Message: I have a client who has a baby boy who is 14 months old. He is exclusively breastfed, but he refuses all kind of solid food. The mother has tried almost everything. He appears a little overweight. She asks if she has to wean him?
Ameera Hassan, IBCLC
Cairo, Egypt
Barbara & Kay Respond:
Dear Ameera,
Normally, between 4 to 6 months, babies become curious about foods and begin to reach for food from their mother’s plate. Eating with the family becomes an enjoyable social experience. When a child refuses all attempts to get them to eat solids, we would not describe this a breastfeeding problem. Millions of babies enthusiastically consume solids while continuing to breastfeed.
Sometimes mothers misunderstand how much food the toddler should eat. They may describe a child who eats only small portions or merely tastes things as “not eating”. However, small portions are normal for toddlers. In addition, some toddlers are very resistant to certain foods or even to being fed. Many families tell funny stories about toddlers who would eat only one food for weeks, or who would only eat if allowed to feed themselves.
Once babies are 6 months old, parents should try putting small amounts of mashed food from the table in front of babies and allowing the baby to taste things without any pressure to consume more than they want. Flexibility and a relaxed attitude are necessary when feeding toddlers.
There are some reasons for outright refusal of solid foods:
1. Vitamin and mineral deficiencies can result in food refusal. Sometimes the child has a medical problem that results in inability to metabolize micronutrients; sometimes the mother has a deficiency and the breastfed infant becomes deficient because the mother’s milk is lacking in a specific vitamin or mineral. There are case reports (see references below) of Vitamin B(12) deficiency resulting in solid food refusal.
2. There could be a mechanical problem in the child’s throat or intestinal track (a blockage or stricture) that may affect his willingness to swallow solids or ability to digest anything but a liquid diet.
3. Sometimes feeding aversions develop as the result of early unpleasant oral experiences (such as long periods of intubabtion.) Feeding aversion can also result if something about the solid food feeding experience feels unpleasant to the child.
You mention that the boy appears slightly overweight. Could an undiagnosed illness of some sort be causing him to retain fluids and appear swollen when perhaps he is actually malnourished?
Once again, we think this should not be labeled a “breastfeeding problem” but as a feeding problem.
The baby should have a medical evaluation, and the mother tested for Vitamin B(12) deficiency. Perhaps the mother could receive counseling to insure that she has realistic expectations of toddler feeding behavior. Breastfeeding should continue while they figure out why the baby refuses solids.
Please let us know what the result of your investigation finds. We are curious about this case.
Update
Ameera contacted us with the following additional information:
They did the blood work on the baby and everything looks fine. The pediatrician is not convinced that it is necessary to do invasive investigations like endoscopy. His diagnosis is that the baby is taking too much milk through breast feeding so he is too full to try any new food. He advised the mother to let the baby get hungry as much as possible. According to the mother this did not work, so she decided to wean him completely and abruptly despite anything I said to her. Today will be the third day without any breastfeeding. I am waiting to hear from her about the outcome of her decision.
Barbara & Kay respond:
It is good news that the baby’s blood work showed no problems, but how frustrating to still not have an answer. Perhaps more will become clear over time. Just to be re-emphasize one point, the Vitamin B(12) deficiency that is referred to in the reference below was a maternal vitamin deficiency that affects the baby, so the mother’s Vitamin B(12) levels should be checked.
References:
Eur J Pediatr. 2011 Jul 7. [Epub ahead of print]
Solid food refusal as the presenting sign of vitamin B(12) deficiency in a breastfed infant.
Ide E, Van Biervliet S, Thijs J, Vande Velde S, De Bruyne R, Van Winckel M.
Source
Paediatric Gastroenterology and Nutrition, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
Abstract
Dietary vitamin B(12) (vitB(12)) deficiency, although common in the elderly, is rare in childhood. We report on an exclusively breastfed 8-month-old infant, presenting with persistent refusal of solid foods. Three months later, developmental regression and failure to thrive led to the diagnosis of vitB(12) deficiency, as a consequence of a subclinical pernicious anaemia with vit B(12) deficiency in the mother. Treating the infant with parenteral vit B(12) induced prompt recovery including acceptance of weaning food. Conclusion: This case illustrates refusal of complementary foods as a presenting symptom of vitB(12) deficiency in a breastfed infant. Symptoms, diagnostic tests and treatment of vitamin B(12) deficiency are reviewed. Early diagnosis and treatment are important to prevent irreversible neurological damage.
Eur J Pediatr. 2010 Mar;169(3):373-4. Epub 2009 Oct 28.
Food refusal in 1-year-old child.
Source
Paediatric Gastroenterologist, Princess Margaret Hospital for Children, Roberts Road, Subiaco 6008, Australia. Madhur.Ravikumara@health.wa.gov.au
Abstract
This is a case report of a 1-year-old, otherwise healthy, girl who presented with the history of refusal of solid foods and vomiting of 1-month duration. She underwent upper gastrointestinal endoscopy, which revealed an eye-catching endoscopic finding and the cause of her symptoms.
My son did not want to start solid until he was 18 months, so he was exclusively breastfed for that whole period. I try everything to offert him food and he just refused. Then one day he saw us eating spaghetti, he wanted to try it, he did and then he started eating regular food like is older brothers.
I always wonder why?
He was born at home, was exclusively breastfed for 18 months than after the introduction of solid he kept on breastfeeding till he was 4,5 years old. He was a healthy baby, started walking at 9 months and was very active.
Now he is a 31 years old man, 5’5″ tall and super healthy.
Ginette Belanger, IBCLC
My son is 14 month old and he refuses be fed for me. He eats the whole meal with teachear at daycare. 3 weeks ago, his blood was tested and he was anemic. For that reason, I needed to start weaning, but he doesn’t eat anything. I try to give him food several times a day, spoon by spoon. So, it’s hard because know he loves being breastfed by he need solids, too. He is overweight (3 pounds) but he doesn’t shows any sign of anemia. Sometimes, I think if the blood test was correct.
hi my daughter is almost 6 months old and is on similac HA, zantac, motilium, and gaviscon. her pediatrician diagnosed her with food aversion a month ago. seems like she has silent reflux and developed food aversion over time. she keeps gagging herself with her index finger.if this does not work and she continues coughing as if food is coming up and continues vomiting, milk will be changed to rule out any allergies.
earlier she was breastfed and given formula milk (forcefully with a syringe as she will not latch for moret han 4 minutes and probably my milk supply had been low from beginning). my baby was a petite baby when born and was at 15 th percentile for age weight graph. she kept dropping and reached 3rd percentile. last month, after 3 days of going cold turkey on breastfeeding, she finally took a bottle. there are good days and there are bad days in terms of feeding. she is gaining weight but is still on the same percentile.
my baby has no interest in weaning. i have tried rice cereal, wheat cereal, oat cereal, semolina, carrots, peas, butternut squash, banana, and homemade custard. earlier she would open her mouth, taste it and then refuse. however since last 2 days, she keeps her mouth shut an does not even want to taste anything. i am getting really worried as her milk intake has not increased much since 1 month and she needs solids now.
any help will be appreciated. thankds
Hi, I have 18th month old daughter and she refused all solid and crying too much, she want only mother feed and she feeding too much and we are very frustrated to not getting any solution .
how can we start solid and stop breastfeeding ?
What kind of person puts a 6 month old on Zantac? Why do sheeple trust these kooks? Educate yourself on how to have naturally good health and use natural medicines for your children. It sounds like you must not have been very healthy from the get food so your baby wasn’t healthy . Who the fuck puts a six month old on pharmaceutical drugs?
Hi. I have 18 month daughter who love to breastfeeding then food.. When I at work she sometime forget the breastfeeding but when stay with me at home only want breastfeeding then food so I worried about her if her stomach is OK.
Hi gaogane
I have the same issue. Please tell me what you find out
Right now I was searching some tips from internet for my 1 year old baby who likeS only breastmilk and doesn’t eat any solids and I read those comments relaxed a bit that I’m not the only mother who is struggling I hope she starts solids soon which I’m really tired to breastfeed her day and night.
My daughter is not eating much she asks fir breastfeeding most of the day and night. She eats broccoli pasta, strawberries if she wants to in amount of 2,3. Whatabix before going to bed. She gets lately so upset and dont let me do anything. She wants her full attention. She is 20 months now and i am worried how to stop her breastfeeding.
Hi Ruxsora,
My son is 11 months old and he is still only breastfeed and refusing solids and refusing to drink out of bottle. I tried different bottles when he was younger. But now he drinks water from the sippy cup. I tries putting milk in there but he refuses it.
When giving him food it’s like he’s going to vomit. I’ve tried purée foods also.
My 13 months old daughter has been exclusively breastfed and refuses any other food..now she likes indomie but never let’s me feed her.. and I know she’s not enough herself.. I am thinking of weaning her ..I dunno how
My 14 month old son will eet solids, almost everything as long as my breastfeeding wife isn’t around. His twin sister weaned herself at 3 months and is now bigger and heavier then her brother. At daycare with the grandparents and even with me he’ll eat loads. But when mommy is around all he wants is being breastfed. He still need nightfeeds because of it and will go in full midnight tantrums if he doesn’t get any. One night a went down and started feeding him leftovers and he ate a adult portion of food. Should I tell my wife to fully start weaning, I dont want to be that unsupportive father. Bu I feel she is in the way of our sons development
I’m so glad I found this form . I have a 15 mo old that absolutely refuses solids . She never took a bottle either so I’ve been nursing her on demand . She drinks from a 360 cup BUT will ONLY drink water from it. She won’t even drink juice . She’s a chunky tot in the 100th percentile . Her pediatrician doesn’t see a concern but I’m going crazy trying to get her to eat solids .