Children that do not eat is becoming more prevalent each year. Although we may not understand “why” the number is increasing there are often medical issues during infancy that can be the cause to feeding dysfunction later. Here are just a few but more common:
- GERD: Gastroesophageal reflux disease is a digestive disorder that affects the lower esophageal sphincter (LES), the ring of the muscle between the esophagus and stomach. Typical function is that food passes through the LES into the stomach and is digested. With GERD the contents of the stomach flow back into the esophagus because the LES is weak. This can cause pain in infants and occasionally blistering due to the acid in the stomach. If this occurs in an infant, they learn very quickly how much they can drink/ eat before they experience pain. They will often graze eating only 1-2 ounces at a time but frequently throughout the day and night. Parents need to understand that GERD does not always involve spitting up. Signs to watch are arching during or following a feeding, waking multiple times during the night, turning the head to the right side and irritable. If a child learns early that feeding hurts they will often not trust food and their diet becomes very limited. I cannot stress enough if a baby is on medication for GERD, do not discharge it too quickly. Wait until the transition to table foods has been mastered.
- Food Allergies: many children have allergies or sensitivity to foods. Some are diagnosed earlier than others. If a child has a sensitivity to a particular food but is eating that each day they will soon learn that eating is not enjoyable. Imagine if every time you drank milk you would begin to itch, you would stop drinking it. A baby cannot tell us what is happening so be aware of warning signs such as a rash, eczema, red spots near the mouth during or after eating, scratching while eating or distress with and following eating. There are not the only warning signs but are more common than others.
- Tongue -Tie/ (Ankyloglossia): Can inhibit feeding. The lingual frenulum under the tongue is often short, thick, anteriorly displaced therefore decreasing the mobility of the tongue. This will interfere early on with suck-swallow-breathe patterns and interferes with safe swallowing if severe. A simple procedure of using a laser or clipping the frenulum allows for improvement in range of motion of the tongue therefore improvement with sucking and feeding skills.
If your baby is having difficulty with feeding, please keep these in mind. As parents, we are supposed to be able to feed our babies and its very discouraging to a parent when they are not able to. Please understand that there is help there for you and your child.
