"Bottle feeding dependency" in children with developmental retardation

We experienced five cases of developmentally retarded children with "bottle feeding dependency", that is, refusal against entry of purees or solid foods into the mouth. All five cases had moderate to severe mental retardations (DQ: 17 - 37). No abnormal oral reflexes or functions were present. All had been bottle fed and rejected any purees or solid foods for a long period by turning the head, hiding the face or struggling to avoid being fed. Finally we attempted to force them to eat. Despite their initial refusal, small amounts of pureed food was forcedly pushed into their mouth. As a result, their rejecting behavior was overcome in two or three days, and food intake into the mouth markedly improved within one week. It is suspected that the rejecting behavior does not always represent aversion for solid food. We also found that termination of bottle-feeding was effective the transition to eating. Our experience indicates that forced feeding can overcome the rejecting behavior and prolonged "bottle feeding dependency" in children with developmental retardation.