are doing this.

Towards independent eating [edit | edit source]

You desire to encourage your child to learn to be more than contained in eating. To prepare for this, encourage her to play, taking her hands and toys to her mouth. If her residuum is poor, she will need special seating to help her. But don't let her special seating go a prison.
If your child is developing some head and trunk control, reduce the back up that you give, but brand sure she even so keeps a good sitting position.

HINTS TO ENCOURAGE YOUR Kid TO EAT More than INDEPENDENTLY

• In the beginning, guide her manus to assistance her learn to feed herself
• Put a biscuit in her hand, guide it to her oral fissure, and run into what she does with information technology…you might be surprised at how much she manages to feed herself
• Don't end her putting her hand in her food and trying to feed herself
• Put a wet face up cloth under the basin to stop it slipping on the table as she holds it
• Try bending the spoon and then the nutrient all the same comes towards her at the right angle
• Put some padding round the handle to make information technology easier for her to grip and hold the spoon

Remember, all children mess when they are learning to eat. Children with cerebral palsy may mess more than, but it is function of learning and developing command.

PDF Handout [edit | edit source]

Hambisela_Module_6_Feeding_Your_Child

Sources and references [edit | edit source]

Ideas from many sources have helped u.s.a. to develop the Hambisela programme. The following material and references have been peculiarly helpful, either as sources or equally inspiration on how to present grooming, and we gratefully acknowledge their use. In many cases we accept been given permission to employ photographs. Where permission could not be obtained, the faces take been re-touched in order to protect identity.
1. "Disabled Village Children – A guide for customs health workers, rehabilitation workers, and families", David Werner, The Hesperian Foundation, Berkeley (1999).
2. "Promoting the Development of Young Children with Cerebral Palsy – A guide for mid-level rehabilitation workers", World Health Arrangement, Geneva (1993).
3. "Let'due south Communicate – A handbook for people working with children with communication difficulties", Earth Health Organisation, Geneva (1997).
iv. "Customs Based Rehabilitation -- Training and Guide", World Wellness Organization, Geneva (1989).
5. "Cognitive Palsy, ga se boloi (it's not witchcraft)", Physiotherapist Section of Gelukspan Center, Reakgona.
6. "Polokwane Infirmary CP Group Manual", Polokwane Hospital.
7. "Community-Based Rehabilitation Workers – a South African training manual", Marian Loveday, SACLA Health Project, Cape Town (1990).
eight. Foden Manuals one-4, Foden Center, East London (1999).
9. "Practicing the new ways of feeding your kid at habitation", Diane Novotny, Speech, Language and Feeding Therapist, Western Cape CP Association & Red Cross Children's Hospital, Greatcoat Town (circa 2006)
x. "Learning for Life", Masifunde 2002, Staff Development Special Intendance Centres, Cape Mental Wellness.
eleven. "The Pedagogy of Mid-Level Rehabilitation Workers", World Wellness Organization, Geneva (1992).
12. "Disability Prevention and Rehabilitation in Primary Health Care – A guide for district wellness and rehabilitation managers", Earth Health Organisation, Geneva (1995).
13. "Disability Prevention and Rehabilitation – A guide for strengthening the basic nursing curriculum", World Health Arrangement, Geneva (1996).

Hambisela Project: Cognitive Palsy

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