Hypersensitive oral reactions are exaggerated responses to touch in the mouth or around the face.
Children with hypersensitive oral reactions may not let you into their mouths for feeding, tooth brushing, or play. They may have problems moving from one food texture to the next, spitting out or gagging on any food but puree. They may gag when a spoon touches the tip of their tongues. A tiny lump of food may be gagged on instead of swallowed.
Some children become so sensitive and emotional that their reactions go one step beyond hypersensitive and become aversion reactions. These are stronger, more emotional, and less logical reactions. These children may cry, fuss, pull away, push food away, or refuse even to let you near their mouths. Gagging may turn into vomiting in an aversive reaction.
Fears can develop around feeding or any touch around the mouth. Children may try to control all aspects of a meal in an effort to protect themselves from uncomfortable situations. They may want only certain food textures, certain spoons, certain plates, and certain cups. Parents become frustrated because their child will eat only a few foods prepared in very specific ways. Face washing and tooth brushing can seem impossible.
Why is My Child Hypersensitive?
We’re not sure why children develop hypersensitivities, although there are some clues. Children who have had a history of uncomfortable medical procedures around their faces (such as tubes down their throats) may be overly sensitive because of the memory of those experiences. Children who have been fed through stomach tubes may be overly sensitive because of lack of experience using their mouths. But there are many others for whom the cause is unknown.
For most children, mouth hypersensitivity is one part of an overall body sensitivity to touch or changes in touch. These children have a hard time handling touch on other parts of their bodies as well. Therefore, treatment for the face and mouth needs to be part of a treatment plan of relaxing or desensitizing touch reactions throughout the body.
The gagging or vomiting component of hypersensitivity should be looked at carefully to determine the cause.
For some children, excessive gagging reactions are due to abnormal structures in the throat or esophagus (the tube leading to the stomach), making it hard to swallow most foods. In some children, the esophagus does not move food efficiently toward the stomach. Food collects in the tube, and children gag as it becomes too full.
Some children gag when their systems are stressed. Others gag when they have foods backwash up from the stomach with reflux.
It is important to understand the cause, so that proper treatment can be prescribed. Discuss your concerns with your child’s doctor and pediatric therapists. Together, you can determine if specific medical tests are necessary, and what will help.
If any structural problems are found, your doctor will help you understand the next steps in medical treatment or medications.
If nothing is wrong physically, your next step is to contact a feeding specialist or pediatric occupational, speech, or physical therapist. These professionals can help you work out an appropriate program for gradually decreasing your child’s hypersensitivity. A dietitian will help you find creative ways to offer foods, to ensure a balanced diet during this time.
What do Do About Oral Sensitivities
Treatments for the hypersensitive child may include three parts:
- Helping the child handle touch better throughout the body
- Helping the child handle touch better around and in the mouth
- Working on ways to help the child handle the many touches of eating
Specialized pediatric therapists can work with you to custom design desensitizing activities for your child in all of these areas. Here are a few general ideas:
Because most hypersensitive children have body as well as mouth oversensitivities, they may allow touch or cuddling only if it is their idea. If you try to approach them, they may push you away, or rub or scratch the spot. The touch may be quite agitating.
- Helping your child handle deep pressure or firm touch is usually a good starting place. Light ticklish touch can be too overstimulating. Massage can be an excellent activity for these children. It is deep pressure touch, given in an organized, predictable way. When your child can anticipate the ouch, it makes it easier to handle. A variety of other firm touch activities will be described by your child’s therapist.
- Let your child know that you are going to touch. Approach within the child’s vision so that the outch is not a surprise. Often, touch is handled better if the child sees it coming. Children seem to be able to “prepare” themselves for the touch and sometimes can react more appropriately.
Your child needs to learn that touch around the face and in the mouth can be fun. It does not have to be as emotional and scary as your child has learned to perceive it.
- Remember that the mouth is the most sensitive part of the face. Start by touching places away from the mouth and work toward the mouth. Consider starting on the trunk or back of the arms and make a game of moving toward the face. In this playful way the game becomes a distraction, so your child isn’t just worrying about the touch. You also are moving in a predictable fashion that is less scary.
- Singing is nice to combine with touch activities. The predictability of the tune helps your child prepare for the touch.
- Play face touch games with stuffed toys and dolls. Kiss your child’s face with the stuffed toy, then let your child kiss the toy or your face. Playfully taking turns with touching can help your child handle play around the mouth.
- Encourage your child to put toys in the mouth during play.
- Tooth brushing with regular or electric toothbrushes can help.
- Wipe the face regularly with warm cloths, using deep pressure. This can be calming to an over reactive child.
Eating involves many different types of touches that you, as the feeder, need to understand. The spoon, fork, and cup touch the lips as they bring food to the mouth. The food temperature is a touch. Food texture (lumpy, wet, thick, and so on) is an important touch of eating.
- Some children remove food from the spoon with their teeth very rapidly, so that the spoon doesn’t touch their lips. Try gradually keeping the spoon or cup at the lips longer. Use the child’s most favorite foods for this activity.
- Distract with games or songs.
- Food temperature often can cause overreactions. Remember that room-temperature foods tend to be easier to handle. Notice the temperatures your child handles easily. Make temperature changes very slowly and with foods the child likes.
- When children overreact by gagging when you try to switch from strained foods to thicker, more textured or lumpy foods, you probably need to make the transition more slowly. Unfortunately, store bought baby foods are not designed with the overly sensitive gagging child in mind. The textures often move from very runny strained foods with carrot lumps or obvious pasta pieces. These children need the changes to be made very slowly.
They usually will do better moving from strained foods to thickened strained foods, to blended foods, to thickened blended foods, to thickened blended foods with tiny, very soft lumps. Remember, it is easier to hide lumps in thickened foods. They are much too obvious when presented with strained foods. Good food thickeners include cereal, dehydrated baby foods, instant potatoes, instant puddings, and ground cracker crumbs.
Let Your Child Be in Charge
When you present new body or mouth touches or new food textures, always start with familiar touches or textures. Making games of the touching helps children think that the touch or the eating or the new texture is their idea. Move at your child’s pace, but be persistent.
Children with hypersensitive reactions to touch in the mouth and around the face need extra help learning to handle the touches of everyday life, especially for eating. You do not have to struggle with this one alone. Your child’s doctor, dietitian, and therapy team will work with you and your child to figure out the best way to help. Let them know how you are doing!
Therapy SKill Builders 602-323-7500 / Catalog No. 4332 (1994)