From bottle refusal to spoon refusal: what can I do to encourage feeding?

Question

She's 10.5 months now. At around 3 months of age, she started bottle refusal, refusing milk from any bottle shapes whatsoever, unless she's half a sleep.

So we started her primarily on solids at 5 month old age, with a little bit of milk mixed in.

This went ok from 5 months to 10 months of age. Now, at 10.5 months, she decided anything fed to her on a spoon is a no-no - she closes her mouth shut and turns her head.

For the past 2 weeks her average day consists of: breakfast - a steamed egg. lunch - 5-6 spoons full of rice cereal/mixed veges/pureed meat/etc, which is only 1/3 of a bowl. Dinner- same as lunch.

In the past 2 months she's gained a total of 5 oz's, weighing 18 lbs and 10 ozs, and is slipping on the percentage chart steadily. Any stranger who carries her remarks, "She's so light!" When I give her baths I can see her rib cages.

Otherwise she's happy: hits all development milestones: (except only knows to crawl on her belly but not all on fours), makes random sounds, points, grabs, laughs, etc.

What should I do?

Answer 1

When my son was that age, he also started to refuse his food. Turned out he was fed up with the bland steamed veggies etc we made for him, and wanted to eat real food. We started to give him our food (and started to cook without adding salt, for his sake), and he went back to eating well.

BTW, you're painting yourself/your kid into a corner by calling her a 'terrible feeder' - don't do that, it's just normal baby behaviour. Instead, try to remember that your kid is learning a lot about eating, and that she's progressing through different stages, and that it's very difficult for her to communicate when she's ready for something new. It seems that she's only having pureed foods, plus steamed eggs? Honestly, I'd revolt, too! Maybe try some finger food; soft fruit, steamed veggies, or even things like pancake and drop scones! Exploring food should be fun! And absolutely allow her to make a mess, it's part of the process.

And consider having more than three meals a day; at that age, she should have about two snacks in addition to the three meals.

Answer 2

Disclaimer: I'm not an expert on child nutrition. My own daughter is currently 7 months old, so I'm not exactly sure what a 10 month-old can or cannot handle, food-wise.

Firstly, I'd talk to a doctor about exactly how much nutrition she should be getting per day. The fact that you can see her ribs seems like a sign of malnutrition to me (again, not an expert!) and is something I'd want to address. The doctor may also have some ideas on how to get her to eat.

Assuming you eat your own food in front of her (we do) then try to eat as much of your own food as you can with a spoon. Lots of soups. Spoons can also be used for mashed potatoes, etc. If you eat spaghetti, make sure you have a spoon involved for spinning stuff on your fork. You get the idea. Make a big deal about the fact that you're using a spoon and maybe she'll warm up to the idea of using one herself after she sees mommy and daddy using them all the time.

If it's the spoon, specifically, that she's objecting to, is it possible to find other ways of giving her food? Maybe try a plastic fork instead (kids can be weird like that, right?) Ideally one with blunted prongs to minimize any risks. Or let her eat with her hands. It would be messy, I'm sure, but if it works, it works.

Finally, you could try bribing her. Find something she likes; a particular toy, a favourite nursery rhyme (ie: itsy-bitsy spider) or perhaps some kind of hand game she enjoys. Use this thing as a bribe when feeding. Tell her she can have it after she eats and make it clear that she can't have it beforehand. If there's a particular type of food she does like maybe use that as "dessert" for after she's finished the rest. (Note: This doesn't need to be a "real dessert food" like chocolate - it could be a specific veggie or something else that she enjoys.) Bottom line, some sort of reward to offer her if she agrees to eat her regular meals without so much fuss.

Answer 3

When a child that young starts to refuse something so necessary like a bottle it can be a sign of oral aversion issues. These can be from any number of things, but should be evaluated to ensure the child can & will intake an appropriate amount of nutrition & not develop additional aversions with age regarding texture, etc.

Did you talk to the doctor when your baby first starting bottle refusal? What did the doctor do to assist you in making sure she was adequately fed? Were you ever referred to someone to assess her mouth such as a pediatric dentist or an ENT? Do you know if anyone ever mentioned your baby having any ties (lip tie, tongue tie, also referred to as a frenulum sometimes)?

I would talk to the Dr & ask for a referral. Oral aversion can be a sensory issue & it doesn't generally just get better, it is a challenge that becomes difficult to ensure your child has a good intake. They can avoid certain textures too, especially with solids.

I wouldn't worry too much on weight, but I would use that as a reason to push the doctor for a referral if they were reluctant for any reason. Also discuss that baby has been on primarily solids for so long. A child doesn't even have to have solids that 1st year for optimal growth (although I would recommend you add them at 6 months unless told different for a specific reason for that child(. My point is only that solids are not a nutritional requirement in the 1st year if the infant is given large enough volume of breastmilk or formula. By contrast, solids are nutritionally insufficient for a child of that age range as you cannot mimic what is in formula or breastmilk with green beans & smashed banana. The liquid portion of the intake has the appropriate balance to optimize the growth & development in an infant. Solids aren't medically considered sufficient until after a child has reached a year because they often lack the density of nutrients (small stomach size) and the fats (for optimal brain development). For this reason alone, I would be talking to her doctor sooner than later as her brain needs a high fat diet for a while longer here & she needs nutrients. Bottlefeeding or breastfeeding isn't' something we do to be easier or because a child won't take solids, it's a necessity as they need that liquid portion of their diet more than they need anything else nutritionally.

Here is one article on aversion. It is most likely to be an issue with a preemie, but can happen to any baby. https://www.verywell.com/oral-aversion-in-the-premature-baby-2748511

Answer 4

Well, you aren't going to enter her into an agricultural contest, are you? There is no point in trying to make her meet some average weights: the important thing is that she is healthy rather than plum. If her own comfort level is at a sub-average weight, there is nothing to be gained by force-feeding her and overruling her eating desires: that tends to have worse effects later in life.

The important thing is checking that her weight stays within healthy rather than average regions. Especially if that isn't the case, checking for food allergies and intolerances may be a good idea. As long as she is otherwise fit and reasonably active and developed for her age however, turning a deaf ear to all the relatives who would rather have a joyous ball might be doing her a favor.

You might want to check with a doctor what kind of low weight would be detrimental to her health: the averages in developed countries are usually way above that.