Overcoming Oral Aversions in CDH
Oral aversions and weaning from a g-tube while maintaining adequate nutrition can be one of the most challenging and frustrating parts of the entire CDH rollercoaster. However, do not fear, we have 14 tips and tricks for you that will help take the stress out of mealtimes and encourage your CDH child to have a healthy relationship with a wide variety of food!
1. Play with food: If your CDH toddler is struggling with oral aversions, take some of the stress away from food and eating by letting them play with food rather than eating it. You can put together taste-safe sensory bins made out of things such as pasta, let them fingerpaint in pudding, use carrots as wands or lightsabers, or play with ice. Anything to make food less intimidating.
2. Experiment with Textures: Early on, begin introducing your baby to various textures, both orally and with their hands. When they are old enough, start experimenting with a variety of food textures and consider introducing textured toys they can chew on. Some great options include the z-vibe for motor stimulation and chewy tubes. Brushing their gums with a finger brush or NUK brush is also great.
3. Different Bottles: If you are having trouble getting your child to accept a bottle and physical reasons (such as a tongue and lip tie) are ruled out, try offering different bottle options. You may ask your friends to borrow various types or purchase several different types until you find a winner. Sometimes just changing the size or shape of the nipple will help. Depending on your child’s age, you can also consider skipping bottles and going straight to a small cup (metal shot glasses are perfect) or a cup with a straw (the honey bear is a great straw option). The Montessori method actually recommends children as young as 5-6 months start using open cups, so it isn’t as crazy as it sounds!
4. Encourage Sucking: Offer pacifiers, teethers, and non-nutritive ways to suck as soon as possible. These could include nursing (after you have pumped to empty) or allowing your baby to suck on your finger. If they are having trouble getting them to start sucking, you can try adding a drop or two of breastmilk, sugar water, or something to the pacifier to get them interested.
5. Regulate the Sensory System: Before you begin any type of therapy, it often helps to regulate the sensory system first. This can be done through 10 minutes of swinging, spinning (if they are old enough), brushing with a therapressure brush.
6. Learning Through Pretend Play: If your child is slightly older, learning to accept food through play is a great option. Take the pressure off of consumption and instead let them play with pretend play food, read books with food (some great options in our Amazon list), and practice feeding baby dolls.
7. Take the Focus off of Eating: Many strong-willed kids like to exhibit control and power. They learn pretty quickly that we really want them to eat, and some kids will use this desire to their advantage and refuse our attempts. As hard as it is, don’t put too much emphasis on the process. Keep it light-hearted and fun, never force or demand anything, and give your child choices so that they can have a little power while you still ultimately remain in control.
8. Use Comfortable Items: It is often really helpful to use your child’s favorite foods to introduce more variety. For example, if they love yogurt, you can work on accepting strawberries by dipping them in yogurt. Or if they love spaghetti noodles, you can introduce a little sauce or a different shaped pasta.
9. Have a “No Thank You” bowl: When introducing new foods to an older child it helps to give them a way out so that they never feel forced or trapped into having to eat something. This is a bowl on the table where they can place any food they do not care to eat right now. The bowl is especially helpful if they would otherwise throw the food across the room or on the floor in frustration/disgust.
10. Keep it Fun: It is definitely important to keep things fun when working on oral aversions! You can visit this blog for more ideas on how to make food fun!
11. Take it Slow: When it comes to food acceptance and textures, take it slow. This could be as basic as having your child keep the food on their plate instead of immediately going into the no thank you bowl. Once they are comfortable keeping it on their plate, have them touch it with their fingers. During the next interaction, you may have them kiss the food or put it between their teeth for a second and then into the no thank you bowl. Once they are okay with this, you can have them put it in their mouth briefly or take a small bite. Keep taking these little steps until they accept the food. Also, keep in mind that it can take 10-15 introductions of a single food before a typical kid accepts it, so for our CDH kids, it will likely be even more!
12. Chiropractor: Believe it or not, chiropractors experienced in pediatrics can be very beneficial when it comes to oral aversions.They will be able to work on the soft palate of the mouth, help with tongue movement, and increase their nurse/bottle feeding ability with success.
13. Follow Cues and End on a Good Note: When it comes to oral aversions and food therapy, it is important to keep it fun, don’t push, and stop before they get overloaded. The goal should always be to end on a good note. Remember, our CDH kids have oral aversions because of all the negative things they had in their mouths as babies and the lack of sucking practice early on. Forcing them to eat in order to get up from the table, holding a bottle in their mouth when they don’t want it, or ending the practice while everyone is frustrated only serves to reinforce and validate those negative feelings.
14. It Takes Time: Remember that it will take time to wean from a g-tube or overcome oral aversions, and that is okay! Food acceptance is not a sprint, it is a marathon, and eventually, your child will reach the finish line.
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