Oral Defensiveness

Evidence 

https://www.sciencedirect.com/science/article/pii/S0002916523121447 

Johnson Samantha, Matthews Ruth, Draper Elizabeth S, Field David J, Manktelow Bradley N, Marlow Neil, Smith Lucy K, Boyle Elaine M 

Infants born very preterm (<32 wk of gestation) are at high risk of oral feeding difficulties during the neonatal period, including problems coordinating suck-swallow and swallow-respiration reflexes, neurological immaturity, and readiness for oral feeding. Feeding difficulties may persist throughout childhood, manifesting in delayed feeding skill development, food refusal, difficulties weaning, oral motor dysfunction, oral hypersensitivity, and eating behavior problems. Prolonged exposure to nasogastric tube feeding and the provision of mechanical ventilation during neonatal care have both been associated with feeding difficulties and oral sensitivity in very preterm survivors. 

Education 

Oral defensiveness (also called oral aversion) is when a baby doesn’t like anything near or inside their mouth. 

This can make feeding extremely hard. A baby might not want to eat, drink, breastfeed, or even be touched near their mouth. If this keeps going, it can affect their growth and health. 

Some babies develop oral defensiveness because of: 

• Tubes in their nose or mouth (like feeding or breathing tubes) 

• Reflux (pain from milk coming back up) 

• Tongue ties 

• Being born early (premature) 

• A scary event like choking 

• Force feeding 

• Pain in their mouth, throat or tummy 

• Sensory issues (some babies are more sensitive to touch or taste) 

Sometimes there’s no clear reason at all. 

You might notice your baby: 

• Seems hungry but won’t eat or drink 

• Pushes away, cries, or arches their back when feeding 

• Only feeds when sleepy or sick 

• Gets upset when a bib is put on or food is nearby 

• Eats only a few sips or bites 

• Won’t open their mouth for the breast, bottle or spoon 

• Throws food or skips feeds 

• Isn’t growing well or gaining weight 

The good news is that you can help your baby feel better. Here are some gentle ways to help: 

• Try skin-to-skin cuddles to help your baby feel safe 

• Don’t force feeding—let your baby come to the breast or bottle when they’re ready 

• Keep feeding relaxed and calm 

• Make It Fun with Play 

• Use soft toys like teethers or baby spoons to play near the mouth 

• Dip toys in breastmilk or a favourite taste if you like 

• Show your baby fun mouth play—like kissing, licking or chewing on toys 

• If your baby seems upset, stop and try something easier later 

• A baby toothbrush or vibrating teether can help some babies 

• If your baby eats some foods, try adding small changes 

Empowerment 

Sometimes oral defensiveness is a sign your baby needs extra help. Some babies who don’t like things near their mouth may have delays in speaking or learning later on. Many babies improve with the right support, most won’t have long-term problems, especially if they get help early. 

If you are worried, talk to your child health nurse, doctor, or a feeding or speech therapist. 

Useful Links 

Bright Start Therapy 

https://brightstarttherapy.com.au/wp-content/uploads/2016/11/Oral-Defensiveness-Handout.pdf 

Miracle Babies Foundation 

https://www.miraclebabies.org.au/content/oral-defensiveness/gkc660 

Very well family  

https://www.verywellfamily.com/oral-aversion-in-the-premature-baby-2748511 

Raising Children 

https://raisingchildren.net.au/newborns/premature-babies-sick-babies/development/premature-development-concerns 

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