Shakespeare wrote about “the infant mewling and puking in the nurse’s arms” when describing the first stage of life.  Spitting was common then and it’s common now—affecting all babies.  But obviously some more than others.  My colleague, Dr. Ben Gold, an expert in the field, lists 3 causes:

  1. A smaller stomach,
  2. A less stretchable stomach, and
  3. The angle the stomach and esophagus make with each other is less than 90 degrees.

I add a 4th:  The strength (or tone) of the valve (the lower esophageal sphincter) between the esophagus and stomach.

Because the majority of children who are wheelchair or bed bound have a difficult time eating, special emphasis must be placed on how the feeding is accomplished. The difficulties determine the strategies and techniques needed, and they in turn, have a tremendous impact on the foods--even for the child who can eat by mouth.

enteral nutrition syringe

When foods can be eaten safely, tube feedings may merely supplement the child's own nutrition. The caregivers can continue to feed the child actively. This dual feeding method (by mouth and when needed, by tube) provides the child, parents and caregivers great satisfaction. Mealtimes improve because there is no longer any worry about what's consumed. The need to force down medication or nourishment is now replaced by using the tube.