Helping Your Child With Down Syndrome Learn To Self-Feed: A Few Quick Tips

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Noah’s 11 months old in today’s video and we decided to try and let Noah self feed today. As you can see he really enjoyed it (as we did his mommy and daddy.) I thought I’d share a little bit about our experience with allowing Noah to self feed for the first time for any of you getting ready to try this with your child.

It’s messy

I am not going to lie, my biggest fear with starting self-feeding with Noah was the MESS. I have seen this kid eat off a spoon and it isn’t pretty, so I could only imagine what he will do when he is in control. So the first step in deciding to let your child self-feed is getting a really good mop and lots of paper towels. It also helps to let them eat in only their diaper…your washer and dryer will thank you later. I have all but abandoned bibs as they only keep one section of him clean and Noah is able to target every area outside of that with excellent precision.

When to start

I quickly realized that I had no idea what I was doing or where to start. It is best to try self-feeding when a child is able to support themselves while sitting. Since this is sometimes delayed in children with Down syndrome I don’t think they need to be sitting on their own so much as being able to sit well when supported in a feeding chair or high chair. They also should be able to reach out and grab things and have fairly good aim at their mouth.

When they start doing this with toys, they should be more than willing to do this with food. They should also be making some chewing movements with their mouth, they don’t need teeth, but they do need to know what to do with a more solid food. Teeth will determine the consistency of the foods you will try. If your little one does not have teeth yet you’ll want to stick to easily mashed items. It’ll also be easier if they are interested in what is on your plate while you are eating.

Noah started grabbing our drinks and food which made me realize that maybe I needed to give him his own plate.

baby down syndrome self feeding with apple

I don't suggest starting with an apple. :)

When we were introducing solid foods with Noah our pediatrician recommended to start with puffs, a classic. They dissolve almost instantly in the mouth and are easy to handle. I think our OT was a bit shocked when we told her with excitement that Noah was advancing his diet. I couldn’t quite figure out why until we tried the puffs. These things are not quite as easy to pick up as they look. As hard as Noah tried, he could not get them to his mouth himself. We gave up on self-feeding for a little while after that as I assumed that he was not ready.

Type of grasp determines food choices

I finally had an epiphany one day when I was at my best friend’s house.  She knows all the cool stuff people are trying and had a book lying around called The Baby-Led Weaning Cookbook: 130 Recipes That Will Help Your Baby Learn to Eat Solid Foods – and That the Whole Family Will Enjoy, by Gill Rapley and Tracey Murkett. (Long title, huh?) I was skimming through it and with their help it finally clicked what I was missing. I needed to match Noah’s grasp development with his foods.

Puffs are for those who have a great raking ability and more importantly a pincher grasp which typically develops around 9 months when children usually start eating more solid foods. The average age of a child with Down syndrome having a pincher grasp is 20 months. The reason I wrote the post on grasps is because I had just figured this stuff out and knew I would be referencing it now as I talk about feeding. Noah is still at a radial palmar grasp which makes puffs pretty hard to pick up.  I had set him up for failure because I didn’t figure out his grasp prior to giving him foods.

Foods to start with

The book mentioned above has a great table matching grasp type with food choices. They recommend starting with large stick-shaped pieces of food. I started with bananas. They recommended making it look like an ice cream cone with the peel still on with the banana exposed at the top. Noah grabbed onto that, brought it right to his mouth and started gnawing on it. See…if I just put the right thing in his hand.

Some other options are veggie straws which are basically tube-shaped puffs, larger pasta with a shape that is easy to grasp like rotini, or cutting long narrow pieces of bread. Using long pieces allows the child to hold an object with an edible section exposed that can easily be put in the mouth. Compare this to the puff which gets hidden in the hand and has to actually be released into the mouth. The teething crackers, such as the ones we are using in the video, are also great as they dissolve easily and stick out of the hand since they are fairly large.

self feeding baby infant

Animal cookies are always a favorite.

Next you can advance to foods that your child can pick up in clumps. Think rice, mashed potatoes, apple sauce, mac and cheese (do see why you need a good mop) and one of Noah’s favorites eggs. These are offered when your child is doing a raking grasp. Puffs can be offered at this time as well.  When we started with these Noah was still eating the parts that were on top of his hand and not so much releasing it into his mouth.  I however believe that this helped him realize that if he opened his hand there was more goodness inside

You can get smaller and smaller as the grasp develops to where some day instead of your child picking up a clump of rice, he is picking up the individual grains.

Likely will not get all of their nutrition at the beginning

I did not rely on Noah to get all of his intake from self-feeding alone.  I would give him some things to play with as give him meals by spoon feeding in combination with milk.  As he starts getting better I will stop giving him things off a spoon as much. You need to have a balance, and it may take a while before your child is able to eat enough on their own.  This is ok.  The whole point at the beginning to to be exploring not necessarily providing nutrition.

The Gag Reflex

Your child will gag. They are supposed to gag. You want them to gag. It will scare you. You may have your hand on the phone for 911 before you realize that your child is ok. Gagging is not the same thing as choking. Choking cuts off the air supply where as gagging gets a chunk of food out of the back of the throat so that it can get worked on some more. With choking you will not hear many sounds from your child and they will likely be changing colors, now is the time you want to shout “Annie, Annie are you ok?”, get your child out of their chair, put them over your knee and give them 5 back slaps to help get that item out as well as call 911.

However if they are trying to gag an item of food up, give them a few seconds and it will get there. Starting with mushy or slippery things helps the child swallow without problems. I have seen Noah swallow whole noodles before without difficulty. Chicken on the other hand causes us a lot of problems with gagging as he tends to not chew it enough. (NOTE: If you ever have any concern that your child is choking, or not able to breathe, you need to call 911 immediately. Additionally if you have questions or concerns about this please be sure to talk with your pediatrician, as this post is not and should not be taken as medical advice.)

Patience

I thought that letting Noah self feed would speed up the feeding process…I was very wrong. It has slowed it down, but that’s ok.

Noah eats his meals with us as usual, and I try to give him whatever we are eating plus or minus a few things. He likes to shovel the food in so we have to place it in front of him slowly. It is great to share eating times together and has finally brought my husband and I to the dinning room table rather than eating in front of the tv.

Offer variety

I know that several children with Down syndrome have problems with textures in their mouth. Your OT or ST should be helping with these issues. I encourage you to offer as many different textures as you can. Also try all sorts of different fruits and vegetables so that your child gets used to eating them. It can take something like 7 exposures to a food before a child will accept it as something they will eat. I find parents often just give the child what they know they will eat rather than branching out and trying new things. \

It’s very easy to get into a routine. Obesity is a big risk for our kids, and getting them to eat fruits and vegetables now will only help them in the long run.  I noticed our friends over at The Fun House always offered their children fruits and vegetables at each meal, and their children devoured them.  They definitely inspired me to be well aware of what I am putting in my child’s mouth.  Do we venture out to pei wei and pizza…sure.  But they are being eaten with a fruit or veggie on the side. :)

What foods did you try with your child first?  What were you afraid of most?  What challenges have you faced with feeding?

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Comments

  1. Great post from Dr Mom :) – is that an opportunist doggy friend in the footage hoping that Noah doesnt learn the art of self-feeding too quickly!!

    • Ha,ha…you better believe it.

      The funny thing is Noah and the doggy (Gizmo) have already become “partners.” Noah’s learned the dog will be his best friend if only he’ll lower his hand at give him a little yummy treat. ha,ha..

      It’s cute. (But a bad habit to get in to.) :)

  2. amy snay jacobs says:

    This was a great post and I wished I had it when I started feeding James. I was so scared. Even though he is my 4th child, I felt like I did not have a clue. James loves to feed himself. He has only 1 tooth at 14 months so we are still limited a bit by what he can eat. But he loves eggs, mac and cheese, mandarin oranges, bananas, grilled cheese.

  3. Susanna says:

    I didn’t realize at first that some speech therapists specialize in feeding issues which, of course, can begin with bottle feeding, not just when self-feeding. People would always ask me why my infant needed speech therapy not realizing that the speech therapist helped with feeding and oral motor exercises to be sure the child was learning to chew properly, to chew on both sides of the mouth, to use his tongue to clear food from his cheeks and the roof of his mouth. Who knew there was so much involved in simply eating? It’s a grand adventure! BTW, my son has a doggie partner in crime, too! They are best buds! =)

  4. Kate Taylor says:

    Thanks guys! Awesome timing for us . . . We are just 9 months behind you all and super thankful for your site and info. As baby Noah blazes the trail ahead of us you have continually been one of the best resources we have found :) We have been “swiping” puffs onto the floor for a few weeks now which while tons of fun provides little self feeding success . .. and the gagging thing was freaking me out. Looking forward to trying some new ideas!

    • I hope they work!! Gagging will always freak you out, but it does get easier to let them try to get the food out of their throat before slapping their back :) Let us know how it goes.

  5. My little guy, who has Down syndrome, will be 11 months in a couple days and we are doing Baby led solids with him too. we started once he seemed ready at almost 9 months. He has no significant delays so far so he was sitting well and reaching for everything. His therapy team is amazed how well he is doing. It is amazing what these kids will do if you just give them the chance!

  6. maddison jacobs says:

    abby i strip aimee down to diaper only n i got old sheets n made a poncho like thing to put on her it covers all of her . and for the floor i use the other sheet in the set . so all i have to do is toss them in the trash if to messy or in the washer .. she loves puffs n bananas i cut up into slices i havent tried apples .she loves eng peas too she squishes them then licks her fingers . i learned also the hard way to put on one of her hats to protect the hair cuss some how the fingers find their way to the hair every time .lol thanks ofr the video .

    • Apples aren’t the best first option which I quickly learned. The cookbook had recommended them but noah snapped off a piece and quickly gagged. I think they are probably good when there are not too many teeth and they are basically gumming it but when you can bite it it requires some serious chewing. :)

  7. Great article–Thank you for the great suggestions. My little guy (9.5 months) is ready to self feed, but I have only given him puffs for self feeding. The poor little guy just can’t get those darn things into his mouth! I will try some of your other suggestions. I totally forgot about the pincer grasp often being delayed. Thank you! I’m sure my little man will thank you too!

  8. Sara Wolff Kratowicz says:

    Thanks so much! Our Janie is 5 months now and is still just getting breastmilk from a bottle, but I trust that we will be venturing into other foods soon. She’s bringing toys to her mouth constantly and sucking and biting on her thumb, fingers, and anything that gets near her mouth! Our OT and ST said we needed to wait until she was sitting until we tried any solids. I will look into the feeding chair you mention above and see if that’s an option for us.

    • The pediatrician in me is going to come and recommend waiting until 6 months :) which is because of food allergy stuff. we used our carseat initially for feeding the once Noah was sitting better went to that chair as it reclined. Your therapist may have great recommendations.

  9. My Otto is just 7 months. We are having constipation issues…so we are going slow with the feeding. I’m pureeing as many veggies as I think he might eat adding textures slowly. He loves acorn squash, pears with goat’s milk yogurt, carrots and peas…and everything else he tolerates. I need to get him some more avocado to keep things moving. Or mango. The blueberries worked too. I love to make him food and then stick it in my ice cube trays and freeze it. Then stick it in a baggie and label it. So much better than canned food! I think we are a year behind you so thanks for all your tricks & tips!

    • I liked making my own purees until I got to meats and got grossed out :) We have constipation issues as well, but since starting more veggies and fruits it has gotten a lot better.

  10. Thanks for this post. Our little boy with DS is doing so great in so many areas at 23 months (walking, saying a few words) but he does not self feed. He furthermore doesn’t even like to eat “table” foods. His diet is entirely baby food.

    As soon as he puts a piece of table food in his month – say, for instance, a banana, his long tongue goes crazy and he forces the food out of his mouth with it. If something does get to his throat, he gags a lot. We’ve been giving him time to try and self feed every day at lunch time, but he hasn’t made a lot of progress recently. He just “spits” the food out with his tongue every time. Of course we’ll keep trying, and eventually he should get it!

    • have you tried self feeding with the purees? I know it is messy, but he can get his hands in it and get it to his mouth. Noah does love a good apple sauce bath :)

      • Funny you mention that — we actually have tried that recently with apple sauce, and it worked pretty well. Of course he was a mess, but he put some in his mouth. I guess we are wondering how to get him to even eat “table” foods, even without self feeding. He pushes all that food out of his mouth with his tongue immediately. Our OT hasn’t been much help. We are considering finding a specialist.

        • I would. I would probably go to a speech therapist who has a bit more training in this area. Usually speech therapist focus on either feeding or language so you will just have to ask if they feel comfortable with feeding.

  11. Random thought about gagging…..Little Man (19 months, who does not have DS but does have a metabolic disorder) will actually gag to the point of throwing up. He has a fabulous gag reflex. Unfortunately, that makes for an even messier situation…

    I’ve learned to not panic when he throws up after gagging, clean him up, and let him continue eating. Sometimes, he doesn’t want to eat after he’s done that and then I’ll just take him for some cuddles and something to drink (or something I know he won’t gag on). He usually gags on newer foods. Once he’s figured out how to eat something, he doesn’t forget :)

  12. Thanks so much for the info. Elias is only 3 months right now but I know I’ll desperately need the advice of those who have gone before. I’m sure life is busy for you so thanks for taking the time to post this info.

  13. Little Marcus is 4mo old and still completely on premie high calorie formula. He still has a pending heart surgery and they need to get him to gain some weight. He’s still a little thin for his age. My husband is a stay at home dad and sometimes when I get home he will say “Marcus didn’t like blackberries?”… uuummm.. WHAT DO YOU MEAN MARCUS DOESN’T LIKE BLACKBERRIES”.. I guess he will put a tad on his tongue and watch his reaction. I told him we need to start cereal first before we do blackberries. We have a great team from the regional center of Los Angeles. They send people to our house for now for the OT and DT and when he’s older we can go to the center. I LOVE LOVE watching your videos and following you, it helps me see where little Marcus might be. I get to read the other parents posts and I have learned SO MUCH. AGAIN!! Thank you so much for sharing your life with us. I tried to start a video diary when I was pregnant, before I even knew M2 had DS and IT’S A LOT OF WORK!!!! I commend you for keeping up with it. Til next time…

    • It is hard! That is why we are so behind. Your husband sounds like my husband :) I am glad you are having good luck with therapies and such. Let us know how the surgery goes.

  14. Stephanie says:

    Just wanted to comment on the apple choking comments above- one way to introduce apples is to grate it. The babies shouldn’t choke (or gag) too much with it then :)

  15. Audra Kahne says:

    Self-feeding was a real challenge for my son, but we are finally making some great progress at 18 months. Judah’s challenges were 1) no teeth until 13 months and 2) not having the pincer grasp thing down. He also LOVES eating, so he will cram a lot of food in his mouth if offered larger pieces (which were easier to grab). Straw shaped food such as sweet potato fries was easiest for him to grab first. This website has a lot of good suggestions for baby food and finger foods: http://wholesomebabyfood.momtastic.com/babyfingerfood.htm. On this page in particular we have made a lot of the apple/turkey sticks and the banana pancakes. Somewhere on the site is also an idea for “rice balls” which is basically rice put into a food processor until it becomes sticky, and then I added ground chicken and pureed vegetables. They are easy to pick up and to chew. Now that he has developed the pincer grasp he’s able to eat things like halved blueberries, peas, and cheerios. Hope this helps somebody!

  16. Audra Kahne says:

    Oh yeah, and mandarin oranges ar great because they are hand-sized and kind of dissolve in his mouth. :)

  17. Informative post. One awesome benefit to self feeding is that it frees up Mom or Dad to clean up dishes quickly or eat your own meal all at one time. One thought about the apple – I always starting by putting apple or peach in one of those baby “net” feeders. Love the suggestion about the banana. That is what I frequently have started with. Also very cooked carrots – get mushy and chunkier to pick up than those puffs.

  18. Thank you, thank you, THANK YOU!! I have been trying so hard to teach my 2 year old self-feeding and it has been driving me crazy. He doesn’t have DS, but he does have a condition called Cortical Visual Impairment and will not grasp objects to hold them himself. He will rake and scatter puffs, but cannot bring them to his own mouth. He also cannot or will not hold his own bottle, another source of frustration. I want to get him off the bottle, but I am at a loss as to how to get him to give it up. Sippy cups and straws haven’t been a hit for us. Any suggestions would be so welcomed :)

    • The way I taught Noah how to drink from a straw was using just a regular old juice box. I know the straw is small (however your child hopefully has normal tone unlike Noah). The bend in the straw allows for it to rest against the tongue which should trigger sucking and then you are able to squeeze juice in the mouth. Noah rarely gets juice, so he thought it was awesome and wanted to figure out how to get more.

  19. Thanks for this post. My son is 10 months and eats really well but I have given up too easily with self feeding and I know I need to start on it again as that is the only way he will learn. This has given me some great ideas!

  20. Thanks for the post!! I guess because physically, Easton is smaller than the typical 8.5 month old, I didn’t think he would be ready for puffs or food with more texture. But during a visit to his pediatrician, we were encouraged to try more foods, puffs, and even table food if he didn’t like the baby food. Well what do ya know?! He LOVES puffs! He has the racking down, but still hasn’t figured out how to open his hand to get it in his mouth. So, we cheat a little. If I place the puff between his thumb and index finger, he can get it right into his mouth with no problem! He also loves the cheddar puffs (glorified baby cheetos), and teething crackers. We still don’t have much luck with baby food…he thinks this is the BEST time to show off his raspberry skills. We haven’t given up, though. We will find what he likes. I also requested that ECI get a speech therapist out for an evaluation. I hope she has some suggestions for us. Until then, I will continue having baby food speckled clothing, and he will continue enjoying his puffs!

  21. littlebirdsmomma says:

    Thanks so much for this post! Little Bird is 8 mos old, and so ready to self feed. I’ve been giving him tiny pieces of banana, avocado and cooked pear, and he can take a piece from me, but rarely can transfer it successfully to his mouth. He usually opts to take my hand and guide my fingers to his mouth to eat. It is obvious that the size of the foods prevent him from eating, but I was afraid to give him large pieces due to choking hazard. “Stick-shaped” food NEVER occurred to me. I am soooo excited to get him lunch today! He is going to be so proud.

  22. This is really inspiring. Our Ariston is 15 months 4 weeks and likes to feed himself but I get nervous because he inhales food and only has one tooth. I do try to expose him to lots of fruits and some veggies. I never thought to let him try to eat foods that clump, as it relates to him still grasping with his whole hand. We attempted his first self-feeding of messy food and the outcome was a huge mess with little making it to his mouth but he loved it.

  23. Belinda says:

    Wow! I am so glad I stumbled across this post (when searching for your take on the flu vaccine). My little girl is 10 months tomorrow (& has DS). It has been so fun introducing her to new solid foods, but I am at the start of encouraging her to self feed. This post is super informative – can’t wait to check out her grip when she wakes up so I can find out where to start. I’m not sure she has made the connection of hand to mouth yet though…did Noah naturally do that or do you have some tips to encourage that too?

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