http://www.new-vis.com/

Rebecca asks about a one year old who breastfeeds but has a severe aversion
to anything in his mouth including most foods and textures and has never
mouthed toys or his hands.
I have a little experience on this topic and it sounds to me like this
child is certainly in need of further assessment and probably some therapy.
 Most likely it would be a pediatric Occupational Therapist or a Feeding
Therapist (larger pediatric hospitals will have feeding clinics, these are
usually speech and occupational therapists).  He sounds like he has major
sensory issues but it is unclear the origin.  Some babies have a
hyperactive gag reflex, others have chronic undiagnosed GERD with severe
esophagitis and so become very oral defensive, and of course there could be
a dozen other reasons.

Some of the basics they will do in therapy would be gradually exposing the
child to new flavors and textures (for instance, start with the fine puree
he will accept, and then add a few cracker crumbs), working on mouthing
toys and textures (simply allowing something into his mouth), often they
will use a nubby NUK brush or a teething toy to dip into a pureed food or
liquid and then mouth it as a way of introducting flavors and textures.
There are also some oral motor exercises used before attempting feeding,
such as circling the lips and cheeks with a finger, gently rubbing the
inside gums, or rubbing an ice cube near the mouth.  All this is done as
part of play and verrrry slowly, only as the child tolerates and enjoys,
with the goal of making every oral experience positive, not negative.

I am well aware that many 1 year olds may seem to breastfeed almost
exclusively and disregard almost all solids (hey, I had one kid like that),
but it is not normal for a child not to tolerate any foods or textures, and
the statement that he does not mouth toys or fingers is a red flag to me.

There is a great website at http://www.new-vis.com/   kept by an expert
Oral Motor therapist, she has articles, books and useful items/ products
for sale.

Hope this helps,
NancyH
Nancy Holtzman RN BSN
Great Beginnings New Mothers Groups
Boston MA
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