Pediatric Oral Aversion

Oral aversion is the fear or reluctance to eat or drink.


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What is a Pediatric Oral Aversion?

A child with oral aversion strongly dislikes or is afraid of anything touching their mouth. This can lead to a refusal to eat, drink, be touched, or an overactive gag reflex. If left untreated, children with oral aversion can develop serious, possibly life-threatening complications. 

What are the signs and symptoms of a Pediatric Oral Aversion?

Oral aversion is common with premature babies, and babies typically exhibit symptoms within the first year of life.

Symptoms include:

  • Appearing hungry/thirsty, but refusing to eat/drink
  • Pulling away and arching back while feeding
  • Feeding only when tired or sick
  • Fussing or crying when a bib is put on, put into feeding position or when a bottle/dish is present
  • Malnutrition
  • Only taking a few, small sips or bites
  • Poor or stunted intellectual development
  • Refusing to open mouth when a breast, bottle, spoon, plate or food is present
  • Skipping feedings
  • Stunted physical growth or failure to thrive (insufficient weight gain)
  • Throwing food

What are the causes of a Pediatric Oral Aversion?

There are several possible reasons that can contribute to oral aversions:

  • Choking episodes – a baby can develop an aversion after a particularly scary choking event
  • Discomfort/pain – any condition or sore affecting a baby’s mouth, throat or gastrointestinal tract can stop a child from eating due to pain
  • Force feeding – this stressful event often creates an unfortunate cycle, instead of helping the child
  • Intubation and other medical traumas – babies and children who have a tube or a suction down their nose or throat for long periods of time can become afraid to eat
  • Other medical conditions in the neonatal intensive care unit (NICU) – some swallowing related issues can lead to oral aversion, including gastroesophageal reflux disease (GERD), congenital diaphragmatic hernia or tracheoesophageal fistula 
  • Sensory processing disorder – children with sensory disorders may be particularly sensitive to the feel, smell or taste of foods and drinks, including during breastfeeding

Pediatric Oral Aversion Doctors and Providers