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What to Know About Oral Version

Reviewed by Melinda Ratini, DO, MS on June 16, 2021

Oral aversion is more than just picky eating. This common diagnosis can be frustrating for parents and children alike, but there are steps you can take to help your child get the nutrition they need. 

What Is Oral Aversion?

Oral aversion is when a child doesn’t want to eat or allow anything to touch their mouth. Children with oral aversion will avoid all food or just foods of certain types and textures. Serious cases of oral aversion can lead to nutrition problems.

Symptoms of oral aversion include:

  • Refusal to nurse
  • Turning away from food
  • Gagging
  • Coughing
  • Choking
  • Avoiding anything near the mouth, such as a toothbrush
  • Not growing as expected

‌Oral aversion is common with premature babies and parents usually notice symptoms within their child’s first year of life.  Oral aversion can also happen in older children due to sensory issues or in response to a negative experience with food, such as choking. 

Causes of Oral Aversion

If your child is showing signs of oral aversion, it could indicate either a sensory issue or a motor issue.

Motor issue. If the cause of oral aversion is a motor issue, that means your child has difficulty moving food through their mouth or swallowing the food. This can be due to muscle weakness, anatomical issues, or poor coordination. ‌

Sensory issue. If the cause of oral aversion is a sensory issue, that means your child is very sensitive to the feeling of food or anything in or near their mouth. Children with sensory processing disorder can be especially sensitive to the taste, smell, and feel of food. Infants with sensory processing issues can have trouble breastfeeding.‌

‌‌Fear. Fear of a negative consequence, such as choking, can cause an oral aversion to develop. If your child had a frightening experience related to eating, this can trigger an oral aversion.

Helping Your Child With Oral Aversion at Home

While it can be frustrating when your child refuses to eat, it's important not to force food into your child’s mouth. Force feeding is stressful and can lead to more food aversion. Instead, create a relaxed environment around food and eating to put your child at ease. ‌

Reinforce good behaviors around food with praise or small rewards. For example, offer a sticker when they take three bites of a new food. If your child reacts negatively, like throwing a tantrum at mealtime, show no emotion in your response. Sit silently or turn away until your child calms down.‌

Things to consider at home:

  • ‌Do not force your child to eat anything.
  • ‌If your child has a few balanced food choices they're willing to eat, then allow them to focus their diets around those foods. Their food choices will eventually expand.
  • ‌Share some positive interactions with your child and food without the expectation of eating. Examples could be cooking together or building a mashed potato sculpture. 
  • ‌Encourage non-food activities that engage your child's sense of touch. The oral sensory system is part of the tactile system, so playing with sensory toys regularly can be helpful. 
  • ‌Use gum, a toothbrush, or an oral sensory tool to help your child get used to different feelings around their mouth. 
  • ‌Practice and play with pretend foods and toys. Demonstrate bringing the play foods to your mouth.

Getting Professional Help for Oral Aversion

If your child isn't getting enough nutrients or isn't growing as expected, you should seek out professional treatment options. You can start with your child’s pediatrician. The pediatrician might refer you to a speech-language pathologist for a feeding evaluation.‌

After a feeding evaluation, the cause of the oral aversion will determine the treatment. An interdisciplinary approach is best for a child with severe oral aversion. ‌

The interdisciplinary team might include a:

Treatment for motor-based oral aversion will include exercises for your child’s tongue, cheeks, and lips. This will improve coordination and allow your child to strengthen the muscles needed to eat and drink. ‌

Treatment for sensory-based oral aversion will have the goal of reducing your child's sensitivity around food and improving their mealtime behavior. You'll be given strategies to create an environment at home that will help your child succeed. 

With a consistent approach to treatment, your child can overcome their oral aversion. Your patience and encouragement will go a long way towards helping your child succeed. Be sure to celebrate every small victory along the way to a more varied diet. 

Show Sources

SOURCES:

Adolescent Psychiatry: “Food Refusal After An Incident of Choking: A Posttraumatic Eating Disorder.”

Children’s Health: “Pediatric Oral Aversion.”

Children’s Wisconsin: “What are oral-motor and oral-sensory problems?”

Journal forParenteral and Enteral Nutrition: “Interdisciplinary Strategies for Treating Oral Aversions in Children.”

Stony Brook Medicine: “Oral Motor and Sensory-Behavioral Feeding Impairments.”

Your Kids Table: “Conquer Your Child’s Oral Aversion with a Positive Plan.”‌

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