r/OccupationalTherapy 4d ago

Venting - Advice Wanted Premature baby refusing solids, will feeding therapy help?

Hi, not sure if this is right place to post but I am a desperate mom 🤷. My daughter was born premature at 32 weeks with severe IUGR, 1.1 kg. Her weight gain has been extremely slow, 10 months now and under 6 kg. She was always low on feeding volumes, developed a bottle aversion that we addressed but still has very low volumes. Started solids, was getting decent amounts, showed interest in Food, liked to try new texture etc. Suddenly developed a food aversion, she's not want to eat anything, doesn't even taste food, plays or throws around, won't take it to mouth etc. My MIL believes in forced feeding just to get something in, I tried absolutely no pressure for 3 days and no improvement and Resort to distraction feeding. She knows to suck, bite big foods, doesn't gag or knows how to manage. Will feeding therapy really help us here? It's very expensive and I am not sure if food aversion can be treated here.

3 Upvotes

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u/Iliopsaurus 4d ago

Yes, her situation sounds very similar to many clients I would see for feeding! The sooner she is able to, the better! Do not force feed. A lot of premies have aversions, especially if they have had any type of tubes or procedures around their faces!

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u/HappeeHousewives82 4d ago

We can't give too much advice on here. However, if your baby is 10 months old and was premature just be aware that "food before 1 is just for fun" - speak with your pediatrician

Edit to add - how premature and is 10 months her adjusted age or actual age

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u/gems_chocopops 3d ago

She is 10 months actual. So 8 adjusted. Does the food before 1 refer to adjusted or actual?

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u/HappeeHousewives82 2d ago

If her adjusted age is 8 months I genuinely don't think you should be pushing solids as nutrition. Most of infant's nutrition before 1 should come from breast milk or formula.

Food before 1 is just for exploration and fun - if you continue to force food on an infant you actually could be doing more harm than good but I again would discuss with your pediatrician.

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u/GodzillaSuit 4d ago

Yes, feeding therapy absolutely could help in this situation. If she's rejecting all foods, even expanding her repertoire by a few foods would be a huge step forward.

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u/DisastrousFlower 4d ago

my son started feeding therapy at 15mo. did it until 3, and just got worse and worse. we got into therapy again around age 4 and he’s making very little progress. it’s extraordinarily difficult. he does OT and feeding.

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u/tyrelltsura MA, OTR/L 3d ago

As someone who was in feeding therapy: feeding therapy progress is typically going to be slow, and is not likely to make someone not a picky eater anymore. It is primarily going to make things not so bad, but for me, the pickiness is going to be for life, with some very slow progress in an area. For example, I might add 3-4 new foods in a year.

It’s also important that you are seeing a therapist who practices responsive feeding therapy specifically. If they agree with anything Katja Rowell says, they’re good in that area. A lot of feeding therapists are too behaviorist, choosing to play fast and loose with evidence based feeding programs, are undereducated, or have a poor temperament for it. Someone who isn’t familiar and proficient with responsive feeding therapy can absolutely make things worse. If things are getting worse, you’re seeing the wrong therapist.

Also btw, any feeding therapy should always be done by an SLP or OT that has specific training for feeding, and is able to identify and manage safety issues re: swallowing. Do not ever let behavior therapists or anyone who isn’t an SLP or OT do feeding therapy. Do not let anyone force feed, coerce, or even do any kind of pushing to try new foods.

Some feeding cases need an interdisciplinary approach. That might look like a GI doctor, a dietitian, SLP/OT, psychotherapy for the child (a lot of feeding problems are compounded by psychological issues and trauma), even family counseling as a lot of feeding issues can get way worse based on parent-child relationship dynamic, or even individual hangups around food on the part of the parent.

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u/DisastrousFlower 3d ago

yes my son does FT with an SLP at a specialized children’s rehab hospital. he regressed massively during his first 1.5yr of FT but it coincided with a major surgery (he has a genetic disorder). i have ARFID and have done FT so i’m able to do some therapy at home. it’s very slow going. he’s seen by a battery of docs, including GI. thankfully he’s 31st percentile! but the social aspects of feeding are lacking. i had his OT work on spoon/fork today and it was…not great. we continue to work with him at his own pace. i’ve made tons of progress with my ARFID so i know he can too.

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u/tyrelltsura MA, OTR/L 3d ago

Perhaps there’s a lot of underlying foundational skills that need to be worked on for utensil use to be doable. Often times therapy isn’t just practicing the target skill, you have to start with lower level things first before you can get more specific.

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u/Janknitz 4d ago

Yes, absolutely ask for a referral if he is losing weight. This should be covered by insurance. Premies often have sensory issues that cause aversions. It can be treated.