Hi! I honestly don't know if this is a problem or not, but I figured it was worth asking. I cannot get my 5 month old, Nick, to eat anything off of a spoon. Actually, about a month ago, he would eat a few bites. Lately, he refuses to eat. If I get it in his mouth, he spits it out and then cries. I don't force feed him, but before we got the Prevacid solutabs, it was a powder that had to be mixed in applesauce. He food out that did not have the Prevacid in it though. He basically pushes it out with his tongue. Is this normal at this age? As far as bottles, they are thickened with rice cereal, and if I don't incline him to sleep, he coughs, gags, etc for about an hour. Sometimes he is pretty congested after eating (better now with the thickened formula). For some reason, the pedi dismisses this stuff as "upper respiratory." So, my plan for him now is to back off on the solids until about another month. I know he gets the nutrition he needs from bottles (even though he only eats 18-21 ounces a day), but is this behavior with the spoon normal at this age?? Thanks!!

Hi Jessica,
Here are some questions I have about little Nick before I can answer your question:

1. Was he a term baby?
2. Are you dissolving the Solutab in water or carefully holding it at the front of his mouth with clean fingers like a pacifier until it dissolves?
3. Does he get his bottle before his pureed food?
4. Are his stools regular (as in at least once daily?)
5. What is his weight percentile?

Lingual or tongue thrust is typically integrated (disappears) around 4 months of age plus or minus 2 weeks. When you answer my questions, I will respond back again.

Thanks!

Robynne

Hi! Nick was full term when he was born. I am holding the solutab in his cheek until it dissolves. I have tried solids before, after, and in between bottles. At 4 months, he was in the 50% for weight and height. Thanks.

Jessica

Oops... stools are regular.

Jessica:

To answer your question, yes this can be a normal behavior for a child Nick's age. This is especially true for a child with reflux. I do not know how much rice your are putting in his bottles, but some infants are getting a Big Mac and French fries with all the added rice! Cereals can be very filling and, and in fact, can back up the reflux if they get constipated. This is why I asked if he was stooling regularly. Other kids handle cereal thickeners well. Some patient's need a commercial thickener, which sometimes assists with better gastric motility and makes for a better meal time.

Regarding the tongue thrust: Try presenting a flat plastic coated or maroon therapeutic spoon sideways. Provide downward depression to the anterior first third (tip) of tongue and use the top lip to remove the puree off the spoon. In feeding therapy, we use 6 seconds of a stimulating video (Baby Beethoven or Mozart) or a cause-effect toy to follow a bite of food as positive reinforcement. After the 6 seconds, the tv or toy are turned off until the next bite is taken. The little ones catch on real fast! The positive reinforcement is then faded out. I never have a patient who has to eat with the tv on before they leave my clinic. Kids learn that eating food is a positive experience. Hope this helps.

Robynne