Woman feeding special needs child

Holt International’s Feeding and Positioning Manual

Guidelines for Working with Babies and Children

This page and the manual are available in the following languages:

What is this manual about?

This manual is intended to support the caregivers of infants and children by providing information regarding safe feeding practices. Additionally, this manual provides:

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General information on infant and child development

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Critical milestones for caregivers to monitor

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Helpful strategies that support not only feeding but enrich the overall well-being of each and every child

Strong child development is the foundation of prosperous communities. When a caregiver supports the development of a child, he or she is contributing to the health of the entire community. Caregivers are vital to healthy, well-developed children. A well-developed child becomes a healthy, productive and independent adult. The work that caregivers do — the love and care that they provide — is powerful and essential for a child to thrive.

This manual is intended to be used by all caregivers within a child’s life. Some of the information in this manual may be of interest to other health care workers, family members of children and community members. Depending on the needs of the individual, some may benefit from reading an entire chapter or section, or some may find it useful to refer to only certain handouts, illustrations, charts or activities.

Download Full Manual or Individual Sections

Download Full PDF: High Quality (219 MB)
DownloadFull PDF: Web Quality (24 MB)
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DownloadIntroduction: More Than a Meal
About This Manual
How to Use This Manual
Sharing This Manual with Others
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DownloadPART 1 :: Feeding Fundamentals: Information for Supporting Positive and Safe Mealtimes
Chapter 1: Feeding Basics for Every Child and Caregiver
DownloadPositioning Basics
DownloadSwallowing Basics
DownloadSensory System Basics
DownloadBreastfeeding Basics
DownloadBottle Feeding Basics
DownloadSpoon Feeding Basics
DownloadCup Drinking Basics
DownloadSelf-Feeding Basics
DownloadFood Texture and Liquid Consistency Basics
DownloadInteraction Basics
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DownloadPART 2 :: Feeding Across the Ages: Information for Supporting Feeding Development and Finding Solutions for Feeding Challenges
DownloadChapter 2: The First Year of Life: 0-12 Months Old
DownloadChapter 3: The Growing Child: 12-24 Months Old
DownloadChapter 4: The Toddler Years: 24-36 Months Old
DownloadChapter 5: The Older Child: 36 Months and Older
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DownloadPART 3 :: Special Populations and Topics: Information for Supporting Positive Feeding Development Across Common Disabilities
DownloadChapter 6: The Child with Disabilities or Special Needs
DownloadChapter 7: Common Feeding Challenges and Solutions Across the Ages
DownloadChapter 8: Make Meal Times Matter: Growing Children with Relationships
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DownloadPART 4 :: Appendix: Strategies, Handouts and Information for Caregivers and Communities
Chapter 9: Appendix
DownloadFeeding Skills Timeline: Eating and Drinking from Birth to 36 Months Old
DownloadTypical Child Motor Development Milestones and Red Flags
DownloadFood Texture and Liquid Consistency Visual Chart
DownloadSpecialized Food and Liquid Example Lists
DownloadModifying Food and Liquid
DownloadDiet Advancement Guide
DownloadCommon Items for Supporting Feeding
DownloadSpoon Chart
DownloadGetting Creative with Seating and Supplies
DownloadFeeding Strategies Techniques
DownloadActivities for Calming and Waking Babies and Children
DownloadHandouts for Caregivers and Communities
Download— Breastfeeding Tips
Download— Feeding and Interaction Cues
Download— Bite and Sip Sizes
Download— Positioning Checklists
Download— Dental (Oral) Care and Toothbrushing
DownloadCommon Feeding Issues and Solutions Quick Charts
DownloadHow Much Should Babies Eat?
DownloadChapter 10: Definitions (List of Special Words Used in this Manual)
DownloadChapter 11: Citations
DownloadChapter 12: Index