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Oct 07

QUESTION – When does one start to worry when baby has not learnt to eat solid food? One member asked this question because her almost 8 months old child did not take to solid food well.

REPLY – The question was forwarded to paediatrician, Dr Cheang Hon Kit of a private hospital in Penang. Below is Dr Cheang’s comments regarding difficulties in eating.

Yes, there is indeed a ‘condition’ with difficulty with swallowing. It has something to do with the swallowing mechanism that is immature/ defective. Muscles around the mouth, tongue and throat have to be well coordinated to get the food to be swallowed. Food especially solids, need to be formed into a lump in the oral cavity and then being pushed to back of the throat. Muscles around the throat (pharynx) then will push further down into the esophagus, the food passage leading to the stomach. Along the esophagus, the muscles will propels the food bolus slowly in a coordinated ‘waves like movement down the stomach. Do you know we can actually swallow even in an upside down position? Ever thought of that?

So, the act of eating is much more complicated than we could imagine. Many things can go wrong and you will have someone having problem in eating/ swallowing. This also applies to elderly persons with stroke, I’m sure you have seen some elderly patients with stroke and saliva just keep drooling. They also have a lot of difficulty with feeding. Back to your question, I think he is probably one of those late starters, where the nerves involved in the swallowing is not so matured yet. I do come across some of these very difficult babies. If the baby is well otherwise and not showing any other signs of neurological abnormalities, I usually advise the mum to wait and try again. If the baby is not putting on weight properly and having other developmental problem, I would strongly advise to have the baby thoroughly assessed by the paeds neuro. Hope that answer your/ her question.