Written by: Martha Davis, M.S., CCC-SLP

Helping your baby transition from liquids to solids is a common stressor for parents. In typical development, the transition between bottle or breast to purees/solids is fairly smooth. There may be some gagging or refusal, but after a short period of time (a couple of weeks), they get the hang of it. But what happens if your baby refuses to transition to solids? This is a common issue that can cause great stress in both the parent and the child, and may continue to get worse if not dealt with properly. 

So, why would a baby refuse to transition to solid foods? Many of my clients’ parents come to feeding therapy stressed and feeling inadequate and have been given advice, such as “She’ll eat when she’s hungry,” “She’s probably just being stubborn,” “He won’t let himself starve.” This advice is often well meaning, but it is not helpful. And, more importantly, it’s not true. Children between the ages of 6 and 18 months do not refuse food simply because they are being stubborn. There is typically an underlying issue that is causing your child not to eat. Therefore, they may very well NOT eat when they are very hungry, leading to growth issues and being underweight.

Because feeding difficulties have a variety of origins, a feeding evaluation can sometimes feel like detective work. During an evaluation, therapists are looking at your child’s feeding skills, but we are also trying to figure out the root of the issue as well. While not an exhaustive list by any means, here are some issues that your child may be having that have caused feeding difficulties:

  • Sensory issues
  • Oral-motor issues
  • Dysphagia
  • Cleft lip or palate
  • Laryngeal cleft
  • GI issues
  • Reflux
  • Laryngomalacia
  • Tracheomalacia
  • Tongue and/or Lip Tie

Many of these issues are medical diagnoses that a feeding therapist cannot diagnose; however, feeding therapists are observant to the signs and symptoms of these issues and can provide an appropriate referral for further medical evaluation.

If your baby is exhibiting any of these symptoms during feeding, please contact your pediatrician for a referral for a feeding evaluation:

  • Difficulty with biting or chewing
  • Excessive drooling
  • Coughing, choking, or gagging
  • Difficulty with keeping food in mouth
  • Teeth grinding
  • Unable to swallow
  • Hypersensitivity to textures, temperature, feeding tools, or different brands of foods
  • Pocketing food
  • Overstuffing mouth with food
  • Drinking from cups that are not age-appropriate

It’s important to address your child’s feeding difficulties as early as possible, as this typically leads to better results and prevents more significant food aversions from occurring.