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Everyday tips

Nutrition and hydration

  • A child with a tracheostomy should always be supervised when eating or drinking by a person trained in emergency CPR measures. Discuss these measures with your child’s health care team.
  • If required, always suction your child’s secretions before meals. If you suction after a meal, coughing may cause your child to vomit.
  • A cloth bib is useful to prevent liquids from accidentally entering your child’s tracheostomy. Avoid plastic bibs that may accidentally block the passage of air through your child’s tracheostomy.
  • Certain children may have difficulty swallowing and may aspirate food and liquids into their trachea instead of normal passage of food through the esophagus to the stomach. To minimize the risk of aspiration:
    • verify your child’s capacity to safely drink and eat with your child’s health care team,
    • never leave your child unsupervised during meals,
    • never leave your infant alone with a baby bottle, even if your child is capable of holding the bottle,
    • if possible, place your child in an upright, sitting position when eating and drinking,
    • instruct your child to eat and drink slowly,
    • avoid using straws,
    • ask your child to chew his food well before swallowing,
    • if needed, provide small meals more frequently,
    • if your child chokes, coughs or seems to have difficulty breathing while eating or drinking, stop feeding and contact your child’s health care team for further recommendations.
  • Be aware that young children can mistakenly put food in their tracheostomy instead of their mouths, especially when they are beginning to learn to eat finger foods.
  • Avoid foods that are small in size (eg, nuts, candies) as these are a choking hazard. Wearing a bib cover is a good way to prevent your child from introducing food into the tracheal cannula.
  • Because a child with a tracheostomy does not breathe through their nose, they often have a diminished sense of smell and taste. Their appetite and interest in food may therefore be altered. Discuss with your child’s health care team.
  • Burp your infant regularly during drinking to avoid regurgitation which can increase the risk of tracheal aspiration. Position your infant on the side after meals.
  • Dehydration can cause your child’s secretions to become thicker and more difficult to clear. To avoid dehydration, ensure adequate fluid intake daily, especially during warmer weather and when your child is more physically active (eg, playing sports). Increase your child’s fluid intake when your child is ill, has fever, diarrhea or vomiting. Talk to your child’s health care team for specific recommendations.
  • Confirm the recommended daily amounts of fluids and nutrition for your child with your child’s health care team.
  • Advise your child’s health care team if these feeding difficulties are present:
    • difficulty or refusal to eat,
    • presence of food in the secretions coming from the tracheostomy,
    • coughing or frequent episodes of choking during meals,
    • vomiting during or immediately following meals,
    • excessive drooling or difficulty in swallowing saliva,
    • excessive quantity of secretions during or after meals,
    • secretions that resemble the liquids or food that were recently consumed,
    • weight loss or no weight gain.

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