Caregivers’ Beliefs, Practices, and Experiences about Spoon Feeding Children with Cerebral Palsy from Rural North Karnataka

Abstract

Aim: Spoon feeding is a foundational skill supporting the transition from breastfeeding to independent eating. In India, however, traditional hand-feeding practices dominate, and limited research exists on spoon-feeding practices, especially in children with cerebral palsy (CP). Gaining caregivers' perspectives will benefit researchers in developing culturally relevant treatment protocols. This study aimed to explore the beliefs, practices and experiences of caregivers of children with CP from rural North Karnataka regarding spoon feeding.

Methods: Eight caregivers of children aged 2 to 17 years diagnosed with oral dysphagia secondary to CP participated in a focus group discussion. The discussion was video-recorded, transcribed, and thematically analysed.

Results: Eight key themes emerged: Spoon-feeding practice in families, Early experience with spoon feeding, Child’s preference towards spoon feeding, Present status of spoon feeding, Communication by the child during feeding, Caregiver preference for spoon feeding, Managing spoon feeding difficulties and Impact of spoon feeding difficulties on the caregiver. Findings revealed a strong cultural preference for hand-feeding, with spoon use limited to semi-solid or hot foods, particularly in contexts such as school or travel. Early spoon-feeding attempts were inconsistent and often involved unsafe techniques, such as scraping food against the child’s teeth or feeding in a supine position. Post-therapy, caregivers reported improved oral motor skills and greater acceptance of spoon-feeding. Non-verbal cues were commonly used by children to communicate hunger and fullness.

Conclusion: These insights underscore the importance of incorporating caregiver experiences into feeding interventions, emphasising the need to develop culturally sensitive training modules for rural Indian contexts.

Implications: Speech-language pathologists must consider these insights when designing caregiver education and feeding therapy protocols. Future research should involve larger and more diverse caregiver populations across different cultural and socioeconomic settings.