Supporting infants aged under six months with feeding difficulties and disabilities

Feeding difficulties include a wide range of issues related to eating or drinking that deviate from age-appropriate norms, often associated with medical, nutritional, feeding skill, and/or psychosocial factors. These challenges can increase the risk of malnutrition and infections, as well as the onset or worsening of disabilities in children. Studies indicate that feeding difficulties affect a substantial proportion of children, with estimates ranging from 25-45% among those without disabilities and between 80-90% among children with disabilities.

Growing concerns about managing children aged under six months experiencing feeding difficulties or suspected/confirmed disabilities highlight a lack of attention and evidence-based guidance for this vulnerable age group. This has prompted the compilation of essential resources aimed at supporting both infants and their mothers. Disabilities are difficult to identify in children aged under six months and sometimes only realised when developmental milestones are not being met. To address this, a document compiling key resources focused on children aged under six months and their mothers was developed to help consolidate existing guidance and research for mother–infant pairs. It is divided into four sections, with each providing a link to and brief description of a relevant suggested/highlighted resource.

First, practical resources on assessment tools are provided, with an emphasis on the significance of early detection of feeding difficulties or disabilities in infants. These issues can be overlooked during breastfeeding initiation and before the introduction of semi-solid/solid foods, when issues are more readily identifiable. Additionally, guidance is offered on providing caregivers with practical support to facilitate safe and comfortable breastfeeding. The section also provides general resources available that provide practical support for the feeding of infants under six months with disabilities and their mothers. Resources specific to certain disabilities (e.g., cleft palate, Downs syndrome, etc.) are provided as well. 

Secondly, a summary has been provided of some key policy documents related to disability. This includes organisational policies and guidance that have inclusive services and mainstream support in health and nutrition services.

Thirdly, a summary of the Disability Evidence Portal (DEP) is provided. This portal has been established as “a knowledge exchange platform that seeks to enable and empower decision makers with evidence-based knowledge to make decisions on how best to improve access, health, education, livelihood and social outcomes for people with disabilities worldwide… through acting as a repository of solutions, evidence and tools for strengthening decision-making within Disability-Inclusive Development.” 

This section also calls for more research on disability inclusion for infants. This group is often excluded from research, which has led to a lack of evidence on care required. Some of the reasons why more research is needed for this age group include the fact that they are more likely to be malnourished and that there are long-term nutritional consequences of disability and exclusion of children with disabilities in malnutrition protocols and guidelines.

The last section of the report provides a summary of ongoing initiatives that highlight the work that could be relevant to advance this agenda.