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Sensory Integration and Feeding

My one-year-old son's hands and mouth are sensitive and we are having trouble transitioning from jar foods to table foods in order to get him off his formula (Alimentum). He holds crackers, but will not eat them. He also gags easily when chunkier foods are placed in his mouth. He does not have any reflux issues or other medical issues he is dealing with.

Your son may be experiencing sensory integration difficulties. An occupational therapist would be the one to make that decision, and I would encourage you to explore that possibility. Children who have sensory integration issues often don't like a variety of textures on their hands or in their mouth area. To help him overcome this, I would suggest gradually introducing him to a variety of textures, encourage him to hold, play with, and mouth toys of a variety of textures--bumpy, smooth, plastic, rubber, wood, fuzzy, squishy, etc. This will help to desensitize him. If he uses a pacifier or sucks his thumb or fingers, encourage him to do this often, so that he tolerates firm substances in his mouth. If he tolerates all of these different textures, you may want to dip them in food, so that he has the combination of taste with different textures he tolerates.

To help reduce the gag reflex, initially just place food, fingers, toys on his lips, then his gums (teeth if he has them), and then the front part of his tongue. If you are using food, then you can push it a little further back on his tongue until he is ready to move the food back to swallow it. If you trigger a gag anywhere along the way, stop at that point and repeat the process until you can move on to the next step without triggering a gag reflex.

With regard specifically to your son's difficulty transitioning from jar foods to table foods, I would suggest very gradually increasing the thickness of the food, perhaps by putting table foods in a blender and gradually making them of a thicker and thicker consistency until he is able to tolerate small, soft chunks (for example rice or small bits of pasta initially). Make sure the initial chunks also are bland if he seems sensitive to various tastes. As he accepts the small (bland) chunks, very gradually increase the size of the chunks, moving to a lumpy mashed potato consistency, and then to slightly larger, firmer chunks like those in canned soups. If your son has a taste preference, start there. For example, if he likes creamy yogurt, move to the same flavor of yogurt with small fruit chunks. Gradually increase the size OR the firmness of the chunks, but not both simultaneously. Also, foods with a variety of chunks (such as some canned soups or cereal with fruit) are more difficult to manage, so save those for last. In addition, he may not like combinations of textures (mashed potatoes and gravy, for example), so avoid those at first.

CC/ TK 7-13-10



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