Information for the public

Eating, drinking and swallowing

Eating, drinking and swallowing

Children and young people who have difficulty with swallowing should be seen by a speech and language therapist who specialises in treating swallowing problems.

As part of assessing your child, the therapist should watch them during a normal mealtime. They should also ask if they have had any chest infections, because this might mean that food is getting into their airway. The therapist should then work with you to make a care plan based on your child's needs.

It's important to work with everyone in the family, and with anyone else who feeds your child. Setting goals can help you see whether things are improving – your therapist should help you do this and ask regularly about how your child is doing.

How the therapist can help

  • Showing you the best position for your child to sit in when they eat

  • Changing flavours and textures of food and drinks

  • Trying out specialised cups, plates and cutlery

  • Helping with behavioural problems to do with eating

  • Trying different techniques when feeding your child – such as placing the spoon differently or changing how fast or slowly you help them eat.

You should not be advised to try devices placed in the mouth (called intra‑oral devices) – these have not been found to help with swallowing problems in children and young people with cerebral palsy.

Children and young people who have ongoing difficulties with eating and drinking, or who get regular chest infections, should be seen by a team that specialises in treating swallowing problems. Such difficulties may include choking or gagging, or regular stressful mealtimes. Sometimes the team might suggest that your child has a type of X‑ray called videofluoroscopy, which shows what happens when someone eats or drinks.

A healthy diet

It is important that your child gets enough nourishment from their diet. They should usually have their height and weight measured regularly to check that they are growing well. Sometimes it is difficult to accurately weigh and measure the height of a child with cerebral palsy, so other measurements (such as knee height or upper arm circumference) might be taken instead. Your care team will explain about these other measurements if they are needed.

If your child has problems with eating, drinking and swallowing it can be difficult to make sure they get enough energy and all the vitamins and minerals they need from their diet. If there are concerns about this, they should be seen by a dietitian for treatment and advice. Any child or young person who is unable to get enough nutrients from their diet should be seen by a specialist team, who will discuss with you whether additional support, such as supplements or a feeding tube, might help.

Vomiting, regurgitation and reflux

Babies, children and young people with cerebral palsy can be prone to:

  • vomiting (being sick) – if the usual pattern of your child's vomiting changes, tell the care team so they can assess your child

  • regurgitation (food coming back up after reaching the stomach)

  • reflux (when stomach acid leaks up into the gullet) – sometimes called gastro-oesophageal reflux disease, or GORD for short (see where can I find out more? for more information).

Constipation

Constipation affects 3 in 5 children and young people with cerebral palsy. It can be painful, and your child should be assessed for it regularly and offered treatments as needed. See where can I find out more? for more information.

Questions you or your child may want to ask

  • Why does my child have swallowing problems?

  • Can you suggest how to change my child's food or how they eat, to make it easier to manage?

  • Is there any special equipment we can use?

  • What help and treatment is available if my child is finding it difficult to eat enough?

  • How can you tell if my child is growing well if it is difficult to weigh and measure them?

  • How might a feeding tube help?

  • If my child has a feeding tube is it safe for them to eat and drink as well?

  • What treatments could help my child's reflux?

  • What treatments could help my child's constipation?

  • Information Standard