20 answers

My Toddlers Gag Reflex

Hello all! I was wondering if there is anyone out there with my same problem. My 20 month old will not chew food. He has had a MAJOR gag reflex since the day he was born. He is not too into feeding himself and not interested in any food that my husband and I eat. He is perfectly content eating his baby food. I have tried to incorporate mashed peas and carrots into his dinners and he will swallow all the mushy stuff and hold the pea and carrot pieces in his mouth - sometimes up to 20 minutes before he just swallows them. His eyes water and almost always gags and sometimes throws up. I'm trying to tell him to chew and I will put food in my mouth and chew so he can see what I mean but after MONTHS of this, he is just not getting it. He will eat goldfish, and tiny graham crackers, but he mainly sucks on them until they are soggy enough to swallow. I had talked to my pediatrician MANY times about this and he says to just gradually make his food more lumpy. Well, either he is just way too laid back for me or I need a second opinion because this has been going on way too long and I'm getting tired cleaning throw-up off the highchair. I would also like to stop the whole "spoon-feeding" buisness by the time my new baby starts rice cereal! :)Any advice would be GREATLY appreciated!

What can I do next?

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I know some children who are being care by mother are having same problem. after they attend full time daycare, they become much better. Children will eat better when they are in a fun enviroment.

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As many others have said, get a second opinion. There is a reason he's not chewing his food.

1 mom found this helpful

I would get a second opinion and possibly a referral to a specialist. Something's amiss here. I have a VERY high gag reflex and always have. In fact, I can't eat carrots because they trigger it. But I can eat... unfortunately a bit too much sometimes! :)

Did your son have a lot of reflux after taking bottles/breast feeding? My son did and long story short, at 2yrs old we started behavioral therapy with a speech pathologist (speech pathologists are trained in swallowing)because he would not eat anything but his approximatly 20 "safe" foods (oatmeal, applesauce, banana, homemade pumpkin bread....all very soft foods). He also would NOT try anything new that was a soft food as well. He went to a year of therapy 2-3x per week before we relocated to CA. He has improved but truly this is a struggle we deal with at every meal. My advice is to consult with a psychiatrist/SLP team. I think if I had waited longer with my son his behavior would be that much more ingrained and even harder (imagine that) to address. Good luck, I understand your frustration...daily!!

Hi A.,
My son was the same way. We would joke that he would need to take baby food to school. He was unable to eat anything lumpy. Just keep giving him strained food. Still give the crackers ans cereal and let him self feed those. Every kid is different and you don't have to do the toddler stage of lumpy food. Eventually he will want to try more big people food around two and a half. My son will be 18 years old in two weeks and he has been eating very well since age three. So just keep offering big people food that he can eat off the tray. Cereal, crackers, cheese, fruit snacks and as long as he has no physical problems it will be alright. I am an old Mom of 3. 26, 17, and 10, I also have two Grandchildren so there is a little bit of experience talking. Good luck and I know your discomfort in the whole highchair tray of BARF. Try not to worry and both of you will be fine. :)

Hi A.. I would definitely get a second opinion and possibly a referral to a specialist. Someone else mentioned seeing an OT which was also my thought. Some kids have sensory issues in regards to eating. We see our therapist through the Early Start program in our county at no charge to us.

Good luck!

HI A.--

I do not have personal experience with children who have gag reflux. However, I have worked with families with children who have gag reflux. Check out the Zero to Three national website and within the website google feeding and there is a great handout of working with babies that have this condition. Also, you may want to be referred to talk with a specialist especially if there is a weight concern or nutrition concern.

My doctor's office gave me some information on toddlers eating problems, and one of its suggestions was that once a child is fully capable of spoon-feeding himself, you should never do it for him. The article said that the best way to avoid feeding problems is to let the child learn to feed themselves as soon as possible and let them be in charge of how much they eat. Keep offering more lumpy table foods and finger foods and let him feed himself. He may not each much at first, but try it for at least a week (it takes several days without any food for someone to actually starve, so don't worry) and see if it makes an improvement in his appetite for those things. Hopefully there's nothing medically wrong, and baby food is really healthy, so I'd say it's Ok to keep giving it to him, as long as he feeds it to himself. Every kid is different, of course, but my kids were refusing baby food by 18 months. I hope some of this helps. That sounds like a really aggravating problem.

I would find another doctor. it sounds like this one is not taking you seriously. If you think it is a probablem then there probably is. Does he have anyother problem concerning his mouth. Speech issues or thumb sucking. It may be something is hurting him when he chews. My frineds little boy's toungue was not attached right and had to have it fixed. but as soon as it was fixed(i don't really know what they did) he started to eat better and talk better.
Good Luck

My son has the gag reflex thing too. He gagged, choked and threw up for three years. He seems to have outgrown it. Of course, now that I've said it, he'll do it again tomorrow.

I would suggest cookies. I know, not very healthy. If he can chew a cookie, he can learn to chew other things. Chocolate chip cookies were the first food I could give my son without worrying if he was going to choke and throw up. I should note that he's a second child, so he had cookies much sooner than my first...

Also try bananas.

Good luck.

Trust your instincts in talking to your pediatrician and I would suggest asking for a referral to an occupational therapist (they are the professionals who work with this type of feeding issue). Depending where you live, there are many reputable clinics. Generally, children already your son's age, who have a hyper-reactive gag reflex and sensitivity to texture, need help to get accustomed to chewing and new textures and the sooner you start, the better the outcome. He is showing some pretty classic behaviors with food (sensitive eaters will often prefer dry cereal-type foods and smooth purees) and it shouldn't be too difficult to move him forward but he should have an evaluation by a pediatric OT with feeding experience (and credentials). Good luck and push your pediatrician a little more for a referral!

I had the same problem with my child; he has never been able to swallow any medication (maybe that is a blessing) because or different textures. I was steam cleaning the carpet for a number of years (5. He is almost 9 and has not overcame this yet. He has Sensory Integration Dysfuntion Disorder. Many autistic kids like him have the same problem. His oral defensiveness formed aversion to most foods. He lives on bread, spagetti, some chicken nuggets, breadsticks, pizza with no cheese or toppings, and some other snacks. I have to supplement everyday or he becomes malnourished.

Psychiatry CAN NOT fix this problem, since the problem may be (in so many cases)the brain-oral muscles connection;( make sure he does not have any other symptoms or signs in the autism spectrum (such as behaviors); otherwise, he might be only immature in his oral muscles).
My son did have OT for a number of years, PT and speech therapy, but nothing helped much in this area. He suffers from yeast (that's why he prefers only carbs) and since he vomits meds, we cannot give him any antifungals.
Hopefuly, I'll find something to overcome this one day. He improved remarkably as I chelated him (detox the heavy metals from vaccines) in most areas except this one.
Good luck

I'm trying to remember what my son could eat at 20 months and I think we were still using some pureed & jarred baby food at that point in combination w/soft, chopped foods (pancakes, bananas, peaches, ground meats w/gravy, pasta & noodles). I wonder if your pediatrician is not too concerned because of your toddler is still gaining weight and also his age. The throwing up part and not chewing is kind of concerning and makes me think you should talk to your pediatrician, especially if your son is losing weight, about seeing a swallowing therapist or maybe an ENT (ear, nose, throat doctor. A swallowing therapist (speech or occupational therapist) for kids could give you ideas on food consistencies and even temperatures of food that would possibly desensitize your son's gag reflex to make eating more pleasurable for him. Good luck w/everything.

My son Ian is 3-1/2 . He is just now learning to fight his gag reflex. He has been a champion puker since birth. We had our entire ground floor tiled in our new house because of his knack for yak. His dad gags easily too.
He ate soft foods for a long time and gradually accepted normal foods - but is still not much of a meat eater or veggies. He did chew Cheerios and goldfish crackers and bits of cheese @ 20 months - if he LIKED it he learned to eat it. He has a girlfriend who is 2 months younger and still really gaggy with new foods but she will eat raw carrots. Go figure - I'm sure part of all this is the toddler need to establish a little control and get on mommy's nerves.
I think if you're getting a fairly balanced diet into him - even if it's all smoothies you're doing o.k. However, he may have pain from teething that makes chewing uncomfortable - or maybe something needs to be looked at. Take him to a dentist and ask your pedi to refer you to a specialist. Is he talking? Is he growing normally?
My son eats things at daycare that he refuses at home because he sees his peers eating it. He will also try new things in a restaurant that he won't touch at home. At home, he knows that if he refuses to eat long enough Daddy will give him crackers or make him a smoothie. Hmmmmm......
Good luck! You're kid is acting like a 20 month old - the not chewing things he likes is the only thing I'd look into. Some kids are just really gaggy.

My daughter had the same problem only worse when she was 2 years old -- she wouldn't even eat soft foods -- just a bottle with a little cereal in it. She was drinking 8 cans of Pediasure a day to ensure she got enough nutrition. Our pediatrician referred us to a feeding therapist (an occupational therapist who specializes in feeding issues). I highly recommend asking your pediatrician to refer you to one. Our insurance paid everything. I had tried everything I could think of and nothing worked. After just one month of feeding therapy, she started eating yogurt. After 2 months, she would eat some other soft foods. After 8 months, she was chewing. She is now 8 and although she is still a very picky eater, she doesn't have an problems. Our daughter had both oral motor planning problems that made it difficult for her to figure out chewing. She also had oral sensory problems and REALLY reacted to different textures of food. Lots of kiddos have trouble transitioning to lumpy textures, but if you've been trying for months, I recommend feeding therapy.

Stanford Children's Hospital has a great pediatric OT named Marianna Thorn. I can't say enough good things about her! It's a bit of a treck from Martinez, so there may be one at Oakland Children's that's closer, but Marianna is out of this world!

Your pediatrician is a joke. Please ask a good friend for the name of someone close and switch doctors right away.
I would also go to a pediatric gastroenterologist and make sure you are not dealing with acid reflux or something else similar. This can be treated.

You are right - this is not "normal" but that doesn't mean it can't be dealt with. Get to the doctor and also check out a pediatric dentist. Maybe there is a problem with the tooth alignment, jaw structure, or something else.

Do keep us posted. I can tell this is exhausting and a child throwing up food constantly is very hard on you.

Blessings and Good Luck,

Hi A.,

I agree with other posters that you should get your son evaluated by an Occupational Therapist. Ask your pediatrician for a referral if your insurance covers it. Otherwise, self-refer to the Early Start Intervention program, which is free.

My 27 month-old son too has a feeding issue. I struggled with it myself and used all sorts of improvement methods that I read about. When I mentioned to my pediatrician multiple times, she always counseled that the problem will go away. Finally, last month, I told her that I really wanted to get him referred and she immediately acquiesced. We had our evaluation this week. Having been told so many times by our pediatrician that my son does not have a problem, I half expected the OT to say the same. But after observation, her professional response was that he should have feeding therapy. We have not started therapy yet, so we do not know how much improvements can be made, but the earlier the intervention is made, the greater the success. I wish I had insisted earlier on the therapy.

Your son sounds like he could really be helped by an OT. I wish you luck!

Get a second opinion, and a third if you still don't feel like you're being heard. I strongly suspect your son should be referred for a swallow study and possibly to an occupational or speech therapist. He may be experiencing extreme sensitivity in his mouth, or may be having trouble coordinating the muscles in his mouth and throat. In any event, someone should be taking a closer look at what is actually going on with him physically when he is trying to chew and swallow. If it turns out to "just" be a behavioral issue, an occupational therapist can still help you work out strategies to help him. Good luck, and I hope you will keep us posted!

I know some children who are being care by mother are having same problem. after they attend full time daycare, they become much better. Children will eat better when they are in a fun enviroment.

Hi Amanada,

Yes, definitely get another opinion. It sounds like you should also request a swallow study and a referral to a feeding therapist. The swallow study will let you know if there is any physical reason why he is having trouble swallowing food. the feeding therapist will help with the sensitivity issues and the chewing processes. The older he gets, the harder it will be for him to unlearn his feeding behaviors. Good luck.

I would consider requesting an evaluation by someone trained in this area. Often either OT (Occupational Therapy) or ST (Speech Therapy) handle issues regarding chewing and swallowing. Whoever you see should be experienced with pediatric issues.

If you live in the are I can personally recommend the OT team at Packard Childrens' Hospital at Stanford. I've seen several of them at work and they have all bee great.

Even if they determine there is nothing significantly wrong they can give you specific suggestions on how to proceed and what may work for your son. If there is something wrong you want it discovered and a treatment plan in place as soon as possible.

K. H.

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