26 mo Won't eat meals, gagging

[Washerwoman]

Hi. My question is similar to another poster here. My 26 mo DS has a history of reflux and food intolerance as a baby. A few months after he stopped his Losec around 15 mo ( he was eating solids & finger foods beautifully) he slowly stopped eating, dropping foods one at a time until now he eats only soft foods and crackers. He does not eat any vegetables or fruit other than sultanas. He will eat fish fingers, hot chips (but not wedges or nuggets!) and small meatballs. He often chokes and gags on larger items, even scones and cut up tiny pieces of meat on the very rare occasion he has tried them. He will go weeks without dinner if we do not give him what he likes.

The paed gastro we saw recently blamed bowel impaction and started him on laxative. His appetite improved but not the gagging or choice of foods. I am concerned that he has a psychological aversion to things as after he gags he becomes afraid of things. How do we get over this fear? It is like he does not even recognise some things as foods, and is scared to even bite into others which he once ate, no problems. He is a big boy (was a 10lb3 baby) so noone is concerned about his size yet. He does get hungry though and his behaviour and activity levels are erratic.

Please, any ideas?

Deb

[the pero clinic]

Dear Washerwoman,

It is good to know that you found an explanation for your son’s lack of appetite - and that it’s now improving. It does, however, sound as though your son has become extremely fussy about his food and now has behavioural issues surrounding his eating.

It is not uncommon for children to ‘go off’ their food if they have been unwell, particularly if they have had issues related to their tummies. With a bowel impaction, your son probably quickly learnt to associate eating with physical discomfort. Do you think he limited himself to foods that were his favourites in the first place? There may not have been motivation to eat anything else!

He is probably now still refusing most foods because of his previous bad experiences (such as pain and fear) with eating and out of habit - he knows which foods he ‘does’ and ‘doesn’t’ eat.

If your little boy is gagging, he may have ‘forgotten’ how to properly bite and chew different foods, or his heightened fear and anxiety around foods is causing him to be oversensitive to the different textures in his mouth.

Getting over the fear and behaviours can be tricky – and usually takes longer to resolve than it did to develop the issues. I would seek assessment and guidance from a feeding specialist to give you some specific recommendations for your son to expand his diet and overcome his fussy eating habits.

Some general ideas include demonstrating and talking him through biting and chewing food, adding different flavours or varieties of the foods he is currently eating, allow him to explore foods again without any expectation to eat it, and avoid confrontations or battles around eating.

This sounds like quite a complex issue, so it might be best to seek professional help. If you need some ideas for where to seek help in your area, please send an email via our website www.theperoclinic.com.au (http://www.theperoclinic.com.au/) and we’ll do our best to help.


the pero clinic