Is it ever okay to force-feed a baby?

Mrs M is a new mother and meal times for her baby are emotionally and physically draining on both of them. “I planned to wean my daughter from breast milk early. At six-month, I have tried feeding her ogi (corn meal) with and without ground crayfish, baby formula, eko (cold pap) with “draw” soup, but she simply won’t eat. It breaks my heart every time knowing she is refusing to eat. My mother-in-law advised that I should allow her do it the traditional way — force feeding her. But I can’t bring myself to allow that. I’m a bit desperate now as I don’t know what to do to get her to eat,” she lamented.

Like Mrs M, many mothers are distraught when their babies do not eat and would try their hands on whatever technique they perceive or are advised can resolve the problem. For new mothers, the experience is more overwhelming as she has no prior experience with dealing with the situation and suggestions pour from every quarters, especially from women who raised their own children using forceful feeding methods. Armed with good intentions, these mothers go as far as forcing food down the throat of the infant, most times overpowering the little ones who struggle, cry and vomit in defiance. Although the mum may feel sad at the state of her helpless, wailing baby, but tough love keeps her going as the question then arises on what is expected of her when her baby refuses food.

Why forcing an infant to eat is dangerous

“When mothers force-feed their babies, it is usually out of good intentions, but most times, they are uninformed about the consequences which in extreme cases can be fatal. No mother wants to kill her child in the name of giving them food, but this harmful practice can inadvertently be very detrimental and should be discouraged. We have heard of cases where a baby is forced food and in the process chokes on the food and dies. Some people will argue that this approach to feeding has been in existence since time immemorial but the truth is that, the fact that something has been going on doesn’t mean it is the right thing to continue doing. Times are changing and we are getting more informed; we should let some practices just die and adopt safer and more productive means of getting things done.

“Unless your infant is suffering from any medical condition, he or she knows how much and when to eat. They will eat enough to stay healthy. Forcing them especially when they rebel by starting to vomit is not the answer,” Mrs Aminat Akinola, a childhood nutritionist and dietician said.

Some consequences of force-feeding an infant include the risk of the following:

Choking and aspiration: Choking occurs when the airway is blocked by food, drink, or foreign objects. Aspiration occurs when food, drink, or foreign objects are breathed into the lungs (going down the wrong tube). It might happen during choking, but aspiration can also be silent, meaning that there is no outward sign. Force-feeding increases the chances of both occurring as food could go down the wrong tube as the child struggles and vomits the food.

Suffocating: Sometimes, the technique applied in force-feeding the infant involves covering the child’s nostrils so he/she is forced to open the mouth. Food, most times in fluid consistency such as pap, is then forced down the open mouth. Though some women say there is a skill to this technique, but it can increase the risk of suffocation as air supply is blocked from the nostrils and food is stuffed in the mouth, thus also blocking air from going in through the mouth. This can easily kill a child.

Aspiration pneumonia:  According to Dr. Segun Fadare of Lanark Specialist Hospital, Ibadan, force-feeding has been identified as one of the major causes of under-five deaths. “One of the factors that can cause pneumonia in babies is force-feeding, which is culturally acceptable in some parts of our society as a common practice. Force-feeding babies can cause foreign materials like foods or liquid into the lungs repeatedly and this can lead to pneumonia. Aspiration-pneumonia occurs when one inhales food, drink, saliva into ones lungs or one vomits,” he told the News Agency of Nigeria.

Future eating disorders: Forcing your child to eat only worsens the situation because it reinforces the child’s dislike for food. The child mentally associates mealtimes and feeding with anxiety and becomes apprehensive whenever it’s time to eat. This results in a vicious cycle. Several studies have also shown the link between forced feeding especially toddlers and future feeding behaviours and aversions.

Why babies refuse food

Several factors can be responsible for an infant or toddler refusing food. Although experts say for most toddlers’, picky eating is just a phase that they eventually pass through, other times, several factors can also contribute.

It could be their being tired, not feeling well, being pressured to eat more food when they have had enough, pressured to eat food they dislike, frequently offered foods that they dislike or find disgusting, continually offered food and drinks throughout the day, rushed at mealtimes, feeling sad, lonely, anxious or insecure, constipated or anaemic.

When a child constantly refuses to eat regardless of all efforts, it is advisable to take him or her to see a paediatrician as it could be indicative of an underlying medical condition. Force-feeding is not the answer.

How to get your child to eat

Dr Gbemisola Boyede, a paediatrician, said, “mealtimes are about much more than food. Meal and snack times give you a chance to help your baby or toddler learn healthy eating habits; feel important and loved; feel understood and respected; trust that others will care for her; feel good about her body.

The goal therefore behind feeding time should be about encouraging your child to become a healthy eater. Dr Boyede recommends:

1. Remember, meals are about more than food. They are a time to connect with your child and to support her overall development. Talk with your child during meals and don’t let her eat alone. This helps build strong family relationships.
2. Create routines around mealtime. Routines make children feel loved and secure. Establish regular meal and snack times beginning when your child is 9-12 months old. Routines help children look forward to each meal.
3. Offer 3 to 4 healthy food choices (that your child likes) at each meal. Research shows that children will choose a healthy diet when they are offered a selection of different healthy foods.
4. Don’t force your baby or toddler to eat. This often results in children refusing the food and eating less.
5. Don’t give up on new foods! Patience is the key. You may have to offer your child a new food 10 or 15 times before he will eat it.
6. Turn off the TV (computers, etc) at mealtime. The television can distract children from eating. It also takes time away from talking as a family.
7. Healthy eating and exercise go hand in hand. So, make active play a part of everyday family life.
8. If you are concerned about your child’s weight or activity level, talk to your child’s health care provider.

Some healthy food options to begin with

You can start with the cereals either pap with infant formula milk or you can also start with the can ready-made cereals available in the shops. Just introduce one at a time. Pureed fruits like apple, mashed foods like potatoes, yams are also foods that can be gradually introduced.