Here you will find tips and information for families about feeding and weaning children with a vision impairment
Feeding and weaning children with a vision impairment
Whether you are breast or bottle feeding, it is a special time for you and your baby to get to know each other. It is important to take time to enjoy the closeness of the regular feeds in the first few months. It gives your child several opportunities every day to feel your warmth, the familiar way you hold them, to get to know your scent, the feel of your clothes, the sound of your voice and perhaps the look of your face. This is important too for children who may be fed by non-oral methods, such as tube feeding.
Difficulties feeding a child with vision impairment
Your baby may be more reluctant to drop feeds than other infants, so weaning may take a little longer. If feed times are difficult or if you are concerned about your child’s weight gain or growth there are professionals who can help. For example, speech and language therapists often help with sucking and swallowing difficulties, and health visitors can advise on early feeding patterns and weight gain, and can assess whether to refer your child to a paediatrician for extra help. If you are returning to work, you may have to plan how you wean your child very carefully. If you are breast feeding you may have to introduce a bottle earlier, and then go on to solids. Most babies with vision impairment enjoy sucking, and you may need to transfer from breast to bottle to cup in very gentle steps.
Clues that help your baby know that it's meal time:
- they have that "hungry" feeling
- you put their bib on them
- you put them in their highchair
- you give them a spoon to hold
- they can smell delicious food.
Some children show they want to feed themselves by grabbing the spoon. Others may need you to encourage their independence. To be able to feed themselves, your baby needs to be able to hold a spoon, scoop with it, put it in their mouth, close their lips round it and then replace the spoon. Learning these skills takes time and you may have a long period where you both have a spoon.
Developing mealtime skills
At mealtimes, babies learn many skills:
- in crawling or walking to their high chair, they are learning to orient themselves
- when they show they want to get up to the high chair or that they want some food they can smell or hear you preparing, they are communicating
- if they are offered a choice of two foods, they are learning about different flavours, smells and textures, and also learning about making decisions
- if they are helping with feeding, they are refining the use of their hands to pick up finger food or control a spoon.
Learning to drink from a cup
- Introduce a cup early so that your baby gets used to handling it.
- Alternate between using a bottle and a cup, and gradually increase the amount of time they have the cup. Some parents find it helpful to give their child the cup at the beginning of the feed and after they have taken a few sips, to give them the bottle as a reward.
- Start with a small amount of water or milk in the cup. This makes it easier to control the flow of liquid and reduces the risk of spills.
- Children with visual impairment need to be taught the sequence of picking up a cup, holding it, and putting it down again, rather than letting it drop or throwing it.
- When your child can drink from a cup with a spout, gradually introduce your child to a cup with no lid.
Introducing solid food
When your baby is ready to start eating solids, take it slowly. Their main nutrition continues to come from their milk and it takes time for babies to accept new flavours and learn to swallow lumpier food. If your child regularly chokes or gags on their food, you should express your concern to the health visitor or GP.
- Remember that fingers were invented before spoons and forks, so concentrate on them first.
- Let your child feel your own jaw when chewing and listen to you eating crunchy foods. They will love it and it helps them to understand what actions are required for eating.
- When introducing your child to using a spoon, put your hand over theirs, holding the spoon. As they get the idea, you can gradually move your hand further up their arm so that they are controlling it more by themselves.
- Tell them what you are doing, "I’ll help you to scoop up the potato". Children like to have a commentary on what is happening and what the food is.
- They may be able to get the spoon to their mouth once you have helped them to load it, but they may need some help to put it back in the dish. It can be worth putting a damp cloth or a dice (non-slip) mat under the dish to prevent it from sliding around.
- Alternate between helping them do it and letting them do it by themselves. But do not let mealtimes go on too long or make your child feel frustrated by forcing the pace of independence. As meals take place at least three times a day try to make them happy occasions for both of you.
- Always show you are pleased with your baby when they can do something for themselves. You can show your pleasure by touching them and through your voice. This stage needs lots of patience with all children.
- All children make a mess and eat with their hands, throw their spoons and can even put their bowl on their head. Your child may be no different! A long-sleeved bib, a big splash mat and a flannel or wipes make cleaning up easier. Clean up at the very end, rather than all the way through the meal. Some parents tie toys to the high chair for their child to play with whilst waiting for their dinner.
- Let your child put their fingers in the dish to explore their food. It is the only way they can find out what they have been given.
- All babies are different - some eat all the food they are given, whilst others are fussy eaters or simply not interested. Try to relax - all babies can pick up on the feeling that you are worried. If they do not eat much or indeed anything, they can always have a bit more next time.
Introducing new flavours
Introduce new flavours early on. Your aim is for them to like a wide range of foods. Encourage them to try tasting something again if they don't like it the first time. Remember that new experiences are accepted best when a child is feeling well, so do not push them if they seem a bit "under the weather".
Food can be a messy business. These are some tips from parents on how to make feeding and weaning easier for young children.
- Talk and describe everything you're doing. Your child may not be ready for the food when it arrives in their mouth.
- Sing a rising scale as the spoon is approaching.
- Eat loudly yourself! That's easier at home than in public - but it will give your child a sense that everyone is doing the same thing, and that they can join in the fun.
- Brush your child's cheek with the spoon to signal that the food is coming.
- Does your child associate being spoon fed with being given medication? You could use different spoons, for example a metal spoon for feeding and a plastic one for medication.
- Try feeding with your finger first, rather than a spoon. Then move on to finger foods, so your child can feed independently.
- Let your child get their hands in the food at first. This can be messy, but will help them to understand the textures and where the food is coming from. You can describe what's on the menu when your baby has more language and understanding.
- Cover the spoon handle and dish in black and white tape to give better contrast (or buy brightly coloured utensils which contrast with your table).
- Create a routine - have a special song for meal times, or tap the spoon in the dish to signal that it is time to eat.
- Some children with sight loss are put off by "sloppy" food. You can try dips as a way of introducing soft food. Even if your baby is too young to eat the "dipper", it can be used like a spoon. For example, use hummus on a bread stick or cucumber.
- If your child doesn't like lumpy food, build up gradually from pureed food to solids.