[momofMikhail]

We came home with our son 3 months ago. He is now 20months old. We are having an issue with him chewing. We thought by now he would at least be trying, but no such luck. He swallows everything whole no matter how big it is. Has anyone else had this issue and if so how did you teach them to chew

[momraine]

Contact an occupational therapist. You may be able to get your ped. to reccomend one or go through your county early intervention. Your doctor should be able to get you information or your school district.

[angelkisses0102]

I second getting him evaluated by an OT...actually early intervention and/or a feeding clinic. My DS had a whole group of issues when he came home (he was 8 months old when adopted but as soon as we started solids...we saw his struggles) and feeding/swallowing was one of them. We did not really address it and here we are 4 years later with a child who eats about 25 foods...total. He did the whole stuff your mouth and swallow routine...he has sensory processing disorder and this is one of his 'quirks.' He is super, super thin and is on pedisure daily. We are finally on the top of the waiting list for private ST (his sensory OT, who is in the same group, does not handle the swallowing issues.)

If I had to do it over again...I would have worked on this sooner...but hindsight is 20/20. He has overcome most of his others issues, we are addressing the SPD and his delays, and swallowing is next. Check with your insurance...ST for swallowing issues is typically covered...ours is thankfully...as is his OT. Not to say it wasn't a battle but we finally got him the help he needs.

Good luck...

[TweetyMom04]

DS-G had this and the opposite problem (not being able to chew and especially swallow foods). He gagged on food more than he did able to swallow foods. He was thin, didn't gain any weight in bulk, maybe an oz here and a pound over a year, etc. I noticed this problem at 1 yr of age when we switched him to Solid Foods. Not until age 4 yrs 9 mo later did the problem get resolved.

He had his Adenoids removed, which the Surgeon stated 'they were impressive' as well as Tonsils removed and Grommits inserted, aka tubes in ears. He is able to chew, swallow, breath normally and is rapidly gaining weight.

[momraine]

My son does not like to chew his food, but he knows how and can when he wants to. He has a whole different set of eating issues. Some kids from Russian orphanages truly did not learn to chew. They are given propped bottles with large holes when they are infants so they don't have to learn to suck, so the muscles don't get the excersize they need. Without sucking they have difficulty with chewing. Also in some orphanges they just give them soft foods until they they are able to just swallow whatever. They don't get the gradual thickening of foods that kids in a loving home get that helps them to learn to chew. A doctor can check and be sure it's not a physical problem, but then an OT will probably work on having you do daily excersizes with him to streangthen his mouth muscles and desensitize him to textures in the mouth if that is part of the problem.

[GCS]

Definitely get him evaluated right away. It is so much better to get the help quickly. Most of us have one regret - waiting too long to find a specialist!

Our OT works with kids with eating issues all the time.

Christina

[ophelia72]

It won't be OT it will be apseech therapist but you will have to go to Early intervention. Even though its not speech per say anything with the mouth goes to speech. They will do a swallow eval and do therapy similar to OT but for the mouth. SEE you doctor! ASAP. Hate to see the little guy choke or you cutting for constantly!

[mschaefer]

Jumping over from the Polish boards... I agree with everyone else on getting an evaluation. It may be a speech pathologist or an occupational therapist, whomever in your area is trained and specializes in feeding issues, and in some feeding clinics both are available.

Our twins both had issues at 25 months when we met them. One had true oral motor issues and needed activities to help teach her how to bite and chew. The other had the oral motor ability to chew, but had sensory and behaviour issues, where she would either swallow things whole, or stuff her mouth so much and hold it there for literally hours. In the second case the OT with a strong background in sensory processing issues was more helpful than the speech pathologist who had excellent oral motor training but not any sensory training.

They are now 30 months and both doing very well. Both are chewing. The daughter with the oral motor issues still has issues biting and needs food cut smaller, but has made great gains. The daughter with the sensory issues has almost eliminated the stuffing of food and when she does revert is responding to verbal cues. She still needs to be served with very small portions at a time when it comes to favorite food or she will eat too fast and swallow whole, but with the proper set-up and cues she too is chewing

[momraine]

Yes, I have seen both OT and ST working with these issues. The starting place would still be the same, your child's doctor. He or she can tell you where to go to get an evaluation and further help in your area.

[momofMikhail]

Thank you for all the advise. I have already spoken to my doctor about this, but he does not think it is something that needs to be addressed at this time. My son has the muscle to be able to bit just chooses not to. Occasionally my son will bit down on something in his sleep and not let go. Last night it was my arm as I was rocking him (once he woke up he let go). He will memic me chewing, but not with food in his mouth. I had the chance to watch his care takers feed another child on one of our visits. They only got foods that were able to be swallowed. And it was shoveled into their mouths so fast they didn't have a chance to chew (while half way laying down). My son rarely chokes on his food. And he just started using his tongue to crush soft foods. I just don't know how to teach him to chew.

[angelkisses0102]

Originally Posted by momofMikhail

I just don't know how to teach him to chew.

That's why you need to involve someone who has expertise in this...typically an OT or ST, not the typical pedi. He needs to be treated by someone who knows how to teach him to chew based on his specific reasons for not chewing...something only someone who is familiar with this can do. Even if your doctor doesn't think it is an issue...is you doctor a doctor who is experienced in treating PI children? The reason I ask is because we got some very bad advice from our very great pedi early on regarding our son. NOW, years later, she agrees I was right but her experience was not with PI/IA kids and that is why I finally went around her. I should have not expected her to know all about PI kids when that was not her expertise.

Good luck.

[sak9645]

If you live near a children's hospital, see if it has a feeding disorders program. These programs feature a multidisciplinary group of professionals, such as a pediatric gastroenterologist, psychiatrist, developmental psychologist, OT, speech therapist, PT, nutritionist, etc. They work exclusively with kids from 0-5, who have problems ranging from failure to thrive, to texture avoidance, to spitting/throwing up after eating.

You will go for an initial meeting with the team, where you will be asked a lot of questions about feeding habits. Then whichever professionals are deemed appropriate will set up appointments to do a detailed evaluation.

The evaluations will be reviewed by the whole team, in your presence, and a treatment plan will be set up. This may involve some visits with the appropriate professionals.

One question that may be asked in your case is whether your child has seen a dentist. While most kids with chewing problems do NOT have dental problems, some do; they don't chew because their teeth or gums hurt. So it's a good idea, if you haven't done so, to have at least one visit with a caring dentist who is familiar with the fact that some kids from Eastern Europe have had very negative experiences with dentists.

As the above posters said, the feeding team is most likely to recommend visits with an OT or speech therapist, if your child has a typical unfamiliarity with/resistance to textured foods. Not all OTs or speech therapists are good with feeding disorders, so it really is best to use one who is associated with a feeding program like the ones at children's hospitals.

Insurance will often pay for the workup and treatment, especially since a physician is usually the head of the program and official coordinator of the treatment.

Sharon

[Ebadge90]

Our son had/has the same problem. It is much better now, after getting him some assistance through early intervention. And his eating problems also have added to his speach delay. In its simplest term, his mouth does not know what to do with either food or forming words.
And get help as soon as you can. Early Intervention, at least in Massachusetts, ends when they turn 3. Don't wait any longer to find our if he qualifies for assistance.

[MustangLippy]

When my daughter came home at 12 months of age she could not chew and had some problem swallowing. We took her to a Dysphagia clinic (or feeding clinic) and they taught her how to chew and swallow.

If you decide to seek help I would suggest finding a feeding clinic in your area and not relying on an OT or ST who does not have specialized experience in this area.

Personally I wouldn't necessarily take the doc's advice on this. I'd be concerned about a 20 month old that does not chew.

[momofMikhail]

Thanks everyone! I'm checking with my doctor for a feeding clinic in our area on Monday. This was my first post, and it has been very helpful.