Find out exactly what it means for a child to have an oral aversion, why some kids experience oral aversions, and most importantly how to overcome oral aversions!
Has your child ever refused to eat… most kids have at one time or another.
Has it ever been a persistent and consistent refusal to bring food anywhere near their face? Or, has your baby acted like a bottle of milk was poison when you brought it towards their mouth?
It’s utterly alarming!
Our minds start to race with more questions than answers, “What could be wrong?”, “Why don’t they want to eat?”, “Do they even feel hungry?”, “How are they going to grow if they don’t eat???” It’s more than understandable to worry, to get annoyed, and dare I say to even try to force them to eat!
When children begin to act like food is a weapon that they must run from, then it’s possible they have what’s called an oral aversion.
What is an Oral Aversion?
Oral aversion is a term used by feeding therapists and the medical community in general. Oral aversion is a diagnosis, but an understanding that a child has extreme sensitivity and fear of food, drinks, and/or any object near or in their mouth. Some children with oral aversions may readily accept drinks from a bottle, sippy cup, or straw, but refuse food of any sort.
Other kids with oral aversion will not tolerate utensils or toothbrushes. Babies may refuse teethers to chew on and virtually put nothing in their mouth (Read more about babies who refuse solids).
Oral aversion can look different from child to child, but what’s consistent is that they act extremely defensive and fearful of the food/drinks/objects they feel they have to avoid.
Who Can Develop an Oral Aversion?
The short answer is any baby or child can develop oral aversions anytime throughout childhood. Although, it isn’t a normal part of development, and most kids will never experience it to its full degree. It’s completely within the realm of possibility for newborns, older babies, toddlers, and children to have an oral aversion out of nowhere or for it to become intensified over time.
However, some children are at a higher risk for developing oral aversions…
Why do Some Children Have an Oral Aversion?
Oral aversion can begin at birth, particularly for babies that aren’t fed from a bottle or nursed from their mother. Babies with medical complications, diagnoses, or are born prematurely may eat from a feeding tube right after they are born. Without the stimulation a bottle or breast provided to the the lips, tongue, cheeks, and entire oral cavity, a child can develop an intense sensitivity.
That lack of oral exposure is the perfect situation for an oral aversion to incidentally occur. Most NICU’s are very aware of this phenomenon and do their best to avoid it from happening at all through swabbing the babies mouth or even rubbing their lips to give some physical input to the mouth.
Some of the common reasons that it pops up after birth are:
- Baby or child must be fed through a G-tube, a feeding tube that enters their stomach directly. Again, the mouth gets used to not being touched and becomes hypersensitive.
- Baby or child must be fed through an NG-tube, a feeding tube that goes through their nose and down the back of their throat. NG-tubes are more temporary in nature and can be extremely uncomfortable, as you can imagine. I’ve personally had the experience, and it’s difficult to say the least. For some children, this experience is so unpleasant that they are sensitive and fearful that other objects near their face will also cause pain or discomfort.
- Babies, toddlers, or kids that have had surgery, or trauma to their mouth or throat can have a similar reaction as they are either concerned that eating or drinking will cause further pain or repeat their troublesome experience.
- Babies, toddlers, or children that have underlying sensory sensitivities. The texture and feeling of food in the mouth can be incredibly uncomfortable, just like nails on a chalkboard would be for me. This, coupled with any of the above instances, increases the risk for oral aversion greatly – as was the case with my child. Head over to sensory issues with food to learn more.
- Babies or children that have a violent vomiting episode. This happened to my second son at 9 months old when he got a bad stomach virus. He was already having difficulty accepting foods, but this intensified our problem greatly because of how sensitive his throat was after repeated throwing up.
- Babies or children that have a significant or frequent choking/gagging occurrence(s) while eating. It only takes one time to scare the pants off of some kids and babies. These gagging incidents sometimes happen due to underdeveloped oral motor skills, but other times are just random.
- Toddlers or children that are already displaying signs of extreme picky eating or Avoidant Restrictive Food Intake Disorder (ARFID), may intensify their food aversions because over time their sensitivities continue to worsen as the lack of exposure to different textures and flavors of foods increases in time. Learn more about causes of picky eating.
- Babies, toddlers or children that have acid reflux, allergies, or other medical conditions may refuse foods because its literally painful, but even after the condition is addressed, the same situation plays out with increased sensitivity, as well as habitual experiences.
- Babies and children that are force-fed, even with the best intentions, can have significant oral aversions if the experience was unpleasant for them, as it usually is. Read more about why it’s best to avoid force-feeding.
In all of these cases, the fear that food can hurt them or be painful raises their adrenaline levels. They feel they are in a fight or flight situation, which is why toddlers will often respond by running away, tantruming, or even hitting and throwing things when food/drinks/objects are in or around their mouth. Babies may arch their backs, trying to get away, and scream for dear life.
As soon as their adrenaline level rises, their appetite shuts off.
And, they are able to sustain an empty stomach without an discomfort. For some kids, they have an additional layer of not having an appropriate appetite to start with and they may never feel hungry. This can be due to many factors including difficulty with stomach emptying or even a poor sense of internal cues, which is called interoception.
How to Conquer Oral Aversion!
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Hopefully you’ve got some ideas on the root of your child’s oral aversion at this point. That will be helpful. Now, what do you do about it? There’s a lot that can be done. As an OT that specializes in feeding and a mom that’s been through it, these are my best tips for overcoming oral aversion, in order:
1. Stop any force feeding.
2. Don’t pressure your child to eat anything. Simply present the food to them, and serve something with the meal they usually eat.
3. Create a positive atmosphere around meals. It’s so important they learn that meals are an enjoyable time. I know this can be harder than it seems. Get more tips here.
4. Be patient. Oral aversions take time to conquer and seeing the small wins (like not crying when they come to the table) are steps forward.
5. Brush their teeth with a firm pressure 2-3 times a day. If they can’t tolerate it, begin slowly, never forcing in case of sensory sensitivity. Start with just bringing it to their lips, then just their front teeth, and so on. This will help to desensitize their mouth. Using a vibrating toothbrush will give even more input, we have one like this and my kids and I love it.
6. Encourage babies and toddlers to chew on teethers. Anything in their mouth is a good thing!
7. Practice and play with pretend foods and toys, bringing them to your mouth, outside of meal times.
8. Have positive interactions with foods, without the expectation of eating. Think about cooking together, which is incredibly powerful, or getting into messy play (think painting with spices, sculpting with edible playdough, etc.)!
9. Play in sensory bins on a regular basis. Even though it’s not near the mouth, kids that are sensitive around their mouths, often won’t even touch different textures. Sensory bins are a great way to change the way their brain thinks. Instead of their brain sending the signal “this is gross”, it can start to learn, “this is okay”. Over time that will translate to the food they eat!
10. Be consistent. You don’t have to do everything at once. Take on one tip at a time, as you can manage it, and be sure that you’ll be able to follow through – at least most of the time.
Getting More Help for Oral Aversions
What you’ve learned here is a solid start and can make big changes, but the truth is picky eating and oral aversions are pretty big animals. To learn a lot more about my 3 Key Strategies for Overcoming Picky Eating, get a seat in my free online workshop right here.
I’d also encourage you to talk to your child’s doctor about your concerns, ask for their recommendations, which may include some extra help. This comes in the way of feeding therapy, usually from an OT like myself, or a speech therapist.
No matter what, know that you’re not alone AND that oral aversions aren’t a life sentence
More on Picky Eating
Picky Eater Tip: Expand on What Your Kid is Already Eating
Clever Tricks to Have a Family Meal with a Picky Eater
The Most Amazing Healthy Snacks for Picky Eaters
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Alisha Grogan is a licensed occupational therapist and founder of Your Kid’s Table. She has over 19 years experience with expertise in sensory processing and feeding development in babies, toddlers, and children. Alisha also has 3 boys of her own at home. Learn more about her here.
Bottle aversion by rowena saved my baby!
Do you give feedback with the patients on an individual basis as to what they need to do specifically?
My 13 month old grandson has a ST & OT however they never discuss what they are doing so the parents can reinforce it.
Hey Sandra,
Yes, an OT and ST should be providing the families with activities to be doing at home, as well as discussing with them what they are doing and why they are doing it. At Your Kids Table all of our families that purchase our courses have opportunities to ask questions along the way!
Hope that helps, I would specifically ask the OT and ST directly.
Best,
Desiree
Hello, my son is now 5 months old and he started to eat less when he turned 2 months. Doctor prescribed a change of formula to Nutrimigen. He got better in a month, but now again he refuses to eat. I must say he only eats when he is drowsy or asleep. It’s so frustrating, please help me. I just started solids and I am scared he will do the same with solids too.
Hey..I am facing a similar problem with my son..he is 5 ‘months old now..he was drinking milk well till he turned 2 months ..he doesn’t drink milk..he arches his back every time I take him to a feeding position..what was your experience with solids ..did your baby do well with solids …thank you
Hi Sunitha! I’m so sorry to hear about your baby’s feeding challenges. Is he not drinking any formula or breast milk? Babies need formula or breast milk until 1 year of age. If he’s not accepting either, definitely consult your doctor right away. They can run tests or recommend a different formula. You can also try feeding him in a more upright position and see if that helps.
Best,
Kalyn
Do you suggest a feeding tube as the first action if you suspect your baby is starting to be oral averse? She was born early and has been in the NICU for a few months with a NG tube. She started out bottling great and now w have seen a big decrease in her feedings. The hospital is trying to have me get a G-tube, but I would like to try other options before going start to a surgery and tube.
Hey!
With any oral aversion, we’d recommend following the items in the article to address it!! With regards to the amount of food that she is eating, I’d discuss what is best course of action with the doctors.
Best,
Desiree
I’ve recently made friends online with a man who lives in Pakistan who has a 3 year old son. I was quite disturbed when he said he was very worried about his child as he still wouldn’t eat solids and just lives on milk. When I told him it was risking his boys long term health, he said his family system was very different from those in the west. The whole family lives together & his boy is the sole grandchild and very spoilt. He has 2 brothers senior to him and he can’t go against their wishes. He had taken him to the Dr but was just told the boy was low on calcium! When I began speaking about the need for sunshine in the production of calcium, he clearly knew nothing about simple health information like this. I gently pointed out that he must tell his family about the health implications for the boy if he doesn’t get on to solid food and try & enlist their support. Can you suggest a book I might send him or an online source he might access. As you start with very young infants, I’m not sure how much he would understand of your program. He might be better off with scientific information to take to his family.
Hey! Thanks for reaching out. We have our online mini course registration going on right now. That might be a good resource for him. He can register for the event HERE.
Best,
Andrea
Hi. My 11 month old has. GTUBE and an oral aversion. We’ve been doing OT therapy. But how do I know if he needs speech also?
Hello, My little one was discharged form the hospital last week she came home with a mic key button, she just take 30 cc top 50 cc when trying to feed her with the bottle.. then we do the g-tube to complete her feeding , she is on a continuous feeding during the night, she is 2 months old.. I’m really desperate .. I’m trying my best to help her and it seems nothing works
Hey Anna,
We understand how hard this can be. Do know it WILL take TIME!! So keep up the great work that you are doing! I’d really focus on trying different teethers with variety of textures around her mouth and in when she allows. Also utilizing a finger tooth brush or regular to get inside her mouth when she allows. Having her touch a variety of textures as you can will be really powerful too! If you are in the US you can look into getting early intervention to help with some of these suggestions and you can read more about it HERE
Best,
Desiree
Hi,
Love your website.
My 14 month old son has had an episode of sickness… he had a very sensitive gag reflex anyway and reflux when he was a baby. When hes poorly he always vomits. He was coughing on some food, had a drink and threw up- this happened several times, now everytime he sees any drink he coughs and gags. You can see hes panicking. Here’s things I have tried;
Drinking out of different cups,
Different drinks
Different temperatures
Drinking out of same cup as him
Drinking with a straw like him
Playing with a child who is a good drinker and encouraging through a drinking party
Water play with cups and drinks
Also I have tried….doing nothing.
I have taken him to gp and they cant see anything wrong with mouth, throat, ears etc…
You mentioned your son had something similar at 9 months after sickness. Please tell me anything else I can try. His nappies are really dry despite watery food.
My 28 month old has been crying in fear every time its time to eat. As if she is traumatized even though we have not done anything to traumatize her. This started this week, before she would eat, not alot, but she would eat. Now she is refusing to even drink water. Please help me. It’s very overwhelming.
We understand how overwhelming this can be!! If she just started recently, I’d make sure she’s not feeling sick or teething, this can be one of the main reasons for sudden onset of not eating. However, I would try to complete some food play with her outside of mealtimes to see if she will engage with the foods and feel comfortable in a no pressure to eat environment. This can transfer over to help with the eating. We also do have a free workshop that will be helpful in some no pressure strategies as well as some other tips to help guide her. You can save your seat for the workshop HERE
Best,
Desiree
Hi Anais,
Even I’m in a similar boat. If you don’t mind, can you share what your journey has been since then? Do you see any progress ? Did you get any therapist help?
Thanks.
Hello Anais, did ur daughter overcome with this issue? if yes then please please do share your method to deal with it. I am also on same boat.
Hey Jain,
Thanks for reaching out to us and others in the comments 🙂 Picky eating can be really overwhelming and as you can see, you certainly aren’t alone! So many other families are having similar challenges. Our free picky eating workshop is a great place to get some suggestions and to start on this journey. You can save your seat HERE.
Best,
Andrea
Anna how are you getting on now ? My little one is 3 months and I have/ had the same problem
My daughter is 11yrs old and she looks at almost all foods with a disgusting look on her face, i can name everythang on one hand of what she will eat. It has drove me crazy to where yes ive gave up, but now i have a 3ry old who is heading down the same path, its causings problems with dad and i
Hey Melissa, we understand how hard this can be!! I’d try to read through this Article to see if this sounds like your daughter!! Best, Desiree
Please check your email. I’m desperate my toddler is afraid of his bottle and hasnt bad milk for 5 days.
Hi Alisha, is there any means to chat with you in person??? I have questions regarding my son. Please I’ll be great full,can you please help me through chat or email???
You can email me at hello@yourkidstable.com
My daughter was just released from the hospital. She had an NG tube for four days and now will not breast or bottle feed.
She is 9 months old. Do you have any tips?
Hey Lanora,
I’d definitely try the oral motor suggestions in the article as she may have some aversions even just from the 4 days. Also I’d look at a good feeding schedule for when to offer foods (breast, bottle, table foods) to make sure she is hungry. HERE is a great article for looking at a schedule!
Best,
Desiree
Hiii….
My 7 year old brother since he was 3 has always refused to eat solid food, when given food he would always vomit and stuff. Now the only thing he eats is soft porridge,bread and tea
Any tips to get him to eat more food?
Took him to the paediatrician the other time, they couldn’t find anything wrong him