My son is seven years old and has recently gone on a solid food hunger strike. He states that he "cannot swallow," however manages to ingest oreos. When we set a limit about eating healthy before a treat he becomes agitated and says that we are "being mean." This was very concerning to us as it came on fast and furious within a month's period where he progressed from inability to swallow particular foods to anything solid and then he became mildly discriminating with his liquid choices. My husaband and I are puzzled and frustrated because this is a child who would eat and or be willing to try absolutely anything. He denies pain upon swallowing and cannot provide a particular instance where this may have begun. He has also started to spit excessively (wads of saliva or food that could not be ingested.) He feels that there is "too much phlegm." The irony in this is that I counsel children with various behavioral issues and yet I have only theories as to what we are up against. I have suspected sensory integration, some ocd tendencies and recently I am questioning whether he actually has complete control here and is being outright defiant to make alterior gains. We are currently checking multiple avenues with our local children's hospiatal (ENT, gastro) to rule out any possible physical causes. We have also recently taken our son off of Singulair which has been linked to aggression, agitation and possible throat swelling (difficulty swallowing.) Any feedback or suggestions?????
I think you're doing the right thing. You are doing what I would do if I were in your shoes. My son is 4 and has Sensory Processing Disorder, but eats fine. I also haven't heard of one just all of a sudden having an aversion. So the medical route is a good choice first off. I also find your Singulair report interesting...You report that it has been linked to aggression,agitation, etc... Well, my son takes this pill everyday. Can you direct me to an informative site on these claims?
Yes, that 's a good thing to get him in with a GI doctor. Also, ask for a swallow satudy/upper GI. It's also possible to get a PH Probe or endoscopy.
He'd really not like the PH probe, so onley suggest that if they are having a hard time getting him to reallly effectively communitcate his troubles.(it's a tube that would be placed down his nose for 24 hrs towards the end of the esphogus to check form reflux/spliration ect.) The endoscopy is a small scope that can go all the way into his stomace and beggining of his intestine. It can check for any other troubles/redness/soreness.
There are also rare disorders (not to try and freak you out) but there's one that makes a pretty perfectly healthy child suddenly unable to eat practically ANY foods, with out getting terribly ill with them. It's a disease that there's little known about it, but a GI would know what it is. (It's like EEG or something like that with abriviations)anyways, you didn't say he's throwing up, so that's good.
So it's probably nothing like that. I just wanted to suggest you ask them about it as a last resort if after testings etc, they still aren't comming up with anything because it's not something that they routinely test for, and they won't unless you ask.
I think you are on the right track.
You might also call the Children's Clininc in Richmond, VA.
They have a feeding clinic there, and work with a wide spectrum of oral aversions and feeding/eating disorders. They have a great GI and therapist there, and if you just want to run a few Q past them before you go to your appointment, it woldn't hurt. Just tell the guy that's the case manager David Smith, or Mandy Lacks, that you really need to speak with someone right away. That you are taking him to this doc, but you'd like to know if there's possibly something else they could suggest that you might be able to bring up with that doctor.That you'd never encountered this with him before, and see if they have anything to offer, or even a web site that might have some info on it.
Also, call the pharmisudical company of that medication, they should have a quality assurance department that takes care of case studdies and things like that, where pepole can get info on different medication reactions/problems. See if you can find any referals form them, or if they can suggest another drug that would do a similar help for him...or even check with a health food store, and see waht they could suggest you ask the GI about....or you know who else are great resources, someone at a compound pharmacy.
Let us know. When is your appointment?
Also, maybe run it past who ever it is that's given him the Singulair. Ask if they've ever dealt with or known of any side effects similar to this type situation.
Keep you in my thoughts and prayers.
You may have a tough nut to crack with your kiddo's situation, Kimberly. For good or ill, the "physician-heal-theyself" situation includes mental health practitioners, as well, and the same phenomenon exists. It may be extra tough for those "in the business" (and sometimes not really our place) to properly dx and/or address related issues which arise close to home.
Here are some gut-level impressions which "stuck out":
1. Kiddo has no problem with crunchy, crackly oreos. Attempts guilt trip when redirected/when parents set limits (e.g., healthy food before junk).
2. Solid food refusal came on fast.
3. The swallowing problem does not apply to liquids.
4. Exessive phlegm / spitting
To be honest, my first take on this is largely behavioral. If kiddo can swallow oreos without incident, kiddo can likely swallow other foods, as well (and has no problem with liquids). I would wonder if the excess phlegm issue could be related to the Singulair itself (it wouldn't be uncommon). Not sure if the phlegm issue resolved when you d/c'd the Singulaire, though. I'd consider the idea, also, that the phlegm could be post nasal drip (or similar) related to seasonal allergies.
Is it possible that kiddo has developed some illness that enables him to consume nothing but oreos and liquids? Sure, it's possible. You really need to ask yourself, though. Is it PROBABLE?
I would encourage you to go ahead and rule out all of the possible medical issues that could lead to this recent change: mostly for your own peace of mind. If it spontaneously resolves after a couple of less-than-pleasant doc appointments and/or tests, I would be inclined not to pursue it any further, though. At that point, I'd chalk it up to a "phase" and address it in the same ways you address behavior issues with other kids: set clear limits, remove reinforcers for the behavior, and apply consequences for non-compliance.
p.s. Quick question: does the swallowing issue apply across settings? For example, does kiddo eat popcorn and a hotdog while out at the ballgame with friends? Is he out of the home at mealtimes for whatever reasons (e.g., camp, playdates).
p.p.s. Unless other behavioral indicators suggest O.D.D., I would not be inclined to go that direction. This truly may be as simple as a childhood "phase" which has gone on long enough (a month, if I read it correctly) that it may take a bit of concerted effort to turn it back around.?
p.p.p.s. (yes, I realize my post scripts have now become excessive...so sue me...LOL) Have you tried getting kiddo involved with cooking/food prep? I wonder what would happen if you and kiddo made a special time of choosing a "special": (do whatever he wants: pancakes, popcorn, whatever) menu for tonight's meal (call it "Kids Choice Night"), go with you to the store to pick out the ingredients, and have him play a major role in the creation/presentation of the meal?
p.p.p.p.s. I'm guessing you are supplementing him with ensure/pediasure? That stuff is VERY tastey, and pretty filling. It's also a double edged sword. Although you can sustain a kid pretty well on multiple pediasures/day - some kids will drink those to the exclusion of other foods purely on the basis that they really are tastey.
Kimberly, I just did a google search and found a lot of hits for "singulair swallowing", that agree with your statement that singulair often causes difficulty swallowing.
Even after the swelling has gone down, your son could still be left with that panicky feeling of not being able to swallow - my father in law has a condition that causes his throat to close around food and it's a PANIC for him - it's awful.
I think you should wait this one out and let him eat what he can swallow comfortably.
Hey, who was from Richmond on this post?? My husband was born and raised in Midlothian, moved here to TN 10 yrs ago and we've been together ever since! I will be in Richmond for a 20yr Meadowbrook reunion in October!
(Desiree', Northeast Tennessee, 4yo boy, 5yo girl.)
hi, I thought I might be in VA, in Oct, but now I am going to wait until early next year. The feeding clinic is at the Richmond Children's Hospital. It's one of the best feeding clinic's in the United States. Also, my son's therapist is Marsh Dun Kline. Possibly we won't even have to take him there, if she can get him to the same place they would, which is very possible.
She's an incredible therapist, and has a business and web site called Mealtime Notions.
She is working with Nathan and I know that she's helped a large amount of families with children who developed trouble with eating. She has written several books, and has a new one coming out I believe soon. She teaches all over the US and Canada.
If anyone needs some advice, she would also certianly be a good one to look up.
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