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Wisdom Wednesdays: Eating Issues, Part One

“She’ll eat when she’s hungry. She’s not going to starve herself!”

When we traveled to China to adopt our younger daughter in 2005, we went armed with this conventional wisdom, a variety of bottles and toddler foods, and the confidence that we could overcome any feeding difficulties with patience and persistence.  When we headed home three weeks later, we left behind the unused bottles and toddler food, our confidence, and most of all, our naive faith in the conventional wisdom that children will eat when they’re hungry.

Our daughter receiving an IV for dehydration at the Children’s Hospital in Guangzhou because she refused all food and drink for three days.

What can cause a child to refuse food to the point of self-harm?  It turns out there are lots of potential factors that can impact the desire and ability to eat and drink.

Medical Conditions: Reflux, food allergies, or lactose intolerance can all make eating or drinking so uncomfortable or painful that a child won’t risk it.

Poor Oral-Motor Skills:  A child who is accustomed to drinking thick slurry from a propped bottle with the top of the nipple cut off may not have developed the sucking and swallowing skills necessary for solid foods.

Our daughter would only use a modified cleft nipple, although she did not have a cleft lip or palate.

Sensory Processing Disorder: A child may refuse food because they are unusually sensitive to texture, smell, or temperature.  They may not be able to tolerate the feel of utensils.  Our daughter would gag if you touched an empty spoon to her lips!

Social-Emotional Delays: Children with attachment difficulties may have difficulty feeding.  They may not be comfortable with the eye and physical contact that are associated with family meals, and refuse food because mealtime is very emotionally stressful for them.

Yangdong SWI nannies, directors, and cribmate visiting our hotel room to help us get our daughter to take a bottle.

So, where can you go for help when you suspect that your child’s feeding difficulties are more than just “pickiness?”  A visit to your pediatrician is a good place to start to rule out medical conditions that may be affecting your child’s ability to eat.  An evaluation by a speech-language pathologist who is trained in treating feeding disorders is the next step.  If your child is younger than the age of three, he or she may qualify for a free evaluation and therapy through your local Early Intervention program.  Children older than three may qualify for services through your local school district.  In addition, there are many things you can do at home to help your child accept new foods.

Play with your food.  I know, Great Aunt Ethel will be horrified!  But before a child can be expected to accept a new food, they have to be able to tolerate the smell and feel of it.  Talk about the food – its shape, texture, smell, color – and then encourage your child to crush it, poke it, wiggle it, or finger-paint with it.  They may just lick their fingers, and voilà!  A new food is introduced.

Go With What They Know.  Introduce a new food with a similar one with which they are already familiar and point out how their similarities.  If your child will eat Cheerios, increase their repertoire by introducing other round foods alongside them; if they adore Goldfish crackers, use these as a gateway to other orange foods.

See, Smell, Touch, Taste, Eat.  Desensitize children to new foods in this order.  If they can’t tolerate the sight or odor of a food, you won’t be successful in getting them to chew and swallow it.  Once they can handle touching a new food with their fingers, you can gradually move the food closer to their mouth by touching it to their arm, cheek, and lips.  Then encourage them to lick the food with their tongue outside their mouth, to hold the food in their mouth for a moment, to chew the food, and finally to swallow it.  Until they’re ready to swallow new foods, a “No Thank You Napkin” can be used for discarding uneaten food politely.

Feeding issues can be frustrating for families and children alike.  Seven years after she refused our first attempts to feed her, our daughter is still not as adventurous an eater as the rest of the family, but she’s developing a healthy relationship with food that will hopefully serve her well for the rest of her life.

~Wendy Thacker is the Assistant Coordinator for LWB’s Anhui Believe in Me school.

Have you parented a child with oral aversion?   We welcome you to share any additional tips you might have.

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  • SK says:

    Overcoming an oral aversion is all about building trust, never force feed and make it a calm, stress-free environment when it comes to eating. NEVER FORCE ANYTHING no matter how frustrating it gets. Building trust is so, so important. Encourage mouth exploration as much as possible (with fingers in the mouth, tongue play, allow toys to go in the mouth). Mimicking games are a big hit in our house and integrating mouth touching is integrated into songs. roly poly, roly poly (hands to the mouth for blowing kisses or fingers in the mouth) is a part of every mealtime. We also use this song for learning new words (our son is 4 months post op for cleft palate repair in Canada and 16 months post op for cleft lip repair in China). We are now 9 months since our son’s adoption at 19 months old and still no solids have passed his lips. Not even one lick of food. It is a marathon not a sprint. All nutrition is liquid by bottle or sippy cup. His comfort level around food has grown leaps and bounds since we met. Playing with food, using utensils, being able to sit still in a booster or high chair for 10 minutes or longer, amazing compared to where he was when we met. His curiosity is peaked at daycare watching other children eat. This is a long road and we know it may take months or years to overcome his severe oral aversion. Patience is a must and read as much as possible to understand this unique aversion. Reach out to as many professionals as possible. Your child will come around (we know our son will) it just may take months, or years. Don’t get discouraged.

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