Posted by: | 2020/09/30


3-year-old with ASD not drinking anything

Hi Dr. Our daughter is 3 years old and has moderate to severe ASD. She is not speaking yet and mostly communicates with us by pushing us to where she wants us to go or putting our hand on what she wants. I'm at a loss as to what exactly could be wrong now? She is eating well (she does not feed herself) and has no symptoms to suggest illness (no fever, rash, cough, stuffy nose etc.), she is playing as normal and is generally content and happy. From Monday evening she has been refusing to drink her bottle. She usually drinks rooibos tea with some milk and sugar from a baby's bottle, 4-5 bottles of between 120-250ml a day. She now either has no interest and gets upset even seeing the bottle or she will come and stand by me in the kitchen and dance enthused whilst I'm making her tea (what she usually does) but will then only drink about 20ml before tossing it away. I have offered plain milk, water, nesquick, oros, juice and even soda in her bottle and in several sippy cups, she isn't drinking an appreciable amount of anything and doesn't appear to really be getting thirsty as usual? I am concerned that she might become dehydrated (she had one wet nappy this morning and nothing further). Any ideas or advice would be greatly appreciated.

Expert's Reply


- 2020/10/01

Thank you for your question. It is difficult to be sure about an answer to your question. Your daughter does not appear to be ill and she still eats quite well, but will not drink enough despite your best efforts. She does not have a fever. There is certainly the danger that she may become dehydrated.

Her refusal to drink is not likely to be due to a new tactile aversion problem with the teat of her bottle as she also refuses to drink from a sippy cup. She also refuses a wide range of fluids despite your best efforts to get her to drink. Her present fluid intake is certainly very low and is of concern. Please look in her mouth and see if you can spot any sores on her tongue or on the inside of her cheeks. There is a common viral illness at this age known as herpes stomatitis that causes painful ulcers in the mouth. Commonly children with herpes stomatitis may eat quite well but will not drink fluids. In any case with the weekend coming up it is important to ask your paediatrician to see your daughter urgently as there is the definite risk of her becoming dehydrated.

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