Thursday, March 3, 2011

7 Getting Him to Eat - Oral Defensiveness

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A goal our speech therapist had for Manny was to have him eating some solid foods by Christmas 2010.  Needless to say we missed that one.  Progress in this area is going very slow for him.  

His oral defensiveness consists of:
  • Only eats pureed foods at room temperatures
  • Gags easily any time any new texture is introduced
  • Dislikes toothbrushing, however if you let him hold the power bush he likes the sound and vibration of it.  He will put this in his mouth by himself and play with it.
  • Doesn’t like messy play.  If food got on his hands while you were feeding him he would stop eating.  Lucky we got past this, but he still won’t put the food on his fingers in his mouth and holds his hand up in the air for you to clean it off.  He got some desitin on his fingers the other day, and wouldn’t you know it, he tried putting that in his mouth.
  • Anything that is not food goes in his mouth.  He’s ruined a cell phone, and remote controls and chipped a front tooth on who knows what.  All toys, hangers, furniture, you name it he will stick it in his mouth and bite it.
  • He resists holding the spoon and feeding himself. He doesn’t like that at all.

  • Vibrating tool to stimulate the mouth
  • Chewy Tube YellowChewy tool to get him using his molars.  When he eats its much like drinking.  It goes in and he swallows.  He does not move the food around to the cheeks or tries to chew the food.
  • Shaving cream for messy play.  He will not put his hands in it.  The occupational therapist started using a paint brush and he likes that.  Painting on the table and on his hands.  Someone needs to help with the paint brush, but at least he stopped from trying to leave the table.
  • Rubbing his face with a dry wash cloth.
  • Having him “kiss” other foods that he might not eat in an attempt to let other foods to touch his lips.
Z VIBEManny was born with a heart defect, and for close to the first 2 years of his life he was in and out of the hospital as the doctors worked on his heart.  After his last procedure there was a dramatic difference in him.  He was happier and therapy went better.  We were lucky; a lot of baby’s with heart defects have trouble with feeding.  Many of them don’t even take the bottle.  Manny had no problem with that.  I remember at one pediatrician visit she had said “Don’t worry, one day it will just happen, and he will start eating.  There was another little baby that had a feeding tube because he wouldn’t even drink from the bottle and then one day he was eating solids.”  I bet the parents didn’t think it was that easy.  I don’t see how without therapy and lots of work this will happen for Manny.  Persistence and patients is key.

Here is some other information on feeding:
Settling down to eat may be a challenge for the out-of-sync child. One reason may be overresponsivity to tactile sensations. The texture and consistency of the mashed potatoes, rice pudding, applesauce, or turkey burger may be intolerable in a sensitive mouth. Tactile oversensitivity in the mouth is also called “oral defensiveness.”
Another reason may be that the food looks, smells, or tastes yucky. A picky eater may have trouble getting the food to his mouth because of inefficient processing of sensations coming from the muscles (proprioception). Or he may need to concentrate not on eating but on staying seated because of inefficient processing about where he is in space and whether he is sitting up or falling off his chair (the vestibular system).
Still another reason may be that the child has not developed a basic sensory-motor pattern involving the coordination of sucking, swallowing, and breathing. The result is poor oral-motor skills, which affect chewing and eating solid food, trying new food, keeping food down, digesting food, and so forth.
Whatever the reason for selective eating, the picky eater has unusual food preferences or a limited food repertoire. He may eat only crispy foods, such as bacon and crackers, or only soft foods,  such as yogurt and macaroni and cheese, or only cold or hot foods. He may crave sour foods, such as pickles, and sweets, such as sugary snacks and juice. As a result, nutritional deficits and cravings may affect his development, weight, and stamina and cause him to have behavioral ups and downs, much like a yo-yo.
Usually absent from the picky eater’s diet, and thus from his body and brain, are essential fatty acids, B vitamins, minerals, and fat-soluble antioxidants. A child who rejects peanut butter, broccoli, spinach, beans, and sweet potatoes, for example, may get insufficient magnesium, an essential mineral. A magnesium deficiency may lead to hearing damage, auditory processing problems, muscle spasms, restless sleep, and sensory-motor difficulties associated with frequent ear infections. A deficiency in zinc (found in eggs, peanuts, bran, cocoa, etc.) may affect the child’s sense of taste and, thus, her interest in food. It may also lead to low muscle tone, auditory and visual problems, rashes and “fly away” hair.
Here are some suggestions to improve your child’s eating:
·         Get rid of junk food
·         Provide nutritional supplements, especially Omega-3 fats (found in flaxseeds, walnuts, and salmon), because the nervous system is made up of about 60 percent fat
·         Provide a vibrating toothbrush or facial/oral massager to desensitize the child’s lip and mouth
·         Take the child for sensory integration and provide a sensory diet at home.


  1. My son just turned one and I'm having trouble getting him to eat table food. My son has been eating Gerber 3rd foods and now we are trying to get him to eat our food. I grind up all his food and when I put it in his mouth he immediately gags before even trying to chew or swallow. My son also loves his bottle and now that I'm trying to switch to a sippy cup he immediately pushes it out of his mouth. Today my doctor told me about this oral defensiveness and after reading it I'm a scared of the future. My doctor told me to continue to try feeding him and maybe in a month his brain will tell him that it is okay. In the meantime what do you suggest I do. I am scared that he is going to have some developmental delays.

  2. Keep trying. Maybe mixing in a small amount into the Gerber food? I get in the mode of just making sure Manny eats, and don’t keep trying new textures. He won’t chew the food. It goes in and he just swallows. Check back at the site in a few weeks, Manny is starting up at Easter Seals for Speech and OT and feeding is one of the things they are going to work on with him. I will post what we are trying

  3. My son is 3 and is oral defensive, he will not eat anything but pureed baby food, or crunchy foods such as goldfish crackers. I suggest you start therapy as soon as possible, had I known what I was dealing with earlier I could have made a lot more progress. Try some preprioceptive activities such as jumping on a trampoline, and brushing his arms, legs, and back to stimulate his touch receptors. These two things are the most affective in desensitising him. My son has no developmental delays except for his eating, but all of the other kids in his feeding group did, I am not trying to scare you but this is not something they just grow out of so the sooner you start therapy and a sensory diet the better, good luck . I find the more I read the better equiped I am to help my son.

  4. I think I may have SPD and I'm 25. So far, I can't seem to find anyone who would do therapy to help me. I have a very limited diet and a lot of surfaces and textures I can't touch. I hate getting wet and once I have bathed or showered, I curl my hands into fists and tuck my thumbs inside because I can't touch anything. I've been doing it so long that my thumb bones are curved. I want to move out of my parents house but the SPD would make living alone very difficult. Any thoughts?

  5. Anything that is not food goes in his mouth. He’s ruined a cell phone, and remote controls and chipped a front tooth on who knows what. All toys, hangers, furniture, you name it he will stick it in his mouth and bite it. oral motor tools

  6. I would love to know how Manny is doing now. His situation sounds exactly like what my 2 year old daughter is now going through. I'd love to know if there's hope.

    1. I'll work on a update. Big changes came this summer!