Babies Preemies Oral Aversion in Infants and Preemies By Cheryl Bird, RN, BSN Cheryl Bird, RN, BSN, is a registered nurse in a tertiary level neonatal intensive care unit at Mary Washington Hospital in Fredericksburg, Virginia. Learn about our editorial process Cheryl Bird, RN, BSN Medically reviewed by Medically reviewed by Joel Forman, MD on August 05, 2016 Joel Forman, MD, is a board-certified pediatrician and associate professor of pediatrics, environmental medicine, and public health at Mount Sinai School of Medicine. Learn about our Review Board Joel Forman, MD Updated on October 25, 2019 Print Fuse/Getty Images Babies need proper nutrition to grow and thrive, and difficulties with feeding in infancy can be a worrisome and dangerous condition. There are many different reasons a baby may struggle with feeding. All merit evaluation and treatment by your baby's physician. Babies who exhibit oral aversion (the reluctance, avoidance, or fear of eating, drinking, or accepting sensation in or around the mouth) refuse to eat or experience significant distress during feeding, causing them to receive inadequate nutrition. Signs and Symptoms Signs of oral aversion include: Appearing hungry but refusing to eatFussing or crying when preparations are made for feeding time such as when placed in a feeding position or when presenting a bottleClamping his or her mouth shut and turning his or her head away from the breast or bottleTaking a small amount of breast or bottle milk and then pulling awayFeeding only while drowsy or asleepConsuming less milk or food than expected for ageDisplaying poor growth Causes A sensory-based feeding disorder, oral aversion is more common in premature babies, and especially those who have experienced a longer stay in the neonatal intensive care unit (NICU) because of unpleasant stimuli to their mouths or faces they have experienced during treatments. Many common NICU procedures are painful and can cause babies to try to push or turn away from anything that comes near their faces, even a pacifier, bottle, or mom's breast. NICU procedures that may increase the risk for oral aversions include: Intubation and mechanical ventilationFrequent suctioningLong-term use of NG or OG tubesInappropriate oral feedings in the NICU Risks Oral aversion can be very frustrating for parents, caregivers, and the babies themselves. There are many psychosocial and medical complications of feeding difficulties, including: Infant and parental distressParental lack of confidenceSocial isolationImpaired parent/infant bondingPoor growthCompromised development Treatment Treating infants with oral aversion may involve collaboration from a multidisciplinary group of specialists, including neonatologists, speech pathologists, occupational therapists, and other professionals who specialize in the care of infants. Some of the behavioral therapy techniques used to treat infants with oral aversion may include initiating pleasant stimuli to the face, use of pain control medications and techniques, and starting feedings gently. If behavioral therapies fail to help an infant overcome oral aversion, a feeding tube may be considered. Feeding tubes, although frightening at first, can help ease some of the anxiety for both parents and babies, and allow adequate nutritional intake for growth and development. Feeding tubes are generally very safe and effective, carrying only minimal risks such as irritation of the nose, mouth or stomach. Was this page helpful? Thanks for your feedback! Track your baby’s most exciting moments with our milestone checklist. Get it free when you sign up for our newsletter. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit