I vote with Laurie Wheeler who suspects the problem with the gagging and
choking infant might be reflux.  There are two types of aspiration:  that
which occurs during descending fluid events (ie swallowing) and that which
occurs when fluids reflux up -- ascending -- and baby aspirates.  The
immature response to choking is brief apnea following by coughing to attempt
to clear the passage.  A swallow study might be in order.

 To be honest, due to the volumes of traffic most physicians must deal with
in the managed care environment (along with the pressure to not do tests) it
probably does take parental insistence to get anyone to attend to a
complaint -- esp. if the baby is not currently running a fever or losing
weight. It is beyond the scope of our practice as LCs to diagnose, although
we may certainly have opinions or suspicions.   When I write my reports to
physicians I stick to carefully describing what I observe and what the
parents report.  This puts it in the chart, and also paints a picture which
may alert the MD that there is something unusual going on which needs
attention.

Barbara


Barbara Wilson-Clay BSEd., IBCLC
Private Practice, Austin Texas
Visit the "LactNews-On-Line" Web Page
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