Feeding Problems

Author: Dr. Alla Gordina

Date: 8.18.2008

“..our 12 month old daughter…is the happiest little baby we've ever met. ..However, she will hardly eat anything at all. The orphanage told us she was a picky eater, but boy is that an understatement. …We were expecting a child who wouldn't stop eating. Never dreamed we'd be in this situation!”

I am always concerned, when I am hearing about a newly adopted child, who is a picky eater.

Any child can have problems eating if he/she is exposed to new

  • Types of foods (meats, fresh vegetables, etc)
  • Textures (dry foods like cheerios or teething biscuits, or if foods are not pureed enough)
  • Smell ( kids are used to the smell of the orphanage food and would not tolerate new and unusual sensations)
  • Temperatures (children are usually not used to cold or very hot foods)
  • Feeding techniques (kids can be bottle-fed through a nipple with a huge hole, and unable to eat from a spoon)
  • Feeding position (frequently kids don’t see the person who is feeding them)
  • Feeding environment (café or buffet rather then familiar room with the small tables and familiar caregivers)

Some of the other reasons for feeding difficulties can be

  • Oral aversions and other sensory deficits will have difficulties with accepting foods, chewing and swallowing.
  • Low muscle tone (generalized or of facial muscles only) will lead to early fatigue and poor feeding
  • Painful lesions in the mouth (past or present)
  • Abusive feeding techniques in the orphanage
  • Medical conditions like ear infections, gastro-intestinal problems, asthma, colds and so on
  • Behavioral and emotional problems

It is extremely important to

  • Anticipate this condition and to request orphanage to show you how exactly this particular child was fed in the orphanage and with what.
  • Be flexible with the feeding routines and techniques – feeding a bottle, spoon-feeding, giving local formulas, feeding with the baby’s face away from you and so on
  • Reduce over-stimulation as much as possible before and during feeding
  • Make sure that your child gets enough rest and sleep
  • Not to stare on your child, while he/she is eating
  • Offer your child warm formula/ milk / yogurt, sweetened enough for this child to take it willingly. You will be able to slowly reduce the sweetness later on.
  • Warm all foods, even milk.
  • Offer Russian-style foods, black bread and so on
  • Create as much routine as possible even while on the road – when the child is eating, with what, how, where and in what order
  • Not to be concern with the lack of food variety in your child’s diet in the first days and even weeks after adoption. Slowly introduce new foods/ textures/ temperatures if your child will tolerate them.
  • Not to give such child a sippy cup; use a bottle with the hole as large as your child needs, slowly decreasing the opening; straw cup or a regular cup can be used too
  • Spoon-feed your child if necessary, even with the fluids like milk and formula

When you will arrive home

  • Don’t expect for this particular child to get better on her own
  • Have the full medical evaluation, and
  • Evaluation by a specialized pediatric feeding team (usually present in speech departments of large hospitals) as soon as possible
  • Early intervention program evaluation has to be scheduled as soon as possible
  • Have formal occupational therapy evaluation
  • Don’t accept “all toddlers are picky eaters” and “You can not starve in a cornfield” as an answer.