Birthdays can be a stressful time, particularly for the child’s first birthday. What parent doesn’t want that birthday picture with their child covered in cake, frosting, or ice cream? For many parents of children who are tube fed, that is nearly impossible. Even if your child can eat any of those things safely, some children have such strong sensitivities and aversions that touching food or having food on their lips will make them vomit. Other children want to eat and are unable to. So what do people do?

If your child doesn’t care about others eating, have a cake anyway. Don’t stress about smash cakes.

You can take pictures with the birthday cake, balloons, birthday cards, a big number, a piñata, or a toy cake! Make a 1st birthday t-shirt. Get creative. If doesn’t have to be a smash cake. Many children do not enjoy their 1st birthdays. Don’t feel pressured by it. You can always take pictures on a different day than the party, if you choose to have a party.

Make a “cake” they can eat.

Some parents have made allergen free cakes, lollipop bouquets, dishes of whipped cream that looks like cake, or Jello cakes. Decorate a bowl and put a puree in it. It doesn’t matter; celebrate whatever it is your child is able to eat.

Have a cake alternative.

There are many toy birthday cakes out there. A Google search will provide you with many options. Older kids may enjoy decorating a “cake” made from cardboard boxes or foam. Have a piñata and fill it with small toys. Make a big cardboard box cake to hide party favors for the guests. Think outside of the box!

Have a party that doesn’t revolve around food.

Schedule the party in between meals. Have children do crafts, play games, sing songs, dress up, play with bubbles, or do scavenger hunts. Have a party at the zoo, aquarium, or play gym. You can set up small snacks and drinks in a separate area, or not at all. Just let guests know in advance that there will not be any food served at the party.

Don’t feel pressure to have a party at all!

Many parents opt out of having a large party, particularly if their child has sensory issues or immune deficiencies. Parties can be hard for a lot of children. You can choose do to something that your child would enjoy. Have over close friends or family for a smaller gathering. Plan an afternoon at a park, zoo or other venue your child enjoys. It is all about what makes your child happy, not about what other people expect.


Halloween can also be stressful for children with feeding tubes. Here are several suggestions to make it a better experience for your child:

  • Hand out non-food treats, and encourage your neighbors to do the same.
  • Participate in the Teal Pumpkin Project. This project encourages those handing out non-food treats to place a Teal-colored pumpkin in front of their house. Participants can also add their address to a map so you know which houses to visit.
  • Let your child trade in his or her candy for a large toy, small non-food items, or money.
  • Swap out collected candy for “safe” candy, such as lollipops.
  • Visit your neighbor’s houses in advance and provide them with a special non-food treat for your child.

Other Holidays

Other holidays can also be challenging. Finding non-food items for a Christmas stocking or Easter basket can be a challenge, as can figuring out how to incorporate your child into holiday dinners. Many times, family and friends make it even more difficult by asking tough questions or making rude comments. While the section below addresses handling holiday celebrations, you might also find our page on Answering Tough Questions, as well as our page for Family and Friends useful in planning your holidays.

Incorporate your child how you think is best

Some children who cannot eat are uncomfortable sitting at a table watching others eat, while others are perfectly fine. If your child feels comfortable, have him join the holiday feast. You can give a tube feeding during the dinner, or simply let him sit and play with small toys while the rest of you eat. Maybe even spice up the tube feeding with a special blenderized meal or a holiday design on the feeding bag, as shown on our Feeding Tube Fun page.

If your child is not comfortable sitting at the table, designate a sibling or relative to play with him during the meal. Some families have children and adults eat at separate times or tables, which may make this process much easier. Young children may even want to take a nap during the meal.

Its fine to skip holiday dinners

Sometimes the best choice is simply not to participate in a holiday meal. Visit with family or friends before or after the meal. If this is not possible, feel free to take a walk during the meal or simply go in another room. After all, what is most important is being with family and friends. Food is just one of many possible ways to celebrate. It is not the only way to make treasured memories. Of course, it is especially helpful if you have compassionate friends and family who are understanding. The information on our Family and Friends page may help them out.

Notify family and friends in advance

If you are visiting in someone else’s home, let your hosts know in advance that your child may need some accommodations. Try as much as possible to be accommodating yourself, but don’t be afraid to ask a relative to make sure snacks are kept out of reach, a quiet place is available for sensory meltdowns, or not to expect your child to eat dinner. It’s less stressful for everyone if plans can be made in advance to make a holiday go as smoothly as possible.

Ideas for Christmas Stockings and Easter Baskets

Lego minifigures
Small stuffed animals
Lip balm
Hair bows or barrettes
Glow sticks
Lighted spinners
Dough, silly putty, or clay
Bubble bath
Oral motor chewy
Gift cards
Glitter glue
Bouncy balls or sensory balls
Nail polish
Fancy trach ties
Therapy brushes
Therapy spoons
Whistle or kazoo