Early Childhood Intervention
Infant and toddler feeding

Good nutrition is important for everyone, but especially important for infants and toddlers. That’s because good nutrition is needed for babies to develop strong immune systems, healthy body functions, and new brain cells. Good nutrition is required for babies to achieve developmental milestones.

Loving and responsive feeding gives babies the ideal environment for meeting nutritional needs as well as basic social and emotional needs. Mealtimes can be a special time for emotional bonding between families, children, and caregivers. Caregivers can lay the foundations for positive, stable, safe, and secure relationships during feeding.

Babies benefit from being held during bottle feeding, even when they are able to hold their own bottles. Bottle feeding is a wonderful opportunity for eye contact, loving touch, and a soothing voice and maybe even a song or two. As a baby gets older, a quick tickle can add laughter and joy to feeding time.

Self-feeding is an important developmental milestone. On the advice of the child’s physician, babies may begin eating soft, semi-solid foods by the age of 4 to 6 months. Soon after that, they take an interest in what other people are eating and drinking. As their fine motor skills develop, they learn to bring food to their mouths, and sometimes get it in! They also learn to hold an open cup. Because this is often a messy time, a supply of bibs will come in handy.

Another step in the self-feeding process is dropping food, bowls, spoons, and cups on the floor. Again, this is messy but developmentally appropriate. In spite of how it may seem, babies don’t do this to make you angry or give you more work to do. It’s part of the learning. A tarp or towel under the highchair can make cleanup easier.

Common feeding challenges
Sometimes, even when you do everything right, a baby or toddler will have feeding problems. An estimated 25 percent of children will experience some type of eating or digestive issue. The list below can give clues to whether a little one is experiencing feeding difficulties and needs intervention:
difficulty sucking, swallowing, or chewing
vomiting, reflux (backward flow of food from the stomach), and excessive drooling and/or colic
partial or total food refusal
finicky eating
inability to graduate to textured foods
delay in self-feeding
little to no weight gain
tantrums

How you can help
If you observe any reflux, frequent and/or large volumes of spitting, and/or vomiting, inform the parents immediately.

Encourage toddlers to begin self-feeding and make note of any pickiness, delays in self-feeding, refusal to eat, and tantrums during mealtimes.

Posture and seating are often overlooked and can impact a child’s successful feeding. An upright posture with well-supported head, neck, and trunk can help with swallowing. The head and neck should be tilted forward (flexed) slightly with the chin bent toward the chest so that the head does not tilt backward during feeding and swallowing. This ensures that food and fluids do not enter the respiratory tract.

Have ongoing and open communication with the parents regarding feeding problems and interventions so that parents can use the same strategies at home.

If feeding difficulties are not being resolved, a referral to Early Childhood Intervention may be appropriate. With parental consent, ECI services can assist the child, family, and caregivers with the knowledge and skills to support children with these difficulties.

For additional information, visit the websites below.
www.ncbi.nlm.nih.gov/pmc/articles/PMC2851259/.
www.bcm.edu/research/centers/childrens-nutrition-research-center/buildinghealthyfamilies/index.html.
www.nal.usda.gov/fnic/pubs/bibs/gen/infnut.pdf.