7 year old who suddenly won't swallow food

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Not sure if anyone can help but I'm worried my 7 year old is developing an eating disorder.

She won't swallow her food just chews it for ages, moves it around her mouth and ends up having to spit it out.

She will eat yoghurt and ice cream and most soft food but even her favourites like Mac and cheese and spaghetti Bolognese she now won't eat.

She does have very big tonsils as a baseline but I don't think this is related as she doesn't have a sore throat - she just says she can't swallow the food.

She did have an episode a while back when she choked but this seems to have gotten worse a while after this.

Just wondered if anyone have experienced similar and if so how they managed it? It's starting to stress out the whole family at every meal! Thanks

Have you seen the GP about it ?

Speak to your GP. DS2 was similar - he hadn’t stopped eating, but stopped eating a number of foods after episodes of choking.

He had some tests and a specialist speech and language nurse came to the house to watch and listen to his swallow. It was taken seriously, but in his case it was because he couldn’t manage the food well in his mouth. Because he couldn’t control it, he sometimes choked which stopped him wanting to eat ‘suspicious’ foods.

Definitely needs checking out if you’ve not seen GP already. Could be swollen tonsils making her feel she’s going to choke or struggle to get the food down. What is she like drinking? Does she snore when she sleeps? Is she mentioning any stomach ache or discomfort. Is she generally well? Are her clothes fitting the same.

Are their any other signs that are making you think about a possible eating disorder as opposed to something ENT related?

Yes waiting for ENT referral.

I think it's mainly psychological tho as things like chocolate biscuits go down no problem...

That’s good that you have a referral. DS is fine with sweet things too 🤨, but in his case the SALT pointed out that he seemed fine with food that he ate with his hands and with soft food like yoghurts.

He is hypermobile and struggles with cutlery, so she thought that he was also not able to easily cut the right size forkful. This, combined with the fact that he finds it hard to control the food in his mouth (it moves all around his mouth while he’s chewing) led to him choking. He can easily take smaller bites of chocolate, biscuits, etc. because he doesn’t need cutlery for them.

DS also has enormous tonsils, but they have never really caused him problems.

I hope they get to the bottom of it quickly and are able to help. It must be very worrying for you.

It’s good you have a referral. It’s helpful to rule out anything physiological. It’s interesting that chocolate biscuits go down ok (they’re pretty dry texture so you’d think that might be a problem if it’s her tonsils or something ). I hope you find out what’s going on.

OP I’m a SALT, although paediatrics isn’t my area.
Some things you’re going to be asked are textures she will eat, if there are meals better/worse than others or if she struggles more when tired, can she manage food better if it’s cut up for her.

General things that you can do are making sure she’s sat well - upright, feet as on the floor or supported as you can get (harder with kids), sauces on food to make it a bit moister and easier to swallow, sips of a drink throughout a meal. White bread can be an absolute bugger as well - try 50/50 or best of both (any of those undercover type brown breads). They’re the kind of things we tend to recommend/rule out as a starting point.

Also worth a dentist checkup in case something is sore or feeling iffy in her mouth - again you’re going to be asked about oral care so may as well get the answers for that to start off with!

Not a child, but I had this happen to me a few years ago. I had a period of suddenly being really anxious for no real reason and this turned into being unable to swallow anything bar tiny sips of water. I just couldn't make my throat do the swallowing action and then I got it into my head I was going to choke on what I was trying to swallow. I ended up losing a lot of weight, which I really could afford to lose, but with a child that's more of a worry.

I did see my gp about the anxiety and explained how it was manifesting and they gave me pills... luckily they were tiny but it still took an effort to swallow. I then started to slowly try to eat. I'd make ready brek but very thin so it was closer to liquid than solid, and I have tiny amounts of that every day. I'd have cupasoups and not eat the noodles or vegetables that were in it and gradually built up to eating those tiny bits of solid. Same with the ready brek where I'd make it a bit thicker over time.

I get the suspicious food thing. I couldn't eat anything I felt I didn't have control over. So things like bananas or jelly I couldn't eat as I felt I'd be swallowing them before I was ready and then felt like I was much more likely to choke. Even now though, 7 or so years down the line, I can't bring myself to eat boiled sweets and actually find it difficult to watch someone else eat them.
The only time I did have a panic about eating something was some stuffing from a roast dinner. This was when I could eat more solid foods but only very small portions and it would take me over an hour to eat. Anyway, I swallowed the stuffing and it got stuck in my throat. I made myself be calm and just swallowed again and it went down, but it was frightening. It was actually the only time that something got stuck during the whole period of not being able to eat.

I still get anxious moments, but these tend to be when my ferritin is very low, which might have been what set off my eating issue originally.

I think an appointment with the gp would be the best thing to do and see where they suggest you go from there. It is such a horrible feeling, not being able to swallow and then getting the fear that you might choke, so I really do feel for your child. Try not to make an issue at meal times, just give them what they can eat for now. I have to say I used to like pasta, but now I still find it one of the difficult foods to eat and still takes me ages.

I would definitely try and keep the pressure off her at meal times if you can. Make sure what she will eat is available. Keep offering other stuff but any calories are good right now I’d think.
The more stress you create around it the worse it’s going to get.
Give her as much time as she needs. The rest of you need to just get on with eating and chatting as normal.

Until you get that ENT appointment, I would let her have whatever she’s happy with. After that appointment, they may refer you to a dietitian to make sure she’s getting the calories/nutrients she needs. They may provide supplemental calorie drinks or supplements to add to her ice cream/yogurt.

As long as she’s eating something at the moment, it won’t hurt her.

There maybe a reasonably simple solution like removing her tonsils or they may for a while give her an NG feeding tube. Initially, they will try to work out if there’s a physical reason for her not swallowing or a physiological one.

As PP says, they should arrange for a speech therapist to do a feeding assessment where they will listen to her chewing and swallowing.

Good luck, and try not to show how anxious you are. Even though it’s understandable to us, it won’t help her.

Oh, and I would also get onto that ENT’s secretary to chase the appointment. The NHS are a bugger for ‘losing’ referrals.

Thanks so much all - it's getting worse but she's been to the cinema with a friend and had no issue with sweets and popcorn.... I guess maybe I'll have to ban all of that for now so she eats her meals!

It's very hard not to let her see the stress!

My dd had something similar a few years ago, I think she was about 5/6. We kept finding chewed up food that she’d spat out and her clothes were filthy from wiping food down her sleeves. She did also lose weight. We thought it must be psychological but the dr prescribed some sort of nasal spray for catarrh or similar. It did clear up, no idea if it was the nasal spray that did it though! There was no lasting issue and it’s never cropped up again!

I’m not sure a psychologist would suggest you banned anything at the moment! The sweets maybe but anything that has nutritional value (popcorn does!) and she’s happy eating might be a good thing!
If it is purely psychological then I would worry that banning her ‘safe’ foods could make it worse??
I’d really be looking for some professional advice before doing anything too drastic.

Where does she eat normally? If she managed popcorn at the cinema fine then why not try eating infront of the TV so she has a distraction - I know it's not good manners nor a good habit to get into but might just do the trick.

Thanks will try all advice!

I'm in the exact same situation at the moment with my 9 year old daughter. Over the last two weeks she's developed a fear of swallowing food that seems to have come out of nowhere because she hasn't had any choking incidents, she did say she had some pizza and it felt like the cheese was stuck in her throat. Now she's chewing for ages and spitting her food out. It's so upsetting and I'm trying not to let her see how stressed I feel about it. I just want her to go back to her happy self.

We saw the doctor about it yesterday and being honest, it wasn't a very helpful experience other than she ruled out any physical cause, I basically came away with a self referral form for MAST which could get her on a waiting list for some NHS therapy sessions....but I feel like her talking about it puts focus on it and makes her more conscious of her swallowing. When she's playing and in a giddy mood, she does manage to eat a little, she had a cupcake last night for instance. I'm hoping that going back to school will help distract her because being with friends and taking her focus off of her swallow does seem to help.

Did this ever improve op? Going through the same at the moment with my son and no idea why it's happening

I'm not the OP so I hope you don't mind me replying.

I'm still going through the same problem with my DD aged 9. She started having difficulty swallowing in August and we had several visits to the GP, which resulted in a referral to Gastro at the Children's Hospital. It took a couple of months to get an appointment and they decided to book her in for an endoscopy. Another long wait for results but the pictures and biopsies have all come back clear. They suspected EOE which is an allergy condition that can cause Dysphagia symptoms but they know now it's not that.

So right now we've been referred to ENT to see if they want to check her, Gastro Doctor said they might not feel it's necessary and also a referral to CAMHS to get her some help with her anxiety around swallowing solid food.

I'd definitely recommend pushing your GP for a hospital referral so you can rule out a physical cause. With my DD I think it is almost definitely psychological and she has 'anxiety swallow'. It's just strange how it's come out of nowhere and she's never had eating issues previously or any choking incidents.

Is your son managing any solid food? They're expensive but Paediasure shakes have definitely helped with keep my DD's weight maintained. She has two a day and I make them with full fat milk instead of water. I also get her some Dysphagia pureed meals from an online company I found that makes and delivers them.

I had this when I was about 7! (Now 33)
it was triggered by a choking episode. I think I was referred for mental health support as it was classed as an eating disorder although wasn’t related to body image or anything like that, purely fear of choking and then what felt like a physical blockage to swallowing as a result. I can’t remember the ins and outs but I swallow food just fine now x

i remember my mum making lots of soup with loads of nutritional food blended in