17 Month Old Gagging on Anything Other than Baby Food

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Hello L., please don't feel alone! My son is 15 months old and is the same way. He doesn't have the allergies (that we know of) but he has the same problem with swallowing. He has very low muscle tone and that is the problem with him... but he is also delayed in other areas. We have recently discovered that he will accept very bold flavors. For example, he won't eat mashed potatoes but "sometimes" he will eat Garlic mashed potatoes. A speech therapist also works with him weekly through a Birth to Three program. She works with oral tools to teach him to manipulate the food, it sounds like your daughter would benifit from something like that. Is she delayed in any other area, or had any other problems? He wouldn't pick up anything with his hands either, he wanted to try and pick it up with his mouth, he also wants to lick everything? We just kept insisting that he take things with his hand not his mouth, he does better now although there are some things he will not touch. I think it is all sensory? Any way- Good luck, I know how hard it is to watch your child struggle with anything, especially something that seems so easy to do (swallowing).

L., I am a pediatric occupational therapist. Your daughter sounds like she has significant "tactile defensiveness". Usually, this condition is accompanied with other developmental delays and/or low muscle tone. Sensory processing delays contribute to eating disorders and tactile defensivness in the hands like you are describing.For the next month, do lots of play activities involving touching and playing with various textures:i.e. playdough with sand added later for more texure; shaving cream--let her spread it on a table or shower wall and draw in it--caution to avoid eye contact!; purchase a small, hand-held vibrator--about $10 dollars at Brookstone--let her rub her hands and especially around her mouth and on her tongue once she gets use to it. Brush her tongue on the sides and on top with a toothbrush daily and gently on the inside of the cheeks. Then let her play with various food textures with her hands and lick her fingers. Let her get messy and learn to have fun with touch exploration. You can focus on neatness with eating later when she's 2. If you don't see improvement after about a month or 2, consult your pediatrician and ask about a sensory/developmental evaluation by an occuapational therapist with a focus on feeding. Good Luck, S.

Congratulations on the new baby!!
-First of all, I know it's overwhelming. You'll get through all this, honest. We all do somehow. I've always said that "motherhood rots the brain", then we go back for more. If you have family or friends who can help you, now's the time for them to come out and help!
-There's nothing wrong with asking for help.
-We all have a "gag reflex" in the back of our mouths. Try sticking your toothbrush too far back in your throat. This prevents us from choking (food going "down the wrong pipe") on saliva, foods, etc.
-It sounds like your 17 month old might have a "hypergag reflex", where her gag reflex gets triggered with a little less stimulation. Or, she may be gagging and vomiting from other food textures due to her esophagus, reflux, and positioning. Or, it could be distraction - forgetting to swallow with her mouth full. Or, ...
-The doctor needs to know about this. If the pediatrician already knows, pressure him to have her swallowing skills evaluated. As Dawn mentioned, speech and occupational therapists are both trained in addressing these types of concerns.
-I'm familiar with a textured spoon that I believe is used to help to reduce a child's hypergag reflex. We nurses are alternating smooth and textured spoons within the feedings per the occupational therapists' instructions. Thus, the child becomes accustomed to textures.
-When you say "pureed texture", do you mean stage 2 or stage 3 (subtle lumps) or do you puree the food yourself?
-Speech or occupational therapy may be able to help you with more ideas regarding finger foods. But frankly, I don't like picking up wet and slimy things, either! =o)
-One last thing: if she has known severe reflux and she has some swallowing delays, she might benefit from a very, very thorough developmental assessment. The assessment might pick up some other subtle delays that could best be addressed earlier rather than later ... to get them "ironed out" now.
-Good luck, L., and keep us posted!

wow that brings back memories! You mentioned reflux in the past. You mentioned food allergies. Has she had an endoscopy ever? And if so, how long ago?

Eosinophilic Esophagitis is a condition of the esophagus that has only recently been brought up in the medical field. It can cause pain but also swelling of the esophagus. If a child has EE and their esophagus is swollen then any foods with substance to it will be hard to swallow. If the esophagus is too swollen the child will just vomit the food up.

My daughter has a dairy allergy. We didn't know it for a long time. She became very ill and vomited alot of food. Her stomach her too. After an endoscopy we found that her esophagus was almost completely closed up. We started high doses of medication immediately. The problem is that our Gastroenterologist said that it can take up to 2 years for a full recovery. The meds help rather quickly with pain but the swelling takes some time. What takes the longest is the rash on the esophagus, which are called eosinophils.
Your child is rather young. If she has had any food allergens in her short lifetime and they caused EE then one, it will take time to get out of her system and two, meds will be in order.
This might be worth talking to her Gastroenterologist about. A normal Pediatrician is not knowledgeable enough in this area. I found that out recently when the school fed my daughter dairy and she got ill. God bless~

Hello L.

First, consult your doctor as they always say. Mother's intuition is key as well. My children were on table food after age 1 year. Slowly introducing soft foods like homemade mash potatos (using veggie stock or chicken stock instead of milk). Maybe rice and beans (smashed - depending on teeth count). You can have veggies pureed and added within the meals. The baby's tastes buds are changing and that might be her way of letting you know. Also try letting her hold the spoon and feed herself... yes this might create a big mess but sometimes it's worth it to see them eat better. Happy feeding. J.

It might be worth your time to Google 'Sensory Processing Disorder' and see if the symptoms fit into one of the categories. I just recently learned about this. A friend of mine was saying the same thing about food textures and refusing to touch any food that's wet. This is what they decided her child's issue was. I think they are working with an occupational therapist now. Good Luck!

Your letter brought back memories. I have kids 17 months apart also. Bless you! My oldest, now 10 has always had a sensitive gag reflex and reflux. If the food texture is different or if she does now chew her food completely, it all comes right back up. She really has to watch how much food she puts in her mouth. Even as a baby, I can remember sitting in a restaurant and blue berry buckle baby food came back up and all over me! I will say the reflux is much better as a ten year old but her gag reflex is still so sensitive. There have been so many times at church, friends houses, restaurants that she has had to go to the rest room to vomit and come right back to finish her meal. She is healthy and active. So many people see vomiting as a sign of sickness and it has gotten me several unapproving looks when I don't take her home or let her go back to eating. But it is what it is. I know this response was not full of advice...but your child is not alone in these food issues.

My son has the same thing also and he is 2 1/2 yrs. My son has celiac disease (autoimmune reaction in the small intestine to wheat, rye, and barley). Do you notice your daughter chew foods and then spit it out? Like she likes the taste, but is afraid to swallow it? If so, check with your doctor about Eosinophilic Esophagitis. It is non life swelling of the lining of the throat. It happens to a lot of children who have allergies to foods. They can only diagnose it by endoscopy. However, your dr may go by the symptoms you state and start her on a 3 month course of prednisone.

My son still has trouble eating dry food - mostly it is his mind set. I still grind the hamb in spag etc. I just want him to eat and figure the rest will work out in time.

My 5 year old son was the exact same as your daughter. He had reflux his first year and until he turned 3, he was allergic to eggs so his foods were limited. He ate baby food (and minimal table foods...only snack type things) until he was about 19 months old and then I finally had had enough and just stopped buying it. He slowly started eating more foods because he was hungry and I just had to cut everything very small. He still is a very picky eater and he says most of it is because of the texture. Otherwise he is perfectly normal and has no speech problems like others mentioned. I read somewhere before my youngest was born that babies start gumming their baby food and that's when you can try introducing chunkier foods. Well, my 5 year old never did that which maybe could have been part of the problem, that he never really learned how to chew. I still have to constantly remind him to chew his spaghetti or he will try to swallow it whole and chokes. But, I noticed with my almost 3 year old that around 8 months he did start to try to chew his food. I started giving him table foods and he was completely off baby food by 10 months and is a much better eater.

Kids with allergies are typically very picky eaters. My son was/is the same way and he has a severe egg allergy. He is two now, and has just now started eating meat (but only hotdogs or sliced deli meats). I don't think there is anything to worry about and it's likely will get better in time. My son eventually started showing more of a interest in what we were eating and sometimes tries a new food. If he doesn't like how it feels in his mouth, he spits it out and sometimes if we are lucky, will throw it in the trash (or try and feed it to the cat..lol). We are getting there- it just takes patience but I feel confident that he will outgrow this in time. Just make sure to mention it to your ped at her 18 mo visit. We did, and the ped didn't think it was anything out of the ordinary, but you definitely want to get his/her opinion.

Ask your pediatrician about early intervention services in your state. They can offer you an occupational therapy evaluation and provide services if needed. An OT will have a lot of good suggestions to help improve her eating habits. Many children with reflux experience difficulties with textures and oral aversions.

Hi L.,

I second the suggestions to seek a referral to an occupational therapist. It sounds as if she may have some oral motor issues. Like a previous poster mentioned, it's not a bad thing.

My 4y/o nephew did the same thing as a baby. My sister is in total denial that there is any problem and has modified meals for him. He is an extremely picky eater and has speech delays. She even carries an airline barf bag in her purse for the "next time it happens". He has gagged, choked and thrown up at least once for every meal I have been at(We live out of town so this is when we visit or visit them).

The ped dismissed her concerns and told her that he is either eating too fast or putting too much food in and he needs to slow down. I've watched him eat and he doesn't eat too fast but he chipmunks and stuffs food, which is an oral motor issue. Her ped is not educated on sensory issues and because my nephew's weight isn't a concern, there's no problem.

Please listen to your instinct and request an OT evaluation. My nephew has had 3 years for his oral motor issues to become ingrained and this affects my sister as well. She is a ball of nerves during any meal and she can't enjoy a meal when her son eats with her. Stand your ground and don't allow your pediatrician to dismiss your concerns either. A pediatric OT can offer you some insight.

Peace,
J.

Hi L.! I am sorry I don't have any advice about your daughter, other than maybe taking her to her pediatrician.

I just wanted to write to you and encourage you...hang in there! My heart goes out to you- I understand what you mean by being overwhelmed. It WILL get better! Don't be hard on yourself, at this point it really is just about surviving and making it through the day with you and your precious children fed and diapers changed. Everything else is extra and frankly, unnecessary at this point. Take it easy. Let the dishes sit for a while. Sit down and hold your babies and relax. Take care of yourself!

L., My 21 month old STILL gags... I was real concerned and asked my ped. Because i never heard of a 1 yr. old not eating cake for her/his b-day. He said let her eat what she want's. She's texture sensetive. I thought it was all Bull but I guess it's true. Now she'll eat chicken, IF it's cut real thin and small and fries of course. BUT if i give her too big of a bite of baby oatmeal she'll still gags. And she will eat inst. mash pot and cheese but not real pot. She gags on those. So it's all texture. Slowly she's coming along. I still feed her babyfood. Other wise i don't think she's get enough to eat. Just hang in there. Stick with it. Talk to your ped. all babies are different. Good luck.

V. (Stay At Home Mom of Two)

www.ValeriesEssentials.ecrater.com
(Unique Candle Creator)

www.ValerieEssentials.etsy.com

I would check in with the ped about this one. Could be a form of dysphagia which would probably need treatment. I think its important to make sure she is getting enough nutrients.
And I think if she were eating the other foods that are slimy, etc. she probably would be more inclined to pick them up.

Good luck, L.