Feeding Challenges

Good nutrition is important for the overall development of your child. Food nourishes the body and mind. For many children with congenital diaphragmatic hernia (CDH), eating can be challenging. It’s common for babies with CDH to need assistance with a feeding tube for many months. Besides causing frustration, feeding issues can result in poor weight gain and affect your child’s health.

Feeding challenges for CDH patients can include:

Delayed start with tube feeding due to illness
Late start in learning to eat by mouth
Slow learning process of suck, swallow and breathing at the same time
Problems with reflux including symptoms of nausea, vomiting and retching
Difficulty eating or swallowing larger amounts of feedings, resulting in vomiting
Oral sensitivity to new or textured foods
Refusing food in general due to bad experience

Tips for Better Eating

First, be patient. It can take time – weeks or months – to resolve your baby’s feeding issues. Remember that the CDH team is here to support you.
Listen to your baby. Follow your baby’s cues to see if they are frustrated, tired or having any difficulties.
Focus on the positive. Relax and create a positive feeding experience.
Do not force your baby to eat. If he or she is unwilling, stop the feeding and try later or try a different food.
Stop feeding your baby if he/she is getting tired and working hard to breath. Try again at a later time.
Help your baby practice chewing. At 2-3 months of age, allow your child to mouth different soft, durable toys or fingers to develop oral motor skills. This will also help get your baby’s mouth ready for different textures of food in the future. Avoid toys with small parts that pose a choking danger or have sharp edges and points.
Introduce solid foods. Between 4-6 months of age introduce cereal, yogurt, pudding and pureed stage 1 and 2 food. For more lumpy or textured foods, start with solid foods that are mushy and melt easily in the mouth (ex. Gerber puffs).
Gradually add new foods and thicker textures. As your baby grows, start introducing chunkier forms of foods they already prefer. For instance, if they like pureed sweet potatoes allow them to try small cooked pieces (stage 3 foods).
Work toward keeping a consistent schedule. Establish a routine time for breakfast, lunch, dinner and snacks.
Keep a food diary. If your baby continues to have feeding difficulties, keep a daily log of the foods and liquids they eat, the time and any other notes that might be important (ex. runny nose, fussiness). Bring the food diary to your next clinic visit or email it prior to the visit.
Consider using supplements. Your child may need to add nutritional supplements to their diet if they are unable to consume enough calories and nutrition. The CDH clinic team will help you determine if that is the right decision for your baby.
Medications. For babies with severe reflux, medications may be necessary. Your CDH physician will determine the need for any medications.
Track your baby’s development. It’s a good idea to keep track of your baby’s weekly weight for the first few months and during times when feedings become difficult. If you have any concerns or notice any changes, contact the CDH clinic to address the issue.