Anne, you're getting great suggestions and with the conference, no doubt you
have received additional input.  As others have suggested, this pattern does
suggest a consideration of sensory integration issues.  In addition, both
the gag response and birth trauma continue to be of interest, to my thinking
more so than a later interest in table foods.

I do want to underscore another point others have made.  It is not at all
unusual for a healthy 15 month old, nursing ad lib and parented as
described, to be slow to the family dinner table.  Most toddlers are happily
finger-feeding by two years and the vast majority of so-called
"late-feeders" I've seen are chunky, happy kids developing normally in terms
of speech and motor skills.  Toddlers who have embraced solids at 6 months 
or 16 months may still exasperate their parents with unpredictable eating
patterns.  This isn't to say we shouldn't attend the child who is late to
the family table, only that we should keep an open eye to normal patterns of
nursing and child-initiated solids.  While it is currently considered normal
and appropriate to offer complementary foods around 6 months, many
apparently healthy, well-fed children are less than enthused at this age.

The issue is many-faceted but certainly relates to "normal" biological
nursing/weaning patterns which time will no doubt show are tremendously
misunderstood at present!

Frequently we see reference to children "self-weaning" when other factors
spring up between a child and the expected progression at the breast.  We
see this phrase used even when the child's age is measured in months. 
Currently I am in Saudi Arabia where local thinking is that a child should
be nursed for 2 years but no more.  In speaking with women I have yet to
hear any hint of "self-weaning" before this age, only references to the need
to stop, the desire to stop, and the ways to stop.  I will continue to
listen to women's stories with an ear for this, mindful of the many ways
culture influences what we hear and see.

Going back to this particular mother's case, my biggest concern is the
mother's concern.  Mothers know their children and therefore mothers'
concerns should always be given respect.  While it may be that this child
simply needs to begin solids later, the question of why is certainly
important.  There may be big reasons, there may be small reasons.  I look
forward to the follow-up.

Susan Johnson MFA, IBCLC, RLC
Jeddah, KSA

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