Withholding feeds during end-of-life has definitely been the hardest aspect for our carers at Butterfly Home as feeding a child and being “fat” is a sign of caring and good health in this rural Zulu community. Some of the carers even voiced that they felt that we were abusing the children when feeds were stopped during the last hours of life. With more training and cases where children became bloated and fluid-overloaded during their final days we could practically explain how the body loses its ability to manage/absorb feeds and that it actually causes discomfort towards the end. It is still a challenging subject but we now follow each child’s lead to let us know when they are ready to stop feeding.
