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 

Some children don’t like things near or inside their mouth. This is called oral defensiveness (also called oral aversion). 

It can make eating or brushing teeth or even trying new foods very hard. 

Oral defensiveness can happen for different reasons: 

• Your child may have had tubes in their mouth or nose as a baby. 

• Being born early, having reflux, or tongue-tie can make the mouth more sensitive. 

• A scary experience, like choking, can cause fear. 

• Some children are more sensitive to touch, taste, or smell. 

• Sometimes there is no clear reason. 

You may notice your child: 

• Refuses certain foods or avoids mealtimes. 

• Turns away, cries, or pushes food and cutlery away. 

• Only eats small amounts or prefers very soft, plain foods. 

• Gags or spits food out. 

• Gets upset when brushing teeth. 
• May not be gaining enough weight or growing as expected. 

Keep mealtimes calm and safe. Sit together at the table and try not to pressure them to eat. 

Make mealtimes fun to help the mouth feel less scary. Offer safe items like child-sized spoons, cups, straws, or toothbrushes. Let your child explore different textures and tastes at their own pace. You can dip a spoon or straw into a favourite food and let them lick or try it. 

Show them by joining in—pretend to chew, lick, or sip so they can copy you. 

Always go slowly. Do not force food or brushing. Let your child take the lead. If they get upset, stop and try again later. Celebrate small steps, like touching food to the lips, licking a new food, or brushing a few teeth. 

Empowerment 

With time and gentle support, many children improve. 

If your child is still finding it very hard, talk to your child health nurse, GP, speech pathologist, occupational therapist, or feeding therapist. They can give you ideas that are right for your child. 

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/gnol1k 

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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