My Daughter Is Afraid of Swallowing Food, Just Ensure.. Please Help

My BFFs daughter went through all the medical testing and had to see a Psychiatrist. Get a last consult with an ENT, too.

My daughter went through a Pediatric food intervention program with a psychiatrist at age 2. She had developed a "Learned Aversion to Food" after being diagnosed with a severe intolerance to a certain group of foods that caused serious digestive pain and problems. We eliminated the food of course, but she associated food with pain. It was an immensely helpful course of treatment. The psychiatrist had a pleasant room set up with toys and a small table. At first my daughter just was allowed to play while we adults chatted (about non threatening things, like the weather). Then my husband and I sat at the table and had a small snack while my daughter continued to play. After a couple of sessions of this my daughter was invited to the table but didn't have to eat. Then one Cheerio was placed in a very tiny dish in front of her. It took about 2 months but gradually she overcame her aversion to food and participated in having a meal with us. We learned certain helpful tools, like using doll-size dishes so as not to overwhelm her, and to serve her small helpings, and keeping the conversation at the table light, and not stressing.

Then again at age 10 she was experiencing sensory problems to the point where she couldn't handle any foods if there was so much as a strawberry-seed-sized piece in the food. Again she went through a Pediatric Feeding Program at a local hospital where psychiatrists and nurses and nutritionists helped her overcome her fear. It was great. I stayed away for many of the sessions (but I could observe through a one-way window) but for several I was invited to participate and do the same things my daughter did.

She still can't tolerate things like yogurt with fruit added, and smoothies (too thick) but her list of foods she enjoys is varied and healthy. The things she can't handle aren't necessary for complete nutrition. She loves foods like steak and chicken, and vegetables, and mandarin oranges, and plain smooth yogurt, so her list of things she avoids really aren't that significant.

By the way, the psychiatrists my daughter saw weren't what many people think of when they imagine taking their child to a psychiatrist. There was no psychoanalyzing or talking for hours while lying on the couch. The psychiatrist's job was to help someone overcome a habit or fear that was interfering with a healthy life, much as an adult might go to a psychiatrist to get help with an addiction to cigarettes or gambling. It was a great help towards getting our child to approach food in a normal, healthy way, without fear or avoidance. And what was best about it were the useful tools that we as her parents were given to help our child. It was a very practical experience. So you need a psychiatrist who specifically works with children and fears or avoidances, or a pediatric food program.

There are psychiatrists and psychologists who specialize in food aversion therapies. I have a friend who does this, and it's a definite area of specialization.

Yes, you should rule out swallowing disorders, but there is more to it. And it can affect all ages. Some of it is emotional, some of it relates to texture and sensory issues. Sometimes something like reflux is involved, sometimes motility (if the food doesn't move through her system fast enough, she feels full and sick.) I'm also working right now with a teen who is in that latter category, although her situation is complicated by Celiac disease and some very real past problems with pain and inflammation.

You cannot do this yourself. Your stress is natural but it doesn't help your daughter. You cannot talk her out of this by convincing her it's illogical. See the psychiatrist. In fact, the reason I'm working with the teen in question is that she and her mother got into such battles that it's totally dysfunctional. Her parents hired me (in addition to the therapist and the medical team) just because I'm calm, generally amusing, strong and totally objective. The kid and I do all the meal planning and prep so she can be "food independent" from her mother. You can't do that with a 5 year old, but you do need some outside help.

And I know from experience in food science that way too many people have trouble with Ensure and Boost because they are filled with emulsifiers (to keep them from separating) that are hard to digest. So I don't use them. I'd rather have people shake something to mix it than try to force down the emulsifiers that can give them bellyaches.

One suggestion I have is feeding therapy (a form of occupational therapy). My 2 year old son has a history of choking and gagging issues with food texture aversions. He's been getting feeding therapy for the past nine months (since he was about 18 months). It has helped tremendously.

To answer Margie's question - please read Elena's post.

A., Elena and Diana are giving good explanations for what your doctor recommends. The important thing is that you get help for her from the professionals who are trained SPECIFICALLY for what your daughter needs. Make sure about THAT.

I have heard of swallowing disorders. I believe you see an ENT for that. I am not experienced but you could ask about that. Seems like quite a jump from gastroenterologist to psychiatrist. Why did the psychologist feel it was psychiatric?

I'm so sorry she's having this issue.

She does need a therapist/psychologist that knows how this problem works. They will work with you individually and then with her by herself. I'd also think they might want to work with both of you or with you and her dad and her, family therapy for a few minutes every now and then to touch base and ask you how things are going. This way they can work with getting you and dad on the same page as to how it's working out.

Therapy can take time. It shouldn't take more than a few months though. So many times people go and go and go and nothing is achieved. They keep you coming back and do continue to work on things but take their time. So do press them to keep moving forward.

A psychiatrist is a medical doctor that has specialized in mental health and mental health medications. They write prescriptions for 99% of their practice, they don't normally do any sort of therapy. They are doctors and their time is very expensive. They also don't have any training to do therapy. They were in medical school and did surgery and delivered babies and set bones then specialized in the way medications effect mental health.

So getting a referral to a psychiatrist means the person who did the referral things your child might need a medical intervention by using drugs to help her.

;

My son went through the same thing after choking on a piece of food. He stopped eating solid foods completely. He was living on Pediasure. For two and a half months he went to therapy and it started to help a little then it would go right back to step one. I finally found the Kartini Clinic online and contacted them about Food Phobia. As per their advice we started my son on a medication to help ease his fear about eating. Within 8 days his eating was back to normal. The Kartini Clinic was immensely helpful when I was feeling helpless. I hope this helps :)

Why don't you have her help you make the food, that way she'll know exactly what is in it. You can strain the ensure in front of her. That might help her feel more safe