How can I get him to drink from a cup? Possible ASD / sensory issues

[zen1]

My DS3 is 21 months old and I've noticed over the past few months that he is developing "differently" to my other two sons. Doesn't really say anything, but does babble, likes to role his eyes and shake his head from side to side (finds it funny), doesn't point much, very late reaching gross motor milestones. Anyway, when I was weaning him, it took me 5 months to persuade him to take a spoon into his mouth. Now he will happily let me feed him and will feed himself finger foods, but will never let me put any sort of cup near his mouth. I have been trying for about 10 months now. He screams and pushes it away and seems quite frightened. I am currently breast feeding him, but until recently only 3 times a day. Due to pressure from relatives / friends, I have cut down to once a day hoping he will get thirsty enough to try a cup, but he just won't. I have tried eggcups, doidy cups, beakers, cups with straws. Grandparents and DP have all tried and failed. He definately has a problem with things going into his mouth as he has never put any toys or anything to his mouth. I really don't know what to do. I can't keep breastfeeding him forever, but I really don't think that he understands that to drink from a cup would quench his thirst.
MIL want me to introduce a bottle, but I am reluctant to do this (tbh, don't think he would take it anyway), because he is so resistant to change that I just want to go straight to a cup and avoid the bottle. Please can anyone suggest anything that has worked for them?
Thanks

Hi,
Both my dd's wouldn't drink out of a cup until 3 years old. I would deffently not introduce a bottle as you will have the same problem again when you try to move onto a cup. Would he drink out of a straw or a closed cup (spouted cup)? If you can get him to drink through a straw or closed cup then i wouldn't worry too much about an open cup. You could get him used to a straw on its own before sticking it into a drink? Maybe a cup with his favoirite character on?

As for the breast feeding, don't wory about what others say, if its the only way to get fluids into him then you have no choice, you need to do what you feel is best for your child.

Thank you for replying Marne. I feel the same way about the bottle. I have tried a straw, but he screams if we put one near his mouth. We have all tried to show him how to use it, but he won't have it. He seems to be scared / not understanding the whole concept of a cup.

Zen just a thought, might it be as much that he's unsure of what the fluid inside a cup might taste like, as the sensory issue with the cup itself?

Just wondered - as he will happily let you spoonfeed him - might it be worth filling a cup with some kind of drink (maybe some warm expressed breast milk to start with) and then dipping a spoon into the cup and offering that to him? If he accepts it and likes the taste, that might encourage him to have a sip from the cup itself...you could then try the same approach with water/juice etc.

Thanks dietcoke. I went away for 36hrs a couple of months ago and DH tried spoonfeeding him milk from a cup. He took a couple of spoonfulls but when he noticed it was coming from the cup, he stopped taking it altogether. TBH, he is suspicious of any liquids as well as the cup itself. We have even tried giving him liquids out of a bowl, but he never takes more than a couple of spoonfulls. People have told me to just stop b'feeding and eventually he will start drinking, but I can see him ending up on a drip rather than taking a cup. It is so frustrating!

zen1

I have been exactly where you are with regards to the refusal of drinking cups and we did everything that you have already tried (it brought back memories of my own experience). You probably feel very guilty not to mention feeling at your wits end about it all. It is NOT your fault this is happening, please let me reassure you of that. We ended up reintroducing a bottle (try and ignore the pressures from well meaning but ignorant family) and eventually he went off milk altogether once the bottle stopped. To this day he will not drink milk. In our case it was all down to DS's sensory issues surrounding a cup/cold milk and he rarely if ever mouthed anything.

If you have not already I would ask your GP to refer your son to a developmental paediatrician. There are things here that would warrant the attentions of such a person. Early intervention here is also vitally important.

Zen, have been there and done that with dd1.

She is 6 now, and still wary about liquids in a cup.

There have been 2 periods in her life where she has stopped all intake of fluids, completely. The first was when she was 12 months old, and I stopped feeding her. She had previously been taking bottles ok, and also drinking from a sippy cup. She stopped drinking for 4 weeks. Nothing, at all.

The second time she stopped drinkingg was when she was about 2.6 - that time she stopped for 9 months. Not a drop of flood passed her lips.

We made all her foods as wet as possible - lots of soups, slag bol on the runny side,served with cous cous not thoroughly drained, curry with soggy rice, etc. Lots of yogurt, jelly, lots of milk in her weetabix, etc.

And just kept trying with the drinks.

Eventually we found a juice she would drink (pear and pineapple mix, of all things!) and she gradually drank more and more, day by day, slowly, slowly. After about a year or so, she was drinking about 200ml a day.

It was exhausting slow, and there were days when I spent hours encouraging her to take the barest sip.

Thank you Attila and Silverfrog. You are right Attila, I do feel guilty and at my wits end. People do not seem to believe that there is a genuine problem here and I think there is a feeling I am being too "soft" with him. What would a developmental paediatrician do? I am so worried, I just want my DS to be ok.

silverfrog, how is your dd1 with other things? We are at the stage where we are adding extra fluids to DS's meals (very milky cereal etc). How did you manage with nine months of not drinking? What did health professionals advise?

Thanks for your input

dd1 is doing really well at the moment. she is 6 now, and it has been a long hard road (especially with her drinking) on a good day now she will drink nearly 500ml - I never thought I'd see the day. We are at the stsge now where if she doesn't drink as much for a day or two, we don't panic - note it, and think "if that doesn't sort itself out, then we'll do something" but usually it's just day to day variation.

dd1 has a lot of issues with sensory things - smell especially is a problem for her. and she is quite restricted in what she eats (as in main meals) - but then she eats lots of different fruits and vegetables, so it works ok.

with the 9 months of not drinking - no, we didn't get any professional input. the most they ever said was "well, when she is ready, she will do it", or "she can't be thirsty - reduce down her liquid foods, and then she'll drink" - not much help, really!

we tried all sorts - giving her a wet flannel to suck/chew in the hhope that she'd get some liquid out of it (moderate success, but she didn't really take to it)

ice lollies - wouldn't touch them (too cold)

jelly/yoghurt had good success with, and the fruit pots form organix etc

wet foods (soup with bread crumbled into it to bulk it out - can absorb lots more liquid that way), spag bol, etc. she still eats food in sauces now, rather than separate foods, because of this.

luckily, for most of the 9 months she wasn't drinking she would still accept me spoon feeding her - woudln't have a hope now! - so could get watered down stewed fruit into her, thinned out yoghurt, etc.

we also made a game out of using a 5 ml syringe (like you get with calpol) to squirt water into her mouth - she quite liked the feeling of it. and so we might spend an hour or so getting maybe 30ml into her (oh what fun!)

she was never constipated over that time, so must have been getting enuogh liquids, but it was very stressful

Can he copy you? It took me a long time to teach ds1 to use a cup himself but it was only later that I realised that showing him was pointless as he couldn't copy. We had to teach him hand over hand and repeat and repeat and repeat until eventually he got it. He had people demonstrating to him over and over and whilst he watched them quite happily it was of course pointless.

It does sound as if sensory issues mean that hand over hand won't work for you as the issue is the cup itself rather than just understanding what it does.

Agree about a referral to a developmental paediatrician. I would carry on spoonfeeding liquids but from a bowl and maybe give him a bowl of liquid to play with - this might backfire though if he doesn't like getting wet.

Would he drink from a soaked clean flannel? I know you might have problems getting him off that but better than him not drinking at all maybe.

Glad your dd1 has made progress with the drinking Silverfrog. My ds sounds very similar to your dd1 with regards to foods. He loves yogurts and organix fruit pots as well as stage 1 fruit jars, but won't try ice lollies. Have also tried squirting water into his mouth with a syringe, but to be honest, he hates that too. Ds seems to have a problem with certain textures of food (mainly "good for you" foods like fruit and veg) and will not put them into his mouth, so I end up pureeing most things still as then he will eat anything. I will try the wet flannel too, as the one object he does willingly put into his mouth is a muslin square.

saintly, you could well be right about the copying. I just don't know. I bought him a dolly yesterday and was pretending to give it a drink from a cup and spoon feed it to encourage him (he also won't feed himself with a spoon). When I said "Now ds feed dolly", he made a plausable attempt at copying. However, when I was out today with him pointing out simple nouns "tree", "duck", he smiled away happily, but looked at me as though I was speaking another language. Sometimes he seems to understand completely, sometimes, he looks totally blank. I have a horrible sinking feeling when I think about it. Anyway, I will definately try the flannel tip as it might just work. Thanks

Ds1 used to have strong food aversions. He ate no fruit, veg, meat or fish. He would eat hidden cheese. School sorted it but their approach was that it was sensory and they just offered tiny bits of new food so they started with crisps and added a tiny bit of baked bean sauce. It took a year - but he eats really well now. The approach of not hurrying and very small steps seemed to work. Good luck it's very difficult!