Every one of the API principles are incorporated in my home, and I believe in the wisdom of all of them. However one particular principle, feed with love and respect, strikes particularly close to my heart. This has been a hugely important aspect of my parenting journey in regards to my now six-year-old son.
My son was born full-term after an uneventful pregnancy and birth. The most remarkable thing was that he was a very difficult newborn to nurse. He wouldn’t flange his lips out, and wouldn’t open his mouth very wide. At times it even seemed as though he disliked the nipple being in his mouth. I cried so many tears those first few days and weeks, because the one thing I had been dedicated to was breastfeeding my baby, and it was proving to be very difficult.
The next month or two he and I learned together. It would take both me and my husband to get him latched on every single feeding. Finally, we began nursing in concert, and he would open up wide enough, and endure the nipple in his mouth long enough to get his fill and then pop off.
As my son grew, I noticed other things. Other babies we knew were mouthing their toys, and their mothers would talk about how anything left within the baby’s reach was fair game; toys, remotes, books, and even parent’s noses! My son never did any of those things. He never mouthed his hands, or his toys, or his books. We were able to leave small things well within his reach, and were confident that they wouldn’t go in his mouth and be choking hazards. Nothing was accepted into my son’s mouth but my nipple.
Not only did my son not mouth anything, but he did not like anything near his face; not toys, not tissues, not washcloths. Every time something came near, he’d turn his head. If he was not in a position that enabled him to turn away, he would scream.
When my son was six months old, we thought we’d let him try some mashed banana. As per the suggestion in Dr. Sears’ The Baby Book, I used my finger to put some of the food in his mouth. Instead of curiosity, he screamed in terror every time my finger drew near. He obviously wasn’t ready, and AP parent that I am, I didn’t push him as he obviously disliked it so much. “We’ll try again in a few weeks” became my mantra when time after time, month after month, he reacted the same way when we attempted to introduce him to food. It didn’t matter if it was my finger, a spoon, O cereal, or un-mashed bits of fruits or vegetables. It was all met with that same screaming refusal. He wouldn’t even pick up the bits of food to bring it near his mouth!
Six months old became eight months old, became ten months old, became one year old, and still the only thing my son would allow in his mouth was my nipple. The most frustrating part of the whole ordeal was not that my son was not eating and even seemed afraid of food, but rather that the people I told this to, the people I thought were closest to me, did not believe me. Friends and relatives told me, “Of course he’ll eat! Just sit him down and give him food!” I don’t think they ever understood that everything, everything, every single one of the suggestions they were telling me I had already tried months ago. I gave him Cheerios on his plate so he could control the food going into his mouth. I gave him the mashed bananas in a bowl with his own spoon. I had my husband try. I mixed breastmilk with the banana. Six years later, I don’t remember everything I tried, but I vividly remember the frustration I felt when nobody took me seriously.
At my son’s 12 month well child check, I was finally able to convince the pediatrician that my son really and truly did not eat. I don’t know if she fully believed me, but she did recommend that he get evaluated by an oral therapist.
Finally a month later, my son had his oral evaluation. It turned out that at thirteen months old, my son had the oral development of a four month old. I learned that one of the reasons that babies mouth everything is to loosen the fascia in the cheeks and to practice their tongue movements, so that when it is time to eat, the cheeks and tongue will be able to coordinate to accomplish the complex task of chewing and swallowing. Because my son never mouthed anything (and I have my own theories regarding this) his fascia was never loosened, he didn’t know how to operate his tongue to eat. Additionally, his gag reflex was at the front of his mouth instead of toward the back. Even if he had wanted to eat, it would have been physically impossible.
Six months of therapy followed, with exercises and practice at home. I had to put my fingers in my son’s mouth to massage his fascia, manipulate his mouth, and try to get him to accept a sippy cup. He had vibrating teethers, horns and harmonicas to acclimate him to sensation in his mouth. We had special toothbrushes that we used to gradually move his gag reflex to the back. He was so defensive about his mouth, and it was horrible for him and for me. I remember emailing a friend during this time, “Why is this so HARD?” It was so incredibly difficult not to be envious of the parents of kids who ate so easily, whose babies ate so naturally, when we had to work so hard just to get my son to eat one Cheerio.
Finally at 19 months old, my son was “graduated” from therapy, and was on his way to being able to eat and drink food that didn’t come from me.
But the principle of feeding with love and respect was still a huge part of our lives. For many many months, the only food my son would eat were crispy crunchy things, such as crackers or toast. He couldn’t tolerate anything with a wet or mushy consistency. But one can not live on bread alone, so he had to learn to tolerate other foods and consistencies. But again, contrary to advice I was receiving, I never forced him to eat new foods. Instead, I did my best to incorporate the healthy stuff he needed to grow in the foods he was capable and willing to consume. When he began to eat peanut butter, I would grind up dried veggies to mix in with it.
When he began to eat muffins, I would make him carrot-banana-flaxseed muffins. I made him a fruit smoothie every day. When he started eating homemade macaroni and cheese, I would make it for him every night, and when he insisted I feed him every bite, I did. I had spent too long being screamed at when I approached his mouth that I relished in the chance to feed my two-year-old! I respected and worked WITH his oral aversions, instead of forcing him to eat food that he was not ready for. I never once considered the old standby, “If he’s hungry enough, he’ll eat anything.” I knew my son wouldn’t.
The following years were filled with efforts to get my son the nutrients he needs, while encouraging, but never coercing him to try new foods. Every time he ventured a new food experience it was a victory! But for years he ate the same things every day, and avoided so many foods. I’ll freely admit how incredibly frustrating it was, and of course I wished he would just try a certain new food. But I did my best to never let him see that frustration, and certainly never forced him to try anything he wasn’t ready for. I always followed his food cues. And every once in a while, he would make a gain; he’d try a new consistency, a new flavor, a new sensation. And oh, how excited I was when he began to eat cold things, and creamy things, and even began asking for fruit.
Curiously, he’s made the most gains in the past three years since his little sister’s been around. I fully believe seeing her eat absolutely everything without trepidation gave him the incentive to do the same himself.
My son is now 6 ½ years old, and eats just about everything I put in front of him! He eats many consistencies, many flavors, and many foods. He is still a picky eater, tends to eat the exact same things every day (making his school lunch is very easy for me as a result!) and he still has a tendency to vomit if he eats incorrectly; I believe his gag reflex is still not where it needs to be.
But I no longer worry about his nutrition as I once did; I no longer worry if he can eat something I’ve prepared. I no longer lay awake at night crying frustrated tears over it.
I have no doubt that the reason he’s made such incredible progress is because I followed him. I respected him. I respected his difficulties and the huge feat it was for him to eat anything, let alone anything new. My son worked hard at eating, and I never doubted for a minute how very difficult it was for him.
I know this is quite long, and there’s so much of the story I left out. But the main points are there. I’m not sure if we’re supposed to play favorites in respect to the principles, but feeding with love and respect will always be at the top of my list, and will always be an important part of my parenting and my family.
Wow, your son is so lucky to have a mama who is so in tune with his needs. It must have been so hard for you to be so worried, yet at the same time trying to stay positive around food for his sake! Well done, it’s great to hear that he’ll eat everything now!
What incredible dedication! Thank you so much for bringing this condition to our attention. Even lactation consultants would have given you the wrong advice in this situation…following your baby was the wisest thing you could have done. I hope that this will encourage more parents to listen to their instincts. I cannot imagine waiting 19 months to have someone take you seriously. Did the oral specialist have a name or suspected reason for this delay? How common is it?
Thank you for this great example of the power of AP !
Justine,
As for the cause, all we have are guesses, but there are contributing factors. 1.) His position in the womb was such that he couldn’t reach his thumb to suck it as many fetuses do, but instead sucked his lower lip. In fact he was born with a chapped and red lower lip from sucking so much. Since a lip can’t go in as far as a thumb, perhaps that contributed to the fact that he couldn’t tolerate things in his mouth. 2.) Another factor that I believe contributed to it is the sucking they did to get the goo out immediately after birth. Knowing my son as I do now, I know that he is an extremely tactily sensitive kid, (actually is very sensitive all around) and I believe it was just too much tactile input there for him to deal with, and therefore just kind of shut down.
It could possibly have been a combination of those factors, or something that was never considered. We’ll never really know, but those are my two best guesses.
The oral therapist said that she had seen this before, but only in kids who were preemies, or had to be intubated as a newborn for other reasons. My son was the only full-term non-traumatic birth she had ever seen with this.
The diagnosis was simply oral aversion/oral defensiveness.
(I just realized there’s some periods missing at the end of some paragraphs up there in the entry! I’m not sure what happened there!)