Hi whatda,
An overactive gag reflex in children (and adults!) is more common than
you might realize. Aside from having your daughter given a medical
check-up (which you've already done), the number one best thing you
could do is find a group of parents experiencing the same thing with
their children - if this proves impossible locally, online forums are
a great resource. Parents can be a terrific source of a wealth of
information - just knowing you are not alone can be a great comfort.
On to your questions...
1) What is considered "normal" in terms of a gag reflex in infants?
2) What is the normal timetable for babies to move from pureed foods
to table foods?
3) How do babies lose their gag reflex -- is it just a matter of time
(neurological development) or does it take practice?
"Before they're 3 to 4 months old, babies automatically push out their
tongues when anything enters their mouths. This reaction, called the
extrusion reflex, is essential for breast-feeding and bottle-feeding,
and it indicates that infants can swallow only liquids. Even after
losing the extrusion reflex, though, babies lack the coordination to
move food from the front of their mouths to the back for swallowing.
They start to develop that ability between 4 and 6 months of age.
That's also when they start sitting with support and holding up their
heads."
SEE TABLE
WHAT TO SERVE WHEN:
"The switch from an all-milk diet to a mixed diet doesn't happen
overnight. These guidelines lay out the order in which you should
introduce new foods and provide general age ranges for starting
different foods. The age ranges overlap because babies make the
transition to solids at very different rates."
http://www.cnn.com/HEALTH/library/PR/00029.html
"For the first few months, your baby can only suck. As part of the
sucking mechanism, a baby's tongue pushes outwards, and this is called
the extrusion reflex. Babies cannot take food from a spoon while they
still have the extrusion reflex. It disappears around 4 to 6 months ?
it is not until then that solids should be offered. Once the extrusion
reflex has disappeared, solids can be given because the baby can pass
food to the back of her mouth for swallowing.
Around 6-7 months baby makes strong chewing movements and can accept
soft lumpy foods. At first she will ?gag? which is a natural reflex to
prevent choking. It happens because food catches at the back of her
throat causing her to cough it up. This prevents the food from getting
stuck in her throat and blocking her airways. It is quite normal for
small babies to 'gag' a lot at first until they learn to chew food a
little more before swallowing. Even if your baby gags, persevere
because if you continue to feed only pureed food to your baby, she
will have difficulty learning to chew.
Chewing is very important to help with teeth and jaw development and
for speech later on. By 7 months most babies should be well on the way
to eating soft lumpy foods. If this is delayed, babies often have
difficulty with chewing and will reject lumpy foods.
From 8 months baby will enjoy finger foods. Avoid foods that can break
off and cause choking. Avoid raw carrot, raw celery, raw apple, nuts,
sausages, popcorn and hard lollies."
http://www.heinzforbaby.com.au/content/layouts/Feeding/article.asp?contentid=260&cc=39&sc=42
FORUM:
everybody's Bulletin Board » Parenting » Premature Babies »
chewing and finger food 'issues':
"Babies are born with the gag reflex at the tip of their tounge
(always spell that wrong sorry) & it slowly progresses to the back of
the tounge over time until, as adults we only gag when the Dr sticks
something way down our throat. apparently, its not uncommon for prem
babies to have on overactive gag reflex & this take longer to right
itself."
"...we were given conflicting advice ranging from "tough it out" to
"he doesn't have a problem" so not even the professionals agree on
this. In the end we went on our gut feel and took an approach
somewhere down the middle."
"She also advised to give them lots to chew on, eg toys & even toys
that get right into their mouths such as a plastic spoon."
"I can see patience is the name of the game and I understand the
emotional draining."
"It also influenced the order I fed him. I tended to offer solids 1st
and milk later so if he did chuck there was less to lose."
"From experience don't get too stressed about their eating... It's
just been a matter of trying again and again, giving it a break and
then trying agian."
"At about 8-9mths corrected I was told about double baked bread by
another mother - take some slices of white bread, put it a slow oven
(perhaps 150-170) - it will dry out but not actually coook, and it
becomes very brittle. It worked very well for him. It virtually melts
in the mouth and it's easy for them to pick up."
"I seriously recommend you try double baked bread sooner rather than
later. It is so easy for them to eat - easier than toast. Let it cool
when it comes out of the oven - if the weater is humid it will lose
it's propensity to shatter and you'll need to dry it out again."
"Another thing - ignore the age range on the jars of food. We stuck
with the 4mth stuff for ages. The food for around 9mths, and even some
of the 6mth stuff had VERY hard lumps which I used to have to mush up
even for my 2nd boy (36wk, no NICU - 2 more days and would have been
FT) for ages and he will eat nearly anything - his only food problem
is when we haven't got any with us. Often homemade purees are better
(we have a Moulinex - oldfashioned but great for baby food)"
"I do my meat and veges like you- cook it all up then put it through
the blender so it is pretty much pureed. He loves it. I have some pure
vege ones (I freeze them in giant muffin trays) and now, I am cooking
up fish fingers and pulling the batter off to stick the fish in with
the veges. He likes that."
"I did forget to say one thing .The therapist said to me that not to
be concerned about lumps, but more the thickness of the spoon feeds.
she got me adding baby rice to any puree to make it thicker. I cant
remember exactly why but somthing to do with them learning to chew
properly, as if its thick, they have to roll it around in the mouth."
http://www.everybody.co.nz/cgi-bin/ubb-cgi/ultimatebb.cgi?ubb=get_topic;f=26;t=000037;p=
Age-appropriate diet for children:
http://www.nlm.nih.gov/medlineplus/ency/article/002455.htm
What is the usual feeding schedule for infants and toddlers?:
http://www.plateaupediatrics.com/feedinginfo.html
>>>>>>>>>>
4) Should I keep trying to get her to eat table foods or should I just
give up and spoon-feed her pureed baby food for now? For how long?
FORUM:
Subject: Re: transition to solids, gagging
Newsgroups: misc.kids.breastfeeding
"I think all people have varying levels of gag reflex. Julian handled
pureed baby food perfectly well (too well, some might say!), but he
had trouble with things like Cheerios until he was well past 8 months
old. He still has a quite strong gag reflex and many foods he won't
eat are on his "no way" list due to texture/gagging issues rather than
flavor issues. I have heard it said that a strong gag reflex is
sometimes associated with
allergies/asthma, for what that's worth.
Anyway, I wouldn't fret over her gag reflex just yet. Sounds to me
like she's more gaggy than the average bear her age, but I'm not sure
*most* 6.5mo's handle Cheerios very well anyway. (Even my ungaggy
kiddos only started eating things like that at around 7-8 months.)"
"Under the circumstances, I think if I were you I'd probably stop
offering even the pureed baby stuff. She doesn't seem to enjoy it much
and she doesn't really need them yet. If you give her a few more weeks
to a month, you may find she can manage stuff off your plates and be
more interested init. I have a sneaking suspicion that in gaggy
babies, catering to the gagginess by giving lots of pureed stuff
inhibits them in getting over the gagginess. Mind you, that's based on
a non-random sample of one gaggy baby,
but he was *very* late to get over it (pureed stuff until 13-14 months
old) and is *still* gaggy."
"James was exactly like Naomi at this age - the gagging stopped around
10-11 months, but he still did not eat any type of solids at all until
15 months. I have a really strong gag reflex, so I am sure he gets
some of it from me."
"I wouldnt worry too much about it. My son ate baby food okay
starting at about 7 months but couldnt handle anything with any
texture (even those lumpier baby foods) till almost 11 months. My
daughter refused baby food almost completely and didnt touch finger
foods til 10 months and even then would only eat cherios til after a
year. We even went
to a 'feeding therapist' for her (who thought she had muscle tone
problems although I question the diagnosis) and recomended weekly
therapy visits which I refused. She got it on her own eventually. We
just put really big bibs on in case of puking and offered textured
stuff every 2 weeks till they got it."
http://groups.google.ca/groups?hl=en&lr=&ie=UTF-8&threadm=1_cwa.20144%24hd6.16784%40fed1read05&rnum=1&prev=/groups%3Fq%3Dbabies%2520%2522overactive%2520gag%2520reflex%2522%26num%3D100%26hl%3Den%26lr%3D%26ie%3DUTF-8%26as_qdr%3Dall%26sa%3DN%26tab%3Dwg
FOODS TO TRY:
yogurt (flavoured)
applesause
grated cheese (soft)
cooked macaroni (slippery)
Fritos (tasty & disintegrate rapidly)
Double-baked bread (recipe above)
Pita Bread (if it goes down, try making a sandwich with alittle cheese)
>>>>>>>>>>
5) Are there any tricks to getting her to drink from a sippy cup (or bottle)?
It sounds like she is on her way (one sip at a time) - this will take
patience. Try different liquids until you hit on one that she really
likes. Avoid sugary drinks (Kool-Aid) and stick with unsweetened juice
if possible.
Introducing the bottle or cup to a breastfed baby:
http://www.babycenter.com/refcap/baby/babyfeeding/473.html
>>>>>>>>>>
6) Are their any other explanations for her feeding problems other
than an "over-active" gag reflex?
7) Where online can I find simple definitions of medical terms
relating to feeding discorders (e.g., dysphagia)?
Children's Hospital Boston:
Child Health A to Z:
http://web1.tch.harvard.edu/cfapps/A2Z.cfm
What is dysphagia?
Dysphagia is a term that means difficulty swallowing. It is the
inability of food or liquids to pass easily from the mouth, into the
throat, and down into the esophagus to the stomach during the process
of swallowing."
http://web1.tch.harvard.edu/cfapps/A2ZtopicDisplay.cfm?Topic=Dysphagia
[DYSPHAGIA] hyperactive gag reflex
"There seems to be a very strong clinical connection between the kind
of mouthing that the baby does and readiness for lumpy foods. Around
6 months of age babies shift their mouthing behaviors from a more
generalized random awareness mouthing to a much more specific
disciminative mouthing. They become really interested in finding out
about shapes and textures and temperatures etc. with the mouth. They
turn toys around in the mouth and really use the tongue, jaw and lips
to explore all of the parts. I've always thought and felt that they
were really preparing themselves for the lumps that would come later
in food. Pragmatically when kids don't do this kind of mouthing, they
seem to have
more trouble with the transition to textured foods. So one thing you
can do is really help your nephew explore with his mouth. Observe how
he responds to his fingers and toys in all parts of the mouth and
whether he really is mouthing with an interest in picking up sensory
information. The greater movement of the tongue during this activity
also gives kids much more experience with the movements that they need
for collecting food pieces and forming a bolus out of these random
lumps. Most typically developing kids don't have a hyperactive gag
reflex at 12 months. I think the issue for those who are having
difficulties with lumpy foods lies in the fact that food pieces
scatter and settle in the reflexogenous zone for the gag on the back
of the tongue. Increasing sensory discrimination and expanding motor
skills of the tongue and cheeks helps a lot and this can be done in a
safe, non-threatening way with toys and other interesting objects that
kids put into their mouths."
"Begin to make very very tiny changes in food texture with him. Start
out by thickening his pureed food with rice cereal or something like
this that just makes it thicker and heavier, but still smooth. This
increases the sensory input without challenging him with lumps. When
he is comfortable with that, get one of the hand operated baby food
grinders and grind up soft pieces of fruit or vegetable. These will
come out very slightly lumpy but with a consistent size to the pieces.
I like to use some of the vegetable and fruit dices that Gerber makes
for babies because they are easy to purchase and when mixed with
pureed food of the same variety, the taste is the same. The idea here
is that you want to change only one sensory variable at a time. For
example, you can take pureed carrots and mix in a tiny amount of
carrots that have been passed through the baby food grinder. I start
out by giving the baby some of the pureed foods (to take the edge off
his hunger) and then offer a little bit of the ground-food/pureed-food
mixture on the end of the
spoon. Immediately follow this with another bite of pureed food.
Alternate the two until he is more comfortable with small lumps. You
will need to follow his lead in how fast you move in going to food
that is more lumpy. When he is more comfortable with the lumps mixed
with the pureed food of the same taste you can go to having the lumpy
part a
different taste from the pureed part. For example, you could
blenderize pieces of potato or green beans with the carrots etc.
The whole idea is to make the steps very small in both taste and
texture changes."
http://list.dysphagia.com/dysphagia/2000-July/msg00242.html
>>>>>>>>>>
8) What should I expect at our initial visit with the Occupational Therapist?
Your first appointment to the therapist will be a friendly, warm,
evaluation visit, which will include:
1. Physical stats: weigh-in, measurements, etc.
2. Dietary history.
3. Assessment of swallowing.
Going to an Occupational Therapist:
http://kidshealth.org/kid/feel_better/people/occupational_therapist_p2.html
Pediatric Feeding Program
"Some children have difficulty feeding or swallowing while breast
feeding, bottle feeding, spoon feeding or self-feeding. These children
may not be able to eat age appropriate textures or types of food. At
Athens Regional Medical Center, a Pediatric Feeding Team consisting of
an Occupational Therapist and Speech/Language Pathologist provides a
comprehensive evaluation to identify barriers which interfere with the
child's age appropriate feeding skills.
After the evaluation is completed, parent education and a home program
are provided. Recommendations are made regarding a treatment program
and follow-up medical care if needed."
http://www.armc.org/health/rehab.shtml#dysphagia
>>>>>>>>>>
9) Are there any other specialists I could go to who might help?
A Speech Therapist (they are specially trained in eating problems).
>>>>>>>>>>
Additional Links of Interest:
Hand and Foot Teethers: $5.50
Gummy Yummy: $8.50
http://www.new-vis.com/cat/p-oralmt.htm
Baby Feeding & Nutrition:
http://www.babycenter.com/baby/babyfeeding/index
Making Your Own Baby Food:
http://www.keepkidshealthy.com/infant/homemade_baby_food.html
Feeding A Child With Dysphagia (Difficulty Swallowing):
http://www.childrensdisabilities.info/feeding/dysphagia.html
>>>>>>>>>>
In regards to nutrition and weight gain, consider this - feed the
gaggy food first on an empty stomach and move on to the easy food and
breatfeeding second. That way, she will not lose most of her meal!
I hope I've not only been able to help to provide you with relevant
information but also to ease your mind. Your daughter is making
progress and will more than likely continue to do so at her own pace -
be patient (remembering to make each meal relaxed and enjoyable), and
believe it or not, this phase will pass and before long you'll be
worrying about something else (believe me, it never ends, Mom - even
into university and beyond!). If you have any questions, please post a
clarification request before closing/rating my answer and I'll be
happy to reply.
Thank you,
hummer
Google Search Terms Used:
babies "extrusion reflex"
"first visit" "occupational therapist" "dysphagia"
babies "hyperactive gag reflex"
babies "gag reflex"
babies "extrusion reflex"
"sippy cups" teaching
tips "sippy cups"
babies food schedule |
Clarification of Answer by
hummer-ga
on
07 Jul 2004 08:28 PDT
Dear whatda,
"I've been debating whether to go ahead with your rating or ask for
more clarification. (I'm new to this GA thing -- this was my first
question.) I'm happy with the info you got me, but I guess when it
comes right down to it I would really like more. So rather than give
you less than five stars, could you Google some more?"
I'll do my best to have another look for you - I believe one of the
main strengths of GA is the Clarification Request option as it is
there to ensure that the answers posted are as appropriate as
possible. There is no limit to the number of clarifications that can
be posted as long as they stay within the parameters of the original
question (it's nice to bear in mind that researchers receive only 75%
of the posted fee and may have already worked hours on a question).
>>>>>>>>>>
RE: Q. 1-3:
1) What is considered "normal" in terms of a gag reflex in infants?
2) What is the normal timetable for babies to move from pureed foods
to table foods?
3) How do babies lose their gag reflex -- is it just a matter of time
(neurological development) or does it take practice?
Can you find any links to medical websites -- stuff really intended
for Doctors, Occupational Therapists or Speech Pathologists -- with a
discussion of normal vs. abnormal swallowing/ability to eat solid
foods? Don't worry about summarizing. I'm happy to dig through and
look up the medical terms in a dictionary.
Sequence of Developement and Feeding Skills:
http://www.foodscience.psu.edu/Outreach/imgs/ABC's/SequenceofDevel.pdf
Infant Developement and Feeding Skills:
http://www.fns.usda.gov/tn/Resources/ch2.pdf
Nutrition for your Young Child:
http://www.webspawner.com/users/childnutrition/
Here you will find a discussion about dysphagia, but many of the
points are relevant.
See:
Normal swallowing physiology:
http://www.emedicine.com/pmr/topic194.htm
>>>>>>>>>>
RE: Q.4-5:
4) Should I keep trying to get her to eat table foods or should I just
give up and spoon-feed her pureed baby food for now? For how long?
5) Are there any tricks to getting her to drink from a sippy cup (or bottle)?
I'm okay with what you already found -- lots of good ideas and tips
from other parents. But if you can find any medical stuff (therapy
plans, "interventions", "feeding strategies", etc.), I'd love to read
it.
Treatment
* Optimal seating and positioning to ensure a stable base and good
posture. This allows the child to concentrate more on feeding than on
balance alone.
* Oral desensitisation exercises
* Removal of overt or extra stimuli
* Gradual introduction of different stimuli eg. taste, texture, temperature etc
* Oral play and exploration
http://www.chw.edu.au/prof/services/rehab/brain_injury/information_sheets/swallowing/oral_hypersensitivity.htm
"In order to address a child?s oral hypersensitivity, one must first
work through hypersensitivity to touch and textures on his body. For
example, you can play with your baby in a sensory box of uncooked
beans or rice, encouraging her to put her hands and feet in the rice,
or you can help your child to finger-paint with pudding or baby food.
You can also play in the sandbox, the grass, exposing her to different
textures on her body and her face. Bath foam, shaving cream and bath
paints are other fun sensory bath experiences. The brushing program
may benefit your child and can be explained by your therapist. As the
child?s tactile defensiveness decreases, the clinician and parents can
begin to stimulate the child?s mouth. This may be accomplished by
encouraging the child to mouth toys (vibrating toys are especially
effective), by using a toothbrush or Nuk massage brush to play in the
child?s mouth, or for very young babies, by allowing the child to suck
on your finger. For children who are above the age of 8 months and
have not transitioned to textured baby foods or soft table foods,
small amounts of finely ground graham cracker crumbs are added to his
smooth pureed foods in order to gradually increase the amount of
texture tolerated in his food. As tolerated, either the size or the
amount of crumbs is increased, but not both at once. It is important
that a therapist trained in pediatric dysphagia monitors this
progression, ensures that all GI issues are being addressed and aids
in creating a program specifically for your child."
http://www.feeding.com/images/FAQ%20compl%20of%20reflux.doc.
>>>>>>>>>>
RE: Q.6:
6) Are their any other explanations for her feeding problems other
than an "over-active" gag reflex?
Did you really address this one? I guess I'm feeling more and more
that there IS some other explanation. She obviously gags more than
normal, but maybe her gag reflex isn't actually "over active"? Maybe
she just can't get the food moved around in her mouth without getting
it too far back and then she gags?
Oral hypersensitivity or dysphagia or two good possibilities.
Here are some websites for you to investigate:
Virtual Children's Hospital (U of Iowa) - digital library of pediatric health info:
http://www.vh.org/pediatric/index.html
Medline Plus (US Nat'l Lib of Medicine & NIH):
http://www.nlm.nih.gov/medlineplus/sitemap.html
Med Help Int'l (not-for profit)
"tools to make informed treatment decisions", etc
includes a forum - "ask questions to leading physicians and
healthcare professionals"
http://www.medhelp.org/
healthfinder_ - your guide to reliable health information
...a FirstGov site
http://www.healthfinder.gov/
>>>>>>>>>>
RE: Q.7:
7) Where online can I find simple definitions of medical terms
relating to feeding discorders (e.g., dysphagia)? Any other online
medical dictionary sites? BTW, The stuff you found on dysphagia is
great.
Dorland's Illustrated Medical Dictionary:
http://www.dorlands.com/wsearch.jsp
Health Illustrated Encyclopedia:
http://www.mercksource.com/pp/us/cns/cns_hl_adam.jspzQzpgzEzzSzppdocszSzuszSzcnszSzcontentzSzadamzSzencyzSzarticlezSzindexzPzhtm
MedBioWorld
http://www.sciencekomm.at/advice/dict.html
Medical Dictionary - University of Miami
http://www.med.miami.edu/patients/glossary/list.asp?t=DICT
Medical/Surgical Terminology
http://mtdesk.com/swg.shtml
Medical Tests & Procedures - MedicineNet
http://www.medicinenet.com/script/main/alphaidx.asp?p=a_proc
Medications Glossary - MedicineNet
http://www.medicinenet.com/script/main/alphaidx.asp?p=a_pharm
MedLinePlus:
http://www.nlm.nih.gov/medlineplus/mplusdictionary.html
MedTerms - MedicineNet
http://www.medterms.com/script/main/hp.asp
Merriam Webster Medical Dictionary:
http://www.intelihealth.com/IH/ihtIH/WSIHW000/9276/9276.html?k=navx408x9276
Online Medical Dictionary
http://cancerweb.ncl.ac.uk/omd/
Terms and Definitions - Office of Rare Diseases, NIH
http://ord.aspensys.com/asp/resources/glossary_a-e.asp
Virtual Body Tours:
http://www.mercksource.com/pp/us/cns/cns_interactive_tools_vap_index.jsp
>>>>>>>>>>
RE: Q.8:
8) What should I expect at our initial visit with the Occupational Therapist?
YOUR ANSWER:
Your first appointment to the therapist will be a friendly, warm,
evaluation visit, which will include:
1. Physical stats: weigh-in, measurements, etc.
2. Dietary history.
3. Assessment of swallowing.
What is an "assessment of swllowing"? Can you find anything that
describes what they actually DO to the child to evaluate their
swallowing?
The following will give you a good idea of a general assessment,
bearing in mind adjustments for age and ability.
Physical examination:
* During the physical examination, look for oral-motor and laryngeal
mechanisms. Cranial nerve testing of V, VII, through XII is essential
for determining physical evidence of oropharyngeal dysphagia.
* Direct observation of lip closure, jaw closure, chewing and
mastication, tongue mobility and strength, palatal and laryngeal
elevation, salivation, and oral sensitivity is necessary.
* Check the patient's level of alertness and cognitive status because
they can impact the safety of swallowing and ability to learn
compensatory measures.
* Dysphonia and dysarthria are signs of motor dysfunction of the
structures involved in oral and pharyngeal swallowing.
* Inspect the oral cavity and pharynx for mucosal integrity and dentition.
* Examine the soft palate for position and symmetry during phonation and at rest.
* Evaluate pharyngeal elevation by placing 2 fingers on the larynx and
assessing movement during a volitional swallow. This technique helps
to identify the presence or absence of key laryngeal protective
mechanisms.
* The gag reflex is elicited by stroking the pharyngeal mucosa with a
tongue depressor. Testing for the gag reflex is helpful, but absence
of a gag reflex does not necessarily indicate that a patient is unable
to swallow safely. Indeed, many persons with no gag reflex have normal
swallowing, and some patients with dysphagia have a normal gag reflex.
Pulling of the palate to one side during gag reflex testing indicates
weakness of the muscles of the contralateral palate and suggests the
presence of unilateral bulbar pathology.
* Cervical auscultation becomes part of the clinical evaluation of
dysphagic patients. Assess sound strength and clarity, timing of
apneic episode, and speed of swallowing.
* Assessing respiratory function also is essential. If there is
inadequate respiratory force of a cough or clearing the throat, risk
of aspiration is increased.
* The final step in physical examination is direct observation of the
act of swallowing. At a minimum, watch the patient while he or she
drinks a few ounces of tap water. If possible, assess the patient's
eating of various food textures. Sialorrhea, delayed swallow
initiation, coughing, a wet or hoarse voice quality may indicate a
problem. After the swallow, observe the patient for 1 minute or more
to see if delayed cough response is present. DePippo et al suggested a
3-oz water swallow test, which identified 80% of stroke patients
subsequently found to be aspirating based on videofluoroscopic
studies.
http://www.emedicine.com/pmr/topic194.htm
Cranial nerve X (vagus nerve)
"This nerve is mainly responsible for the ability to swallow, the gag
reflex, some taste, and part of speech..."
http://www.mountcarmelhealth.com/healthinfo/Adult/neuro/exam.shtml
>>>>>>>>>>
RE: Q.9:
9) Are there any other specialists I could go to who might help?
Nothing more needed.
Who do I see and how is it diagnosed?
"A Speech Pathologist will be able to assess whether a child is
experiencing hypersensitivity or is possibly having other difficulties
with their swallowing. A paediatric speech pathologist experienced in
looking after children with brain injury or swallowing in infants is
highly recommended."
http://www.chw.edu.au/prof/services/rehab/brain_injury/information_sheets/swallowing/oral_hypersensitivity.htm
Overall I guess I'm feeling that the gagging is a symptom of some
other problem as opposed to the gag reflex BEING the problem. (Like I
discussed re: Q.6 above). So I'm hoping you can find medical info that
talks about gagging as a symptom and then discusses what causes it and
what you can do about the underlying condition. Does that make sense?
Whatda, consider this - your daughter has made some significant
progress already. In your own words:
"But this soon got better, and she almost never gags during
breastfeeding now."
"But over time she has gotten much better and now rarely gags on
things she holds and explores with her mouth."
"She now eats a variety of pureed baby foods, although if you watch
closely you realize that she still gags several times per feeding but
usually recovers quickly."
"She will now drink one sip at a time from a sippy cup,"
"Other than the feeding problems she is a happy, healthy baby."
From everything I have read, patience is the name of the game,
progress is slow. But as long as there *is* progress and you are
following your doctor's advice, don't worry too much about it and try
to enjoy the progress she *does* make.
"Thanks for all your help."
Your welcome - it has been interesting to research this for you.
Sincerely,
hummer
|
