Where to turn with oral aversion!!

My 33 weeker (2 lbs 9 oz) is 11 months old and weighs 17 lbs. He will not, under any circumstance, eat food. He won't take it from a spoon, dropper, and won't feed himself (except for gerber puffs). He is basically exclusively breastfed at this moment. I am going to get him help, because it is starting to affect his health, as we just found out that he has become slightly anemic. Do I need to take him to only a speech pathologist? What about an OT? I would love some direction!

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Our son was seeing an OT who specialized in feeding problems. She was great. But there are a lot of speech pathologists who also specialize in feeding issues.

Henry is almost 10 months adjusted. He doesn't feed himself, except for Gerber puffs. After getting used to feeding himself the puffs for a couple weeks or so, he was more willing to try chunky foods (this is very recent), although he still doesn't like squishy textures (e.g. pasta).

If your son is willing to put Gerber puffs in his mouth, have you thought about trying other hard foods that are likely to give him some feedback? Our OT recommended beef jerky (very thick so that it doesn't break off). Our son can get used to biting down and the feedback from that experience. She also suggested getting really thick carrots that won't break off and dipping them into whatever we are eating, so he can get used to different flavors (and perhaps we'll figure out what flavors seem to motivate him).

What is your son's status on reflux?

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The kid I took care of who had oral aversion had an OT, an ST, AND a PT. His case was a little more extreme though. He would eat NOTHING not even formula. He was fed soley by tube, and even then would throw it back up unless we fed him 90 ml over the course of an entire hour while he was alseep (so he didn't notice that we were feeding him). He weighed only 5 pounds when he was 9 months, and 8 pounds when he was 18 months, so you can see how different these cases are. I'm sure if you go to a feeding clinic they will be able to tell you more accurately what therapy your son would benefit from.

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Eliza, a former 26 weeker who is now 26.5 months, still receives almost all of her nutrition from formula since she has oral motor problems compounded wiht sensory issues. I would suggest evaluations by both a speech pathologist and an OT. Depending on the reason the baby won't/can't eat there may be a need for both services. I would however make sure that whoever sees the baby has a strong background in infant feeding disorders, not just pediatric feeding disorders.

Anne, mom to Eliza Grace 26w4d 575gr 3/15/06

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Whatever treatment plan you decide on...Do not wait. Although my 26 weeker was in PT and developmental therapy weekly, when showed signs of aversion, we chose to wait. She was thriving in all areas.

Now at 17 months we are in specialized oral therapy because her aversions are compounded by low tone and slow development in and around her mouth. The older they get, the harder the treatment is. Lillie is old enough and strong-willed enough to protest new things or things that she dislikes. So our therapy is hard on all of us. No one wants to force things on a screaming, kicking toddler.

Good Luck and as I always say, go with your gut.

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I have 3 children that were all premature. My 3 year old still only eats 5 different foods and they all have to be dry. My 1 year old has such an oral aversion that if I put even a speck of food in her mouth she gags and throws up. Our OT is trying to de-sensitize her mouth, but it did not work when my son was a baby. I have found that unless the child puts the food in her mouth herself, she will not accept it.

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I agree with everybody else's suggestions on here. My son completely shut down with eating and was fed solely by NG tube. I personally didnt have a lot of success with OTs, PTs or speech therapists (and I had some really good ones). I ended up taking my son to a feeding clinic. There are many different clinics that have very different approaches. I used a clinic that took a behavioral approach to feeding. I would recommend this approach once you have done extensive testing (swallow studies, GI scopes, allergy testing) to rule out some common medical reasons why a child wont eat.
A good place to start is with having your child evaluated by a GI. Allergies, reflux, and several other GI issues are pretty common reasons why kids develop oral aversions. Breastmilk is very easy to digest so he could be having some digestion issues with other foods. Without trying to figure out why a kid isnt eating it is hard to recommend the best course of therapy.
Some kids end up not having any current medical reasons why they wont eat. Every study we did with my son was completely normal. He had had reflux early on and we think the pain associated from swallowing caused him to shut down. We chose a behavioral form of therapy because it seemed his eating habits had become a learned behavior that we had reinforced. The clinic we used, Los Altos Feeding Clinic, was very helpful in getting him to eat by mouth again. You may find it somewhat helpful to talk to the feeding therapist we used at the clinic, Ben Zimmerman. He will talk to you on the phone for free. He could maybe give you some things to try. The clinic number is 650-237-9111.
Good luck - it is quite a hard thing to deal with! I know!!

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My 25 weeker daughter that is now 17 months has an oral aversion and a sensitive gag reflex. Our speech therapist is also helping with OT, but she suggested that we use her toothbrush to help desensitize her. It's working quite well.

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I have 25 week twins, boy and a girl. They were a little over a pound each, when they were born. My son was in the hospital for 15 months and my daughter for 4 months. They just turned 2 a few weeks ago!! They both have oral aversions... My son is trached so his aversion is VERY severe. His is mostly because he is so protective of his airway. My daughter is also protective of her airway. For the past 6 months OT and Speach has been working with both of them. My daughter has made extraordinary leaps. She took only bottles for a long time. They started working with hard foods because they said it is easier for her to keep track of where the food is in her mouth. She had to learn how to chew and what to do with the food. The speech pathologist has been great with her! My son is a subborn one... he's not had much success. He gets all nutrition through G tube, so he really doesn't see the purpose in eating yet...

My daughter has made improvements. She still takes most nurishment through bottles but she does eat hard, crunchy foods.. She loves bacon and "strong" tastes. Taco meat and spicy potato chips. The strong tastes help her keep track of the food too.

My son is going to be a tough one.. we're in no hurry, and I know we'll get there!

Although my case is more severe than yours I would say that a speech path could really help! And don't wait!!

See my babies at http://lindsayandtybuffington.angelfire.com



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If you haven't already done so you may may try pumping the breast milk and putting it in a bottle to feed him. This would introduce him to a new texture and you already know ke does well with the breast milk. You may also want to make sure there is no thrush in his mouth to cause pain from other foods.

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I agree that it is extremely important to let them put the food in their mouth themselves. Don't try to feed them... let them "play" with the food and see what it does... by crushing it up and playing with it they can see what they should expect it to do in their mouth. good point!

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