It is harder to use the mouth for eating, and harder to swallow. A small pillow or a rolled up towel can be used to keep the head in a more upright position. You can also use your hand or arm behind the head if this is comfortable for you and doesn't cause the child to push back more. You can place your hand gently under the child's jaw to help with mouth closure. This is only effective if you have started at the bottom and improved the position of the pelvis, shoulders, arms, neck, and head first.
Some older children have contractures.
Sometimes there is a bending or twisting of the spine that makes normal sitting or lying very difficult. Discuss what you can do about contractures with the physical therapist who works with the child. They may have some ideas that will help you get better positioning at mealtimes. Make these adjustments very slowly and gently. Changes usually feel very different and often feel uncomfortable, even if you know they will help the child lie, sit, or eat better.