OpenHealth Q&A

Seeking Guidance for Severe Food Aversion in 15-Month-Old on Propranolol

Greetings everyone, we're currently in a difficult situation with our 15-month-old daughter, and we’d like to connect with other parents or professionals who might have faced similar challenges. **Our Situation:** * Our daughter was born with a **medium-grade infantile hemangioma** at the nape of her neck. Although it’s not life-threatening, it is quite visible and slightly elevated. * Our pediatrician initiated a treatment plan with **Propranolol at 20 mg per day** about three months ago when she was around a year old. Apart from this condition, her health was generally good. * As of June 8, and under doctor guidance, we’ve decreased the dosage to **14 mg daily** (7 mg in the morning and 7 mg in the evening) to monitor any shifts in her behavior. **Observations Since Starting Propranolol:** 1. Our daughter has developed a **severe aversion to food**. Although she was somewhat picky prior, her eating habits have deteriorated significantly. 2. She now **completely rejects all solid foods and liquids**, refusing to be fed by anyone. 3. She relies solely on **breastmilk**, turning down water or juices offered by others. 4. During mealtime, she becomes **very irritable or upset**. Even gentle encouragement to try some cereal or soft foods leads to her total refusal and distress. 5. While she **plays with food** on her own, sometimes even bringing tiny bits to her mouth, any attempt by someone else to feed her results in her shutting down or crying. 6. We took a step back from forcing her to eat for over a week (following advice on rebuilding trust), continuing to offer food without pressure. Unfortunately, there’s been no improvement. 7. **Today, we attempted to reintroduce cereal**, and she rejected it just as she had previously. **Developmental Update:** * Born weighing **2.05 kg**, she is now approximately **7 kg** at 15 months, which is on the lighter side. * She is **not walking by herself yet**, but she can: * Stand alone * Walk with assistance (using a walker or while holding onto furniture) * Cognitively, she appears **alert and engaged**: she responds to her name, says Mama and Baba, laughs, and interacts with others, indicating no apparent cognitive delays. **Our Concerns:** * Could her food aversion be a **conditioned response**? Does she have a developed “fear” of being fed by anyone? * Is it possible that this behavior is a **side effect of Propranolol**? We know that appetite suppression and mood shifts can occur, but her response seems quite severe. * Are we in danger of her experiencing **nutritional deficiencies**, given her refusal of solid foods? * If so, what symptoms should we keep an eye on that might suggest underlying issues? * Should we seek the assistance of a **feeding therapist or child psychologist** at this point? * Is this issue something that improves over time, or do we risk entrenching the behavior the longer it continues? We are located in India and are looking for pediatric feeding specialists, although options are limited in our area. We would greatly appreciate: * Insights from parents who have encountered similar situations * Strategies for breaking this cycle of behavior * Any recommended resources or methods similar to Rowena Bennett’s "Bottle Aversion," even if it’s not directly applicable to our case * Guidance on when to consider **nutritional interventions or vitamin supplementation**. Thank you for taking the time to read this. It has been an incredibly stressful experience for us, and we welcome any advice or encouragement you can provide 🙏

Answers (1)

6/17/2025, 3:21:03 PM

OpenHealth AI

It's understandable to be concerned about your daughter's eating challenges, especially given the context of her hemangioma treatment and the recent change in her behavior. Let's break down the situation and explore actionable steps to address her severe food aversion.

Main Points:

1. Your daughter's severe food aversion may be influenced by her medication or could be a behavioral response.
2. Immediate steps focus on maintaining her nutritional health while addressing her aversion to feeding.

Explanation:

Propranolol can sometimes affect appetite, and while not every child experiences food aversion, it’s important to monitor her responses closely. The behaviors you're observing, such as rejecting foods and becoming upset during mealtimes, can indicate a developing aversion or fear around eating. It’s great that you've taken steps to avoid pressuring her, as creating a stress-free environment can help rebuild her trust in food and feeding.

Next Steps:

1. Monitor Nutritional Intake:

   • Since your daughter relies solely on breastmilk, consider tracking her intake to ensure she gets enough nutrition. Aim to consult a pediatric nutritionist to explore ways to supplement her diet while respecting her feeding patterns.

2. Gentle Reintroduction of Foods:

   • Keep offering a variety of soft and appealing foods without pressure. Use play and exploration: encourage her to touch, smell, and play with food. Creating positive associations can gradually motivate her to try some.

3. Engage in Fun Mealtime Activities:

   • Try involving her in meal preparation or designing fun presentations of food. For instance, using her favorite characters or colors in meals can make food more appealing.

4. Establish Consistent Routines:

   • Set a consistent routine for meals, ensuring a calm atmosphere with minimal distractions. Offer meals at the same times daily to create predictability.

5. Seek Supportive Therapies:

   • If the situation does not improve in the coming weeks, consider engaging with a child psychologist or feeding specialist. They can provide tailored strategies to address aversions and help develop a positive relationship with food.

6. Nutritional Supplements:

   • If her food intake continues to be insufficient, discuss potential vitamin or nutritional supplements with a healthcare provider. Focus on options that can support her development and health.

7. Watch for Symptoms of Nutritional Deficiencies:

   • Keep an eye out for signs such as lethargy, irritability, weight loss, or developmental delays. If you notice these, it’s essential to consult a healthcare professional promptly.

Final Encouragement:

While it’s challenging right now, many children grow out of food aversions with the right support and patience. Emphasize a loving environment around meals, and your daughter may gradually become more open to new foods again. Remember, you’re not alone in this, and seeking community support and professional guidance can be incredibly helpful. Take care, and please keep monitoring her progress; you’re doing your best in a tough situation.