By Céline Baron. Céline Baron is a French sophrologist and psychopractitioner based in Vichy. In addition to a comprehensive background in Communication, Sophrology, and Psychology, she has been trained in Child Psychology in Paris as well as in the detection of autism spectrum disorders. A mother of two, she welcomes many families to her practice.
Oral aversion is a common challenge among preemies and infants, particularly those who have spent time in the neonatal intensive care unit (NICU). For parents, dealing with a baby who refuses to feed or struggles with oral intake can be incredibly stressful. This guide will help you understand what oral aversion is, why it occurs, how to identify the signs, and most importantly, how to help your child overcome it.
What is Oral Aversion?
Oral aversion occurs when a baby demonstrates a strong reluctance to eat or even have objects near their mouth. This can manifest in different ways, from turning away from a bottle or breast to crying or gagging when offered food. Some babies might refuse to eat altogether, which can lead to concerns about their nutrition and growth.
While any baby can develop an oral aversion, it is more common in premature infants or those with medical conditions that required interventions such as feeding tubes, intubation, or surgeries. These experiences can create negative associations with oral stimulation, leading to long-term feeding difficulties.
Common Causes of Oral Aversion in Preemies and Infants
There are several factors that can contribute to the development of oral aversion, particularly in preemies and medically fragile infants:
- Medical Interventions: Babies who have been intubated, had feeding tubes, or experienced invasive medical procedures may associate oral stimulation with discomfort or pain. These interventions, though necessary for survival, can create negative associations with anything entering the mouth.
- Feeding Difficulties at Birth: Premature babies often have underdeveloped sucking, swallowing, and breathing coordination, making feeding a challenge from the start. Early feeding struggles can set the stage for later oral aversion.
- Gastroesophageal Reflux Disease (GERD): Many preemies suffer from acid reflux, which can make feeding painful. Over time, this pain can cause a baby to refuse food, leading to aversion.
- Prolonged Use of Feeding Tubes: Babies who are fed through nasogastric (NG) or orogastric (OG) tubes over long periods may not develop the necessary oral-motor skills for successful feeding. Without regular oral experiences, they may become wary of anything entering the mouth.
- Sensory Sensitivities: Some infants, particularly those born prematurely, may have heightened sensory sensitivities. This means they may find certain textures, tastes, or even the act of sucking overwhelming or uncomfortable.
Signs of Oral Aversion
Recognizing the signs of oral aversion early on can help you seek the necessary interventions. Common signs include:
- Refusing to eat: Whether it’s breast, bottle, or solid foods, the baby turns away, clamps their mouth shut, or pushes the food away.
- Crying or fussing during feedings: Babies with oral aversion may become upset or distressed when offered food.
- Gagging or vomiting: Some babies may gag when food touches their lips or enters their mouth.
- Limited or no oral exploration: Infants with oral aversion may avoid putting toys, pacifiers, or other objects in their mouths, a behavior that is normally expected in development.
How to Treat Oral Aversion: Practical Steps for Parents
Addressing oral aversion requires patience, time, and often the help of feeding specialists. Here are some steps you can take to help your baby overcome oral aversion:
1. Create Positive Oral Experiences
Focus on non-feeding oral stimulation to help your baby build a positive association with their mouth. This could involve:
- Offering pacifiers or teething toys.
- Allowing the baby to explore soft spoons or their fingers.
- Gently stroking your baby’s cheeks and lips to get them comfortable with touch near the mouth.
2. Gradual Desensitization
Start slowly by introducing gentle and positive oral experiences. Begin with minimal pressure by offering small amounts of milk or food on a spoon or finger and encourage the baby to explore it on their own terms. Over time, gradually increase the amount offered without forcing or pressuring your child.
3. Work with Feeding Therapists
An occupational therapist (OT) or speech-language pathologist (SLP) specializing in pediatric feeding issues can provide valuable guidance. They can assess your baby’s feeding abilities, offer targeted exercises, and recommend strategies tailored to your baby’s needs.
4. Maintain a Calm and Relaxed Feeding Environment
Babies can easily pick up on parental stress, which can make feeding challenges worse. Try to create a calm and soothing atmosphere during feedings. Dim lights, play soft music, and keep distractions to a minimum to help your baby focus on eating.
5. Watch for Hunger Cues, Not a Schedule
Instead of sticking to a rigid feeding schedule, try feeding your baby when they show signs of hunger. This might make them more willing to engage with food. Common hunger cues include sucking on their hands, rooting, or becoming more alert.
6. Explore Different Feeding Methods
If traditional bottle or breastfeeding isn’t working, consider trying different feeding methods:
- Cup feeding: Some babies may prefer to drink from a small cup instead of a bottle.
- Syringe feeding: Gently offering milk through a syringe can help if your baby struggles with sucking.
- Finger feeding: Allowing your baby to suck on your finger while receiving milk through a feeding tube can sometimes bridge the gap between tube feeding and traditional feeding.
7. Monitor for Medical Issues
Underlying medical conditions like GERD or allergies can contribute to oral aversion. Consult with your pediatrician to rule out or manage any medical factors that could be causing pain or discomfort during feeding.
When to Seek Professional Help
If your baby’s oral aversion is severe or persistent, or if you are concerned about their weight gain and overall health, it’s crucial to seek professional help. A feeding specialist, pediatrician, or developmental therapist can provide tailored guidance and, if necessary, refer you to specialists who can address the underlying causes of the aversion.
Conclusion: Patience and Support Are Key
Oral aversion can be a daunting challenge for both parents and babies, but with the right approach and support, it is often treatable. By taking steps to create positive oral experiences, working with professionals, and being patient, you can help your preemie or infant overcome their aversion and develop healthy feeding habits.
It’s important to remember that every baby is unique, and progress may be slow. Celebrate the small victories, and don’t hesitate to reach out for help if you need it. You’re not alone in this journey, and with time and persistence, your baby can overcome their oral aversion and thrive.
