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Coping with oral aversion: the complexities of babies who won't eat


Eat, breathe, sleep, repeat -- this is usually the typical daily schedule of a newborn child. But what happens when a child loses the ability to do one of these things?

This week on “Take Care,” Virginia Sole-Smith tells the story of her daughter Violet who required a feeding tube for the first two years of her life. Sole-Smith is a journalist and has written about health and women's issues for Self, Newsweek, Elle, Harper's and BuzzFeed. She also shared her personal story in an article published in The New York Times Magazine in February 2016.

The majority of Violet’s first months of life were spent in the hospital after Sole-Smith and her husband found out she had heart complications which would require many surgeries. Because of the surgeries, a feeding tube was placed down Violet’s throat to make sure she was getting enough calories and nutrients. But then Violet became dependent on it, and avoided anything near her mouth at all costs, a condition called oral aversion.

Oral aversion is often a side effect for babies that are placed on feeding tubes during early stages of life.

“When you keep putting stuff down a baby’s throat, they start to think ‘that’s a bad thing, this is painful, this gets in the way of breathing.’ And essentially [Violet] started to equate the idea of eating, or really anything even coming near her mouth with: this is bad, this is dangerous, I shouldn’t do that,” Sole-Smith said.

To try and wean Violet off the feeding tubes, Sole-Smith and her husband brought Violet to a feeding therapist. Sole-Smith says there are three approaches that can be taken toward oral aversion: the behavioral approach, the child-centered approach, and the radical approach. Of these three, the behavioral approach is the most common. This is an external concept where a child is rewarded for eating so they start to associate it as a good thing.

However, Sole-Smith saw some problems with this.

“My concern was if you want a kid to keep eating for the rest of their life, they can’t depend on external rewards forever. You have to reconnect with that fundamental, internal need,” Sole-Smith said.

Instead, Sole-Smith and her husband took on the child-centered approach with the help of their therapist.

“It was taking a long view. It wasn’t about getting a bottle into her every day, it was about saying, ‘okay she’s traumatized, we need to heal that trauma, we need to support her, we need to make eating safe and pleasurable again,’” Sole-Smith said.

This wasn’t an easy process, and was one that moved in very small steps over a period of months. But Sole-Smith says something as little as getting Violet into her high-chair was seen as a big accomplishment.

These accomplishments grew however, and Violet, who is still a toddler, eventually started to enjoy eating again. Today some of her favorite foods include donuts, strawberries, and pudding.

Although Violet’s oral aversion was due to feeding tubes, Sole-Smith says there are other causes to the disorder and it’s something that effects between 25 percent and 45 percent of the population.

Other eating concerns can also arise in new parents, such as if their child is eating too much or too little, or won’t eat healthy foods that their bodies need in early stages of development.

Sole-Smith says more attention needs to be paid to oral aversion and child eating habits to guide parents when trying to solve these problems.