Sorry for weighing in late on this, and apologies in advance if  I'm
mis-remembering the details.

My experience working  with children and adults who have swallowing disorders
secondary to anatomical or neurological differences makes me  think that it
is highly likely that there is some physiological basis to the symptoms you
describe.

Leaving this aside for now(I'll discuss this more later),I'm wondering how
this child is doing otherwise.  Is the child growing acceptably?  What has
the pattern of weight gain been to date?  If the child has indeed been
thriving on breastmilk, I would provide strong re-assurance to the parents.
Someone else mentioned the rare cases of severely medically challenged
children who have survived on donor milk through adolescence.  I know I saw a
recent article about one such young woman who was getting ready for college.
This info may be helpful to the parents.

My short-term focus would be to try to defuse what must by now be an
incredibly fear and tension-laced eating environment.  Any reasonably
intelligent child is bound to pick up on this atmosphere, and these kinds of
dynamics can create an eating disorder all by themselves.  I would back way,
way off on solid food, let the parents have the confidence that their child
can indeed get adequate nutrition in the short run just on breastmilk(with
the addition of a multi-vit if desired).

When solids are resumed,  I would have all initiation of eating come from the
child---even to the point of sitting the child on mom's lap and letting her
self-feed ad lib.  Basically, no pressure, no focus on amount of food eaten,
etc.  A child who may have developed an aversion to eating  may need to spend
a long time looking, smelling, and tasting food before swallowing.  Mealtimes
should be pleasant, social occasions.

It does sound as if this poor baby has been probed and scoped in a variety of
ways.  I don't recall you mentioning if a videoflouroscopy or modified barium
swallow has been done.  This differs from a regular barium swallow  or upper
GI in that  a variety of food textures are evaluated, and it is a dynamic
evaluation(looks at the structures in motion).  I would hope that an MBS with
what is often called a stage 3 follow through(looking at the esophageal
transit) would definitively rule out any structural abnormalities .

If possible, this evaluation would be done at a university-affiliated
pediatric hospital, as part of a co-ordinated feeding and swallowing
assessment, rather than sending these poor folks round and round to different
specialists.

This sounds like a very challenging situation, which may have a variety of
emotional and behavioral issues as well as the physiological mystery .  I
would be very interested in knowing how it turns out.

Karen Kavesh, Speech-Language Pathologist, nursing a toddler as I type.

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