Tips for getting pt with severe oral aversion to eat?

meanmaryjean, DNP, RN · Jun 21, 2015

If you can figure that one out you'll make a million bucks. One of the most frustrating things in peds.

NicuGal, MSN, RN · Jun 21, 2015

That is a million dollar question! We run into this with older preemies and it carries on when they are older. Is there an OT or speech therapist working with the child?

Pediatric Critical Care Columnist · Jun 21, 2015

Patience. Lots of patience. You have to start with gentle touches with your fingertips on the child's face, gradually moving toward the mouth. Once you can touch the lips, then introduce some textures, like a washcloth or a stuffed toy. When you can touch the child's lips without that head-jerking, anguished scowl, you can start introducing bland, slightly sweet foods just on the lips. You'll know when it's been tasted and found pleasant. Eventually the child will open up a little and you can move past the lips to the tongue. Don't add any textured foods until things like ice cream, yogurt, pureed sweet potatoes and other mild-flavoured foods are tolerated.

Oral aversions develop from a child never having pleasant oral experiences. Suctioning and mouth care are noxious stimuli even for those of us fortunate not to be born early or not to have early ICU admissions. To overcome aversion, the child has to replace those memories with pleasant ones. The process will take a long time and it will be very frustrating but there is hope. So have patience and be persistent. It'll be worth it.

KelRN215, BSN, RN · Jun 29, 2015

Show him an NG tube.