Oral defensiveness, hypersensitivity

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Marissa 11 month old, 8 months adjusted, birth weight of 1lb 1oz. She has been tube fed since birth. She did suck for the first few months but it was a non-nutritive suck and only took a max of 20 ml per feed. She stopped sucking in June when she was admitted for bronchiolitis and we stopped feeding her because she was so tired trying to breathe. When we started a month later she just didn't know what to do anymore.
That brings us to now. I have been trying twice a day since with no luck until last week, when she actualy took 20 ml consistently for a few days! Now she's refusing to open her mouth for the spoon though so win one, lose one. When she did let me put some purees in her mouth, she didn't know what to do with it and eventualy either swallowed it or choked on it. Very scary! The OT thinks its pointless now to try the bottle because in her opinion liquids are harder to move around than solids.. but my instinct tells me otherwise. She's making incredible progress with the bottle, why stop now!

I've been spending lots of time looking up oral defensiveness, oral hypersensitivity, apraxia and oral motor toys to help her out.
I found a really cool bottle that i wish i had found months ago at
http://www.new-vis.com/cart/detail.php?Item=CMF-03-01
along with great chew toys to stimulate the mouth. I just ordered it so i'll write back when i start using it.
My OT is absolutely useless. She sits and watches a feeding without giving me advice. She seems clueless to what is going on and what to do. I found everything i know through these discussions and research online.
I really wish i had help with Marissa! But since i have to do it myself, i'm going to read on those subjects until my brain bursts and hopefully come up with a good plan. Here is a book i'm ordering:
http://www.dysphagiaplus.com/prints-home-program-oralmotor-skills-p-154.htm l
One of the things i'm ordering too is called the Z-Vibe. It has neat attachments like spoons and there's a great book that gives techniques on how to use it. Again its expensive but i think it'll be worth it. I think its worth the money to get all these things because she's getting older and still not eating.

Good luck and please everyone, keep posting on the subject, its so frustrating to have a little one that doesn't eat, we need all the advice we can get!!

3 replies

If the OT isn't giving advice, find another one. Our son's OT was amazing. Gave lots of advice. She studied at the top pediatric feeding program in the country. She was worth her weight in gold.

Also, if your area doesn't have good OTs who specialize in feeding habits, you might want to try finding a speech therapist (ST). Some STs specialize in feeding b/c speech is all about oral development.

Regarding the spoon, I would put it aside for a few days. Will she suck some purees (e.g. runny rice cereal) off your finger? Try that for awhile. Also, if there is a toy that she likes to mouth, try putting a little rice cereal on the toy and let her play with it. It will give her the sense of food on a pleasurable object (helps create a positive association between food and toy).

Also, avoid cleaning baby up until the meal is done. Our son's OT said that mothers who tend to be hyper-clean and make the meal unpleasant for baby by scrapping the chin when food dribbles out have been shown to inadvertently cause oral aversions in their children. Researchers have done empirical studies on it. Chin scrapping is especially a no-no with kids who are at higher risks for oral aversions (e.g., kids who have been vented).

Best wishes.

Oh, one more thing. Never dump food into mouth with the spoon. That startles baby. Bring spoon to baby's lower lip. Can place spoon horizontally over lower lip and a little bit over tongue tip. Let baby get the food off the spoon. Dumping food in mouth has also been shown to cause oral aversions.

my daughter has some oral sensitivities as well...though i believe that she is hyposensitive, rather than hypersensitive. we just started working with a SLP through EI, but with the recent state budget cuts...he had to cancel our last appointment and so we haven't seen him for a month. meanwhile, i keep reading and working with my daughter the best way i know how, but it's frustrating because sometimes i don't know how to help her progress and i'm not a professional.

i recently ordered a z-vibe and one of the ARK textured grabbers. lynsey did fine with bottle-feeding, progressing from the slowest flow to the fastest flow nipples...she did well with purees, fruits, vegetables...it was when it came time to introduce textures that we started to encounter problems. currently, she is 18 months actual/15 corrected and still primarily eats purees. now that she's older too...it's become increasingly difficult to feed her because her palate is more adventurous than her oral-motor skills are allowing her to be. i don't want to discourage her...so i offer bites of food off my plate whenever she shows interest, even though i know that she isn't able to chew and/or swallow it. :/ my husband and i have already decided that if we don't see improvement in the next 2-3 months that we will start looking into a private OT or SLP.

does anyone know a good OT/SLP or someone who specializes in feeding issues in or near las vegas/las vegas area?

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