Feeding Difficulties

Oral Aversion

Oral aversion is when a child is reluctant or refuses to be breastfed or eat. If a child has been tube fed for a long time due to other illness it may also cause oral aversion.

With the help of a speech-language pathologist or an occupational therapist, the child will receive treatment for his negative associations with food. In other cases a child may strongly dislike the texture of certain foods—in this case, therapy will involve decreasing the defensiveness so that child may feed and receive more calories.

Did you know?

Premature infants have an increased risk of having oral aversion both when they are breastfeeding and when they mature to solid foods.


As soon as symptoms appear or oral aversiona problem is suspected, a therapist experienced in working with feeding disorders should be consulted.

  • Crying when near food
  • Gagging
  • Vomiting
  • Turning head away from food
  • Being distracted when near food


Often there are hidden reasons why infants and children have oral aversion. Some reasons may be another illness the child has had, often even when this underlying condition is treated the child remains defensive toward food. A thorough evaluation is needed to determine the factors involved with each child’s case and to help rule out hidden physiological problems.


Treatment for oral aversion may vary from infant to child. For children it can be a long, slow process because many of their behavioral patterns are set. Treatment must include increasing the volume of food and decreasing defensiveness of the infant or child.

  • Intensive daily therapy and treatment that involves small steps toward feeding goals
  • Encouragement with verbal praise
  • Establishment of a routine
  • Involving all members of the family


Dysphagia, meaning difficulty swallowing, is when the swallowing of food causes it to not pass easily from the mouth to the stomach. This may cause food to get stuck in the lungs and throat. In addition, children may have difficulty eating enough—leading to nutrition problems and failure to gain weight or grow.


The symptoms of dysphagia vary greatly from person to person. Some individuals will experience only mild symptoms while others may have severe symptoms or complications. Symptoms of dysphagia may resemble other medical conditions.

  • Failure to gain weight
  • Vomiting
  • Difficulty breathing
  • Trouble swallowing or sucking
  • Weight loss
  • Coughing, choking and gagging
  • Refusal to eat
  • Frequent sneezing after eating
  • Drooling


Dysphagia is often the result of another condition or physical characteristic, some of them may include:

  • Prematurely born
  • Tumors or masses in the throat
  • Cleft lip or cleft palate
  • Large tongue or tonsils
  • Dental problems
  • Diseases that affect the nerves and muscles
  • Craniofacial conditions
  • Objects stuck in the throat

How is dysphagia diagnosed?

Dysphagia is diagnosed through a complete patient medical history, physical exam and sometimes radiology procedures to evaluate the mouth, throat, and esophagus which may include:

  • X-rays
  • Endoscopy: a lighted, flexible instrument (containing a computer chip and camera that is attached to a TV monitor) examines the upper to lower GI tract for any condition that can cause symptoms.