Feeding Difficulties
Many children with disabilities face serious challenges with eating and drinking. Difficulties with chewing, swallowing, positioning or keeping food in the mouth can put them at high risk of malnutrition, dehydration and other health complications. In the countries where Liliane Fonds works, many parents and caregivers have limited access to information and practical support. At the same time, local professionals often lack the specialised knowledge and tools needed to identify and respond to feeding difficulties early.
The Problem
Feeding difficulties and malnutrition are closely connected. For children with disabilities, the consequences can be severe:
- UNICEF estimates that nearly 240 million children worldwide live with disabilities. Children with disabilities may experience feeding difficulties such as problems with chewing, swallowing, positioning, or eating and drinking safely, particularly when families and local service providers lack access to practical guidance and specialised support.
- UNICEF reports that children with disabilities are at greater risk of malnutrition than children without disabilities especially where nutrition, health and rehabilitation services are not accessible or coordinated. They are 3 times more likely to be malnourished, 2 times more likely to experience stunting, wasting or die from feeding-related health complications.
- Evidence from rural Uganda shows that children with cerebral palsy face a substantially higher risk of premature mortality than the general child population, particularly when they have severe motor impairments or severe malnutrition (Namaganda et al., 2020). A recent scoping review similarly found excess premature mortality among African children with cerebral palsy, estimated at approximately 25 times that of the general population (Murugasen et al., 2024).
In low-resource settings, especially in rural areas, these risks are often compounded by limited access to healthcare, rehabilitation and nutrition services. As a result, many children do not receive timely support, such as nutritional advice, safe feeding techniques, referrals or early interventions. This can increase the risk of illness, worsening disability and preventable death.
Developmental Risks
The first two years of life are especially important for developing feeding skills. When a child is not supported to gradually eat more solid and nutritious foods, chew safely or drink from a cup, feeding problems may persist or worsen. Challenges such as choking, coughing and aspiration pneumonia can be frightening and stressful for both the child and caregiver, particularly where nutritious food and professional support are difficult to access.
Our Approach:
Addressing feeding challenges requires a comprehensive approach.
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Pilot
Together with partners in Zambia, Cameroon and Tanzania and a speech therapist specialised in feeding and swallowing disorders, Liliane Fonds piloted a comprehensive approach to address feeding difficulties among children with disabilities between 2024 and 2026. The pilot combined:
- Training parents, nutritionists, healthcare workers and CBR workers.
- Developing simple and practical instructional and information materials for parents and community workers, helping to raise awareness and support basic feeding care practices.
- Providing tools for screening, management and follow-up.
Local organisations also organised cooking classes for parents and caregivers. These sessions focused on locally available, nutritious foods and practical ways to prepare meals that respond to a child’s specific needs. They also created a supportive space where families could share experiences, learn from one another and build confidence in addressing feeding challenges at home.
Feeding to Save Lives
Using the experience and building on the impact of the pilot project, with support from the National Postcode Lottery, Liliane Fonds launched a new two-year project in July 2026: Feeding to Save Lives. The project is being implemented in Cameroon, Tanzania, Zambia and Uganda. It addresses feeding difficulties in a holistic and sustainable way by strengthening family support, community awareness, local expertise, referral pathways and advocacy for disability-inclusive nutrition and care systems.
The project is implemented in collaboration with SPOON Foundation. In each country, one coordinator and two local thematic leads support capacity strengthening among relevant actors, including community workers, health and rehabilitation professionals, families and local decision-makers. They also work to ensure that the nutrition and feeding needs of children with disabilities are better recognised by community influencers, planners and policymakers.
Goal
Reduced avoidable deaths and life-threatening nutritional and feeding challenges among children with disabilities and their caregivers, in Uganda, Cameroon, Zambia, and Tanzania through inclusive, sustainable solutions for survival and growth.
Main outcomes
- Improved Nutritional Health and Feeding Practices for Children with Disabilities.
- Increased household access to nutritious food for families of children with disabilities.
- Inclusive nutrition and feeding support integrated into systems and services at different levels (programmatic, institutional, local, regional).
- Strengthened cross-country collaboration and learning on inclusive nutrition and feeding.
References
Namaganda, L. H., Almeida, R., Kajungu, D., Wabwire-Mangen, F., Peterson, S., Andrews, C., Eliasson, A. C., Kakooza-Mwesige, A., & Forssberg, H. (2020). Excessive premature mortality among children with cerebral palsy in rural Uganda: A longitudinal, population-based study. PLOS ONE, 15(12), e0243948. https://doi.org/10.1371/journal.pone.0243948
Murugasen, S., Springer, P., Olusanya, B. O., Gladstone, M., Newton, C., Kakooza-Mwesige, A., & Donald, K. A. (2024). Cerebral palsy in African paediatric populations: A scoping review. Developmental Medicine & Child Neurology, 66(8), 990–1012. https://doi.org/10.1111/dmcn.15878
Contact
Angelique Kester, Technical Adviser Rehabilitation and CBR/CBID
