Pediatric Oral Aversion

Oral aversion is the fear or reluctance to eat or drink.

What is a Pediatric Oral Aversion?

A child with oral aversion strongly dislikes or is afraid of anything touching their mouth. This can lead to a refusal to eat, drink, be touched, or an overactive gag reflex. If left untreated, children with oral aversion can develop serious, possibly life-threatening complications.

What are the signs and symptoms of a 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

What are the causes of a Pediatric Oral Aversion?

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