I have skype with mothers globally every week whose babies/toddlers are not gaining weight well and often refusing most or all sold foods (this makes up one of the largest parts of my practice). IME, it is rarely a behavioral issue. The most common underlying causes are structural, functional or nutritional. As someone else mentioned--an undiagnosed (or inadequately treated) TT is a common cause. This is not a case for a ped referral (no doubt the ped is already involved), but for a skilled oral assessment. Structure and function both need to be evaluated. I cannot tell you the scores of kids I have seen who began to eat (and talk and walk and sleep) after a much-needed revision and appropriate bodywork. I no longer believe that late walking is physiologically normal and both my own clinical experience and the work done on posture and TT validates this for me. I also find lots of "sensory" kids lose those preferences after revision and bodywork. 

Also, as was mentioned, food intolerances and poor gut function are almost always present to some degree where chidden are refusing solids. I would want to know about any and all indications of gut function from stooling frequency to skin conditions and sleep patterns to maternal history. Bc this child is putting nothing in the mouth--I would be inclined to suspect both a functional and gut issue. Mother's zinc status isn't going to tell us a lot right now as we are already well past the age where zinc has significantly degraded in her milk and the baby should be relying on food sources. Besides, one can usually get a good handle on likelihood of zinc deficiency with the intake questions. IMO, the baby should be supplemented with a high quality mineral supplement. Mom's prenatal will be useless unless it has the right ingredients. Her nutritional profile is very important both in assessment and supporting the baby while this is sorted out. I nursed for 16 years on a vegan diet, but I am also very much aware of and on top of nutritional issues that is sounds like she is not. Vit D exclusive of vit K2 would be a mistake here IMO. I would bet if she were my client I would be suggesting both, but in combination with mag and zinc--otherwise, not very effective. There are far too many people taking far too much D with no co-factors. Look at her fat intake, her reliance on gluten and soy (the first food I suggest anyone eliminate in these kids is gluten--100% elimination and often they grow practically overnight). I usually suggest feeding these kids coconut oil to lick off a spoon and most will take it. 

I do not find that feeding specialists are helpful at all with these kids bc they miss all the underlying issues and try to teach compensations. Compensations do not support normal function. Offering purees is in itself a compensation and does not support normal development. Babies need to CHEW their food to properly develop the maxilla. Proper development of the maxilla is key to the development of the airway. Which leads to my last issue--I would be interested in this kid's airway function. Does he mouth breath, snore, drool, what does his facial structure look like? 

This baby is not thriving. I don't think it's likely a matter of encouraging this child to eat. There is something going on here and a more thorough and holistic approach is needed to sort it out than what is happening with the hospital. 

 

 

Jennifer Tow, IBCLC, USA & France
Intuitive Parenting Network, LLC
 

Date:    Sat, 5 Apr 2014 21:28:29 -0700From:    Felicia Henry <[log in to unmask]>Subject: Re: suggestions please toddler not eating anythingI would also look into sensory integration disorder.  My son has a mild caseconcerning sound - but when I was researching this they mentioned childrenwho won't eat because they only wanted a certain texture in their mouth.  Asa side note while he only responds to sound his does have some of the eatingissues - the amount of salt & pepper he puts on ALL his food is distrubing,it's best to not watch him season his food!  The child may only have theeating issues of sensory integration issues. Felicia L Henry, BCCE, IBCLCOxnard, CA             



From:    Micaela Notarangelo <[log in to unmask]>Subject: Re: toddler not eatingHas level of vit. B12 been checked in child?MicaelaItalyOn Sat, Apr 5, 2014 at 7:27 PM, Cindy Garrison BS IBCLC RLC <[log in to unmask]> wrote:> Donna wrote about the toddler who is not taking solids. Kudos to the> mother for being willing to exclusively nurse this baby well into> toddlerhood.>> I'm wondering if the baby would take mashed food like banana, pear,> avocado, or sweet potato off a finger since will allow her own fingers in> her mouth. That might allow small amounts to go in at a time in a way that> baby has already accepted when teething.>> I t is possible this baby had an oral assault, like deep suctioning at> birth, that has made her very orally averse. It may also relate to food> allergies so it will be important to go slow and cautiously as anything new> is introduced when/if the baby becomes more accepting of food off the> finger.>> I have not used them personally but wonder if those mesh bags that can> hold soft foods for babies to chew on would work since it doesn't appear to> enter very far into the mouth.>

 > Cindy Garrison, BS IBCLC> practicing in Pittsburgh, PA>> Date: Fri, 4 Apr 2014 18:22:09 -0700> From: Donna Goggin <[log in to unmask]>> Subject: suggestions please toddler not eating anything>> Permission to post: 2nd baby B.W. 7# 10 oz., baby is now 16 1/2 months and> weighs 18#.> Baby will not eat any solids at all and is exclusively breastfed, she> won't put anything in her mouth but breast. No food, toys, or teethers. She> puts her fingers in her mouth when teething. Baby is attending a feeding> clinic with an OT who specializes in peds. They have been attending 2x/week> since December. Baby has not put any weight on since December and uses the> same scale each time.> Baby has had an esophagogram which was negative. Baby saw a pediatric> neurologist and everything was normal. Baby is talking, and just started> walking. Brother was a late bloomer but not with eating. Baby was slightly> anemic nothing startling.> Mom is not pregnant, no family hx of allergies. Mom is on a vegan diet,> just started supplementing with B12. She feels like her milk supply is good.> The neurologist and I have both suggested she give baby Carlson Vitamin D> dose 1 drop. Mom doesn't want to do this as the feeding clinic said not to> force anything. Mom doesn't want to have her Vit. D levels checked as bills> for this and their life circumstances are too much. I encouraged her to get> 2000 I.U. between her prenatal and whatever else she is taking and sent her> info about D3. We live in a very cold, cloudy climate which is a change for> her in the past 2 years.> Baby has not had her zinc levels checked. I encouraged her to have food on> high chair for baby to eat if she chooses at every mealtime, which mom said> she is doing. Mom is very stressed about attending the feeding clinic as> she feels like they aren't getting anywhere. Her biggest concern is baby> isn't gaining any weight. I have also encouraged her to attend my support> group and will try and do a pre and post weight if baby will hold still.> Not to sure of the accuracy of this at this age but worth a try.> We welcome thoughts or ideas.>> Donna Goggin-Dolwick, BSN, IBCLC> 


 

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