Feeding difficulties

Background

Children with a disability often face serious challenges when it comes to eating and drinking. Many struggle with chewing, swallowing, or even holding food, which puts them at high risk of malnutrition. In countries where the Liliane Fonds operates, a lack of awareness and limited access to knowledge about these struggles among parents and limited expertise among local professionals means these children often don’t receive the support they need to survive and thrive.

The Problem

Malnutrition is a major public health issue for children with a disability:

• They are twice as likely to die from malnutrition.
• In Sub-Saharan Africa, early mortality is disproportionately high among children with severe motor impairments.
• Globally, at least 240 million children live with a disability, and up to 80% of them experience feeding difficulties.
• These children are three times more likely to be malnourished, 34% more likely to be stunted, and 25% more likely to be underweight.

In low resource settings such as rural areas, the risks are even greater due to poor access to healthcare. Many children never see a specialist, missing out on essential vaccinations, nutritional advice, and early interventions—leading to increased risk of (deterioration of) illness, disability, or death.

Developmental Risks

The first two years of life are critical for developing feeding skills. If a child cannot learn to eat gradually more solid and nutritious food from a spoon, chew, or drink from a cup during this period, long-term problems such as choking, coughing, and aspiration pneumonia may occur. These challenges are especially stressful for both child and caregiver, particularly in areas where professional support and nutritious food are scarce.

Our Approach

Liliane Fonds and its partners in Zambia, Cameroon, and Tanzania are piloting a comprehensive approach to address these challenges:

• Training of nutritionists and CBR workers
• Development and use of a set of instructional and informational materials
• Provision of tools to support screening, management, and follow-up
• Collaboration with government authorities to promote inclusive policies

In addition, local organizations in Cameroon, Zambia, and Tanzania organize cooking classes for parents. During these sessions, parents learn which nutrients are essential and locally available, and how to prepare meals that meet their child’s specific needs. These classes serve as a central space where parents come together to share experiences, support one another, and learn how to address their child’s feeding challenges.

Expert Involvement

Marian Fransen, a speech therapist specialized in feeding and swallowing disorders, played a key role in the pilot phase and follow up. In 2024, on behalf of Liliane Fonds, she trained local trainers and professionals—such as nutritionists, CBR workers, and therapists—in Cameroon, Tanzania, and Zambia. The goal was to equip them with practical knowledge they can apply in collaboration with parents and pass on to others.

Currently, Marian continues to coach several of these professionals online, particularly in Cameroon. She is guiding them in trai

ning others and also developed simple instructional and informational materials for parents and community workers to raise awareness and support basic care practices at home.

The professionals who received training are now applying their new knowledge and insights in their daily work with children and their families. However, much more is needed to reach more children in the long term and to influence existing policies and training programs. This will enable us, together with our partners, to provide sustainable, large-scale support to children with disabilities and their families.