Some other possibilities to explore are sensory and oral
motor/swallowing problems.  An occupational therapist is usually the
person to consult if these are suspected.  In some areas physical
therapists or speech therapists are trained in swallowing and oral
motor/feeding as well.
        Generally, if a child has a sensory integration dysfunction or tactile
defensiveness, they will refuse to touch food with their hands/fingers,
hate it touching their face, and gag and possibly vomit as soon as
solids are placed in the mouth.
        It is not unusual for swallowing to work better for one phase of matter
than others.  Some people can safely swallow liquids, yet cannot handle
solids or mixed phases (stews, soups, etc that combine solid and liquid
food).  Others can safely swallow crunchy foods, but not liquids.  It
depends on the way the tongue works to gather food into a bolus and hold
it until the soft palate can close off the airway.
        For some children, purees and semi solids are harder to handle than
crunchy foods.  Perhaps this mom can try grains of rice or small cereal
pieces like toasted oat rings, and see if her baby can handle them
better.
        And if all the oral motor and sensory systems seem to be working well,
she might need to go to a specialty clinic or hospital to see doctors
who are more experienced with rare disorders than her local ped and
gastroenterologist.  It is not unusual for rare disorders to be missed
or misdiagnosed.  And even not so rare ones.  Judy LeVan Fram and I saw
a mom whose baby had cystic fibrosis and was misdiagnosed with protein
losing enteropathy.  The cystic fibrosis became apparent after the
gastro bullied the mom into weaning.
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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