Food Choices: Where to Start With a Child who is Tube-Fed

January 24, 2020

Posted in: Early Intervention, Feeding, Feeding Tube Weaning

Whether you are just starting to introduce to your tube-fed child, you are preparing for a wean, or you are attempting to wean at home, it is highly likely that you have thought: “What do I start with?”  Parents are often asking therapists for that “magic food” and although we wish we had it, it doesn’t exist! There is no one food that will help your child eat, but here are a few factors to consider when choosing certain foods. 

Independence: 

Fostering independence is so important. When a child is in a new or scary environment, if they have something they can feel in control of, it helps to build success. When starting with independence and autonomy in mind, start with finger foods or foods that children can hold by themselves. This doesn’t necessarily need to be a food that they can chew successfully, but a food that they can feel successful with by picking it up. Big foods are easier to find in their mouth and gives the child space to spit it out, or gnaw on it while they gain comfort. This might be: big slices of pears, apples, sweet potato, etc. Independence could also build with utensils or tools your child uses while eating those foods. At this stage, try to steer away from the focus being on “intake” because this is a time where your child can build comfort. 

Consistency: 

There are different paths to choose when introducing food to your child. As we mentioned above, choosing larger foods and fostering independence, may lead parents to research Baby Led Weaning (BLW). So what is it? It is a common approach that helps with independence by introducing safe, larger pieces of food and following a food progression that helps to build your child’s comfort and skills around food. BLW is meant to be a positive and fun experience for everyone at the table. BLW does allow for full autonomy, which is important for so many tube-fed kids. It is also okay to start with purees and softer foods, if you are doing so in a responsive way. If you are choosing purees, make sure to have a spoon available for your child to attempt to feed themselves, or allow them to use their hands/fingers to explore the puree.  

Familiarity: 

When thinking about “Well, what do I make for dinner?” during a wean or while introducing foods, think about food in a different way. Try and ask yourself what do YOU want for dinner? There is a large market for “kids foods” or that magic food, but it is important to expose your child to what you like to eat. If you’re having pasta for dinner, there are ways to shape those foods to help your child (I.e. smaller pieces cut up, sauce on the side). Even if your child is not able to be successful with that food yet, the importance of the mealtime is the experience and the togetherness. Children benefit from familiarity, therefore when choosing foods, choose foods that you eat and have your child sit in an area where they can initiate if interested. Focusing on this familiarity piece and building a stress-free, positive mealtime environment, your child can feel safe and learn that food is not “work”. 

Texture/Taste: 

Many children are sensitive to experiences from the past (formulas or purees that were warm or too cold) and this could cause your child to be hypersensitive to different temperatures or textures. It’s important to continue exposure to all different foods, with varying tastes and textures. Many times, children surprise us and love seasoned foods! It is important to pay attention to the texture and temperature to start identifying patterns your child may be showing. Spitting foods out is NORMAL when a child is learning to chew and swallow. That doesn’t necessarily mean that doesn’t “work”, but it may mean they need more exposure. 

Making food choices for all children can be stressful. When first introducing foods, remember that it is so much more important to build responsive and fun mealtimes, than to focus on the “what”. Follow your child’s lead, and they will show you more than you might think!