Feeding Aversions

[Anonymous]

Has anyones child gone through one because they had been in so much pain, ie heartburn silent reflux?

My daughter just started with Childrens Hosp of Phila, with feeding therapy to get her to play w food and explore it?

Has anyone done feeding therapy, if so how does it work, how long does it take to work?

What do they do in it?

[Anonymous]

ADISMOM,

I’m sorry that you’re having a hard time with your daughter. It might help if you could tell us a bit more about her story and history, and also how old she is and what tests/meds she’s been through. It just helps for a frame of reference so we can answer your questions better.

I’ll do my best answering your questions-

1) Yes, my dd has been through a lot of feeding therapy. She stopped eating at 8 weeks old due to pain, and the only way I could get her to take anything in was through feeding her while asleep. Even that was really hard, and she would fight and refuse. She arched her back and screamed and would stiffen up and her eyes would roll back- all symptoms we found out here to be Sandifer’s (a pain response from reflux). The aversion started from breast, then to bottle, and then to solids, and eventually anything that had to go into her mouth. If we tried to feed her solids, she would choke and gag and vomit. Eventually she’d turn her head and cry and refuse and arch. Then she refused to go into the high chair at all. She was on a PPI at around 9 weeks old, but the only kind available to us in canada was a compound of prilosec and it never helped her- it wasn’t being made well and the dose was probably not high enough for her. She started doing better when prevacid finally came to canada and we got her on a good dose for her (30-42mg), but by that point she was already 10 months old, and her feeding aversion was ingrained.

2) We started feeding therapy at around 8 months old due to wait lists, etc. Before feeding therapy, we saw an infant psychiatrist and a feeding MD to have her evaluated. The infant psychiatrist was a waste of time. The feeding MD felt that her reflux needed to be better controlled before she would ever eat properly. As my daughter did not have a feeding tube, we did not qualify for inpatient or outpatient feeding therapy programs from the children’s hospital. We did receive feeding therapy 1-2 times weekly in our home by a trained speech pathologist. She evaluated where Hailey was at and then started a program that was suited to her. Hailey would suck her fingers and mouth her toys, but would not allow anyone else to put anything in her mouth, and would not allow food or anything related to feeding in her mouth. We used an approach that encouraged playing with food in a non-eating enviroment with the hopes that if she’ll touch it, then she might taste it, and if she tastes it, then eventually she might eat it. We also used a praise approach, in that she was highly praised for all accomplishments related to food- we started with praise for getting her to touch it, then eventually praise for letting us touch it to her mouth, then praise for her licking it, then tasting it, then biting it, then eating it. We also took her out of the kitchen environment and started feeding in a non-threatening environment. We worked on desensitizing her mouth with brushing using the 1-2-3 away technique. We also worked on different textures- starting with purees and dissolvable foods, to hard munchables, to soft pieces, etc. until she could self feed. We also worked on drinking skills from a sippy cup. She was in feeding therapy for about 10 months. During that time, she also received Occupational Therapy to address her sensory issues that had developed, which also interfered with feeding. We also were in physio to help develop her trunk muscles and other motor issues that could impact feeding. At the same time, our feeding therapist gave us “homework” to do with her at home when we weren’t seeing her (as did the other therapists). At 15 months, Hailey’s therapist recommended that we put her in daycare part-time or take her to group meal times as the next stage to progress her feeding and she discharged us. At that point, Hailey would still only sleep feed bottles, but she could drink from a cup, and she could self feed, and she didn’t gag or choke anymore, BUT her volume of intake and fussiness at the table have been ongoing issues.

I think the thing with feeding therapy is that it’s not a quick fix, but it’s critical. There are lots of different programs depending on where your child is at, and there are lots of different approaches.

I’m a big believer that the first step, though, is to make sure that the reflux is under control, and to make sure that their pain is under control. Otherwise the cause will prevent them from moving forward with therapy. If you give us more information, it might be easier to help you.

I’ll pm you more info.

[Anonymous]

Thank you for all your help so far!!!!

ok from the beginning, she was put on axid, 1 ml 4 times a day at 6wks, this worked for about a month. Then she was put on Prilosec compounded which didn’t work at all!!!!! Then she had a milk scan and it showed severe DGE, so was put on Erythro,ycin, .5 ml three times a day which helped for a week. Now, we are in May, they put her on periactin with the erythro which worked for another month. Now in June, she started to arch like crazy, so we tried Prevacid compunded which failed, solutabs which failed. We’ve just started Prevacid with Caracream, 15 mg twice a day with 2 ml of Erythro three times a day and Periactin 2 ml twice a day.

She will eat purees, apricots, pears, apples and yogurt. She eats every 4-4.5 hrs because that is how long it takes her to desire food.

We went to a feeding eval at Childrens Hospo of Phila and they said they would see her in 3 weeks for another eval, but my daughter also will not put any food in her mouth, only toys. She won’t play with food nor hold her bottle.

Prevacid is slowly helping her pain, but a feeding therapist to come to the house would probably be a good idea, I was told 8 months is to young to start with feeding therapy, is it????

[Anonymous]

Also, where do I find a speech therapist to come to my home, did you get it from your township or district where you live????

[Anonymous]

How old is your daughter?

No 8 months is not too young to start feeding therapy. Our therapist thought it was a good age, and it proved to be a good age for Hailey.

I don’t necessarily think that an in home therapist is better. In fact, I wanted the opposite but it wasn’t available to us. It turned out to be good for us only because our therapist was so good. Often if you go to a clinic you have the benefit of a whole team of experts, and depending on the age of the child, of group therapy.

You can find a home feeding therapist by getting an evaluation by EI (early intervention). I don’t know what the criteria are for an evaluation in the US- In Canada, feeding problems are flagged as urgent, and you get seen pretty quickly.

Hopefully the caracream does the trick. It really was the answer for us. Compounds usually don’t work, and the solutabs are great if your child eats on demand, but most people aren’t told to give them on an empty stomach and followed up with a meal 30 minutes later, so they also don’t work well if not given correctly.

Good luck with the meds.

This site is great, but there’s another site that has a good section for people with feeding aversions:

http://www.parent-2-parent.com/forum . A lot of people on this site also post there in the feeding aversions section.

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