Pediatric Oral Aversion

Oral aversion is common with premature babies, and babies typically exhibit symptoms within the first year of life. Symptoms include:

• Appearing hungry/thirsty, but refusing to eat/drink
• Pulling away and arching back while feeding
• Feeding only when tired or sick
• Fussing or crying when a bib is put on, put into feeding position or when a bottle/dish is present
• Malnutrition
• Only taking a few, small sips or bites
• Poor or stunted intellectual development
• Refusing to open mouth when a breast, bottle, spoon, plate or food is present
• Skipping feedings
• Stunted physical growth or failure to thrive (insufficient weight gain)
• Throwing food

There are several possible reasons that can contribute to oral aversions:

• Choking episodes – a baby can develop an aversion after a particularly scary choking event
• Discomfort/pain – any condition or sore affecting a baby’s mouth, throat or gastrointestinal tract can stop a child from eating due to pain
• Force feeding – this stressful event often creates an unfortunate cycle, instead of helping the child
• Intubation and other medical traumas – babies and children who have a tube or a suction down their nose or throat for long periods of time can become afraid to eat
• Medical conditions in the neonatal intensive care unit (NICU) – some swallowing related issues can lead to oral aversion, including gastroesophageal reflux disease (GERD), congenital diaphragmatic hernia or tracheoesophageal fistula 
• Sensory processing disorder – children with sensory disorders may be particularly sensitive to the feel, smell or taste of foods and drinks, including during breastfeeding