Bubs has always had a bad gag reflex - to the point of changing bottles as the teats would set it off.

Started solids just after 4 months which improved the reflux majorly. He has been absolutely fine on very very smooth pureed stuff - couldn't even give him homemade food as i couldn't get it as smooth as the jars.

As soon as there is the hint of the slightest lump in his mouth he starts coughing and gagging like its the worst thing ever. We are still on very smooth pureed food - i even have to take all his food to daycare, as their food isn't smooth enough for him!

For the last month, i have been trying different ways of introducing textured food - i have tried the jars for his age, didn't work, i have tried letting him feed himself so he knew he was putting that food in his mouth - didn't work, i have tried tinned pears (nice and mushy) and bananas so he can hold them and eat as pleases - doesn't work, i have let him take food off me that i'm eating (dependant on what it is) - but still it sets the coughing and gagging off.

The gagging set everything off last night, he power chucked all his dinner back up, then was screaming in pain because of that (doesn't bother him when it's just a normal 'spill'), so i went to get him from bed and see if i could get some gaviscon into him - but didn't get the chance, i was picking him up and he threw up all over me and in his bed, then again all over the bathroom - we're talking huge amounts out his mouth and nose - very scary for him - i sat him in his seat in the bath so i could rip his sheets off the bed before it soaked in, walking back in and he's just solemnly sitting there with his head hanging down and a look of sadness - it broke my heart - we had great cuddles in the shower as i talked to him about what had just happened.

The above only happens if he does actually manage to swallow sum lumpy food - obviously we don't get this with the pureed stuff.

I will be taking him to the doc in the very near future - is there anything in particular i should be asking - should i be asking for a referral to a paed? Should i just stop trying the textured food for now - even though i know it says on the crying over spilt milk page that at this age, you should be trying to get them to eat textured food.

He's definitely getting all the food he needs (he's a big boy lol), i'm just concerned now that hes getting older and interested in picking up food and taking it off people, that the more he trys to eat and gags, the more days/nights we will get like last night.

One of my two used to gag ALL the time. As she got older it's got better, very slowly, and much slower than "normal" kids, but she's getting there. At nearly 3 she's fine with mince and other smallish size pieces of food, and has taken a long time to finally learn how to chew.

We just held off for a while and kept trying every now and again. She went really well on crunchy food, rice crackers were wonderful! So just try other things, and give him a little more time, would be my suggestion. Try once a week maybe?

Yes, you do need to keep on trying textured foods. Maybe offer them one meal a day only - or even at snack time so that the rest of the meals are kept down and tolerated. Keep on offering them BUT I also think it is important that you talk to your GP about this. Is your baby on any medication for reflux? I wonder if they are refluxing and it is burning, and they just aren't complaining but the damage is there and this is why lumps cause problems. The GP could opt to treat reflux as a trial or to send to a paediatrician. It may just be normal for your baby and it will get better as they learn about solids but go with your gut feeling.

Something you can also do to make it an easier transition is to very gradually mix the textures. We had problems like this with William in that he couldn't manage lumps. So I'd put a tiny amount of older kid baby food into his puree, once he was tolerating that for a week put a bit more in and a bit more the next week and so on. Our problem was every time he got sick he'd stop eating and then we'd go back to square one. I swear I weaned that child about 20 times!

Thomas couldn't control the very smooth purees in his mouth so we added baby rice to the purees to thicken them. We had to make them really thick to start with and then spend a long time gradually decreasing the thickness. Maybe putting something like baby rice into his purees will give him some experience of graininess and so texture without the lumps and so give him a transition.

I've been buying baby food recently for William (11.5) post his reflux surgery and he's still not managing the lumps in 6 month baby food. There seems to be a very big jump in the baby food between the 4 month purees and the 6 - 8 months stuff.
He did manage a can of Watties banana yogurt dessert for lunch today - where he couldn't manage the Only Organics Golden fruit porridge for breakfast. So the tiny lumps of soft banana in the yogurt stuff seem easier to get down - maybe try that one?

When you talk to your GP and possibly go to a paed, you might also want to ask about a Speech Therapist through the Hospital. They deal with feeding issues and might be able to help with the textural transition too.

Have been to see the GP and he has changed us from Gaviscon to Dr Reddy's Omeprazole. Not entirely sure how to give this to him at such a young age as i was told not to mix it with his milk but just put it in a little bit of juice or water, but he won't take it with the water and i don't want him drinking juice just yet when he is completely happy with water normally. Can i hide it in a bit of his food??

Talked to the doctor about the gagging issues and he took a look at his throat - he has a very small gap to swallow food down due to enlarged (not infected) tonsils (which would explain the gagging when he was a newborn from the bigger teats) - he also gets constant ear infections and has swollen adenoids - so when they put the grommets in and remove his adenoids, he has recommended that we get the tonsils removed aswell. So hopefully that will sort the problem and if it doesn't - well then we really have an issue

He has managed a wee bit of normal food (watermelon) on his own, but he got it to an almost pureed state himself lol, would put it in his mouth and chew it up, spit it out, put it back in, spit it out and then finally put it back and swallow it. Tried banana yesterday (again), he loves biting it off, but he's learnt to spit it back out before it hits the back of his mouth, the occasional bit gets through and he starts gagging again.

Eleanor i know what you mean about your boy getting sick and the stopping eating - i'm just going through that yet again with another ear infection, except now he's learnt how to push my hand away, or hit the spoon making the food go flying or just turn his head lol, as you can probably guess - we're back to the not eating solids stage again.

Totally hear ya on the jump between 4mth food to the stage 2 stuff, we're going from pureed stuff to 'mashed' stuff supposedly, but some of that stuff has peas and pasta in it - that's so not mashed. Maybe i should try doing a vegetable mix for him again and seeing if he will eat tht mashed - last time i tried it wasn't smooth enough for him.

A question also - with the Dr Reddy's Omeprazole, can i use thickened formula with this, or do i need to use normal formula?? I ended up just staying on the Novalac AR even though i was on Gaviscon, because out of all the formulas tried that was the one that didn't make him sick all the time, so i don't really want to have to put him through the process of finding a formula that agrees with him again if it's possible i can just stay on it. Am holding off on the Losec now, until i can find out the answer to this : ) I forgot to ask the doctor directly, but it had been mentioned before that, that was the formula we were on and he didn't say anything about gaviscon and that formula - so would i be safe in assuming that the omeprazole and this formula would be the same??

http://www.cryingoverspiltmilk.co.nz/MedicalTreatment/Omeprazolegranules.pdf

Gaviscon should not be given with AR formula but Omeprazole is fine. Just don't give the Omeprazole at the same time as the formula - it needs to be given with something acidic and definitely not alkaline like milk.

You might have to stay with the smoother food until his tonsils are sorted. When do you have an appointment with ENT?

My doctor didn't even say anything about that and i did tell him what formula he was on, it's things like this that make me think that i really do need to find myself another doctor.

Ok, so do i need to wean him off the gaviscon and wean him onto the omeprazole, or can i just stop the gaviscon and start him on the other. Will have to remember to buy some pureed pears tomorrow.

Not going to have an appointment with ENT to confirm the surgery until maybe about April, but a letter has been sent off to the specialist outlining everything in preparation. If i get it done soon, then the doc said it is likely he will have grown out of the grommets by the time full force of winter hits - hence being better to keep him on the pureed food a while longer and getting the lot all done at one time. Will be going private, so no delays of a public waiting list to worry about.

I can't win, i could get the surgery done now and try and start getting him onto proper food sooner, or do the surgery later, keep him on pureed food and have a very picky eater on my hands with bad habits.

Its OK to start losec straight away, you dont have to wean of gavison ....infact some babies have both.Losec may take up to 3 weeks to work correctly so may pay to keep gavison on the go as well.
Try giving the losec on a spoonful of pured pears that used to work well for us.

I would stop the Gaviscon and just use it as required if you are going to continue with the AR formula. No problem giving it with Omeprazole though.

And if he still can't eat appropriate foods, then get the surgery done and get him onto appropriate foods sooner. The longer this is delayed, the more problems you will have. If it is any help Gem's grommets lasted years. Not all do though. From memory, she had hers in in October.

Thanks for that Roz. I only changed to that formula as i had run out one day and i had just been to the docs for bubs as he had another ear infection, so decided to buy formula from the pharmacy at the same time, they didn't have the usual - but she recommended that one and said it was really good etc, i said he was on Gaviscon, she said that wasn't a problem - hence both being used at the same time.

Have gone back to the previous normal formula, bit more spilly again, but not too bad, so i think he is slowly slowly growing out of it - fingers crossed.

Tried the Losec, just kept making him throw up - not his happy chucks as per usual, but proper throwing up, so have gone back to the Gaviscon and he has settled again.

Have to catch up with the doc when he re-opens to get bubs ears checked to make sure they are all clear, so will talk to him about getting the surgery done earlier.

I've just commenced an Infant and Child GORD Network for Health Professionals because these sort of issues come up all the time.

What version was the Omeprazole? Granules out of the capsule or suspension? It was Dr Reddy's brand right?

If you think he is outgrowing the GORD, then you can delay the surgery for this - talk to the surgeon about what you are seeing I guess - or if you aren't seeing them, get GP to pass on information.

It was the Dr Reddys capsules - so granules to put in the pear puree. They just didn't agree with him from the word go, i persisted for a bit before reverting back to the Gaviscon.

Yes i think he is slowly outgrowing it, but the surgery is for his ears, nose, throat - tonsils and adenoids out and grommets in, so he still needs all that done anyway - as its not just what he can eat that is affected, but also how he breathes due to the swollen adenoids.

So we're not any further along food wise at 8months than what we were a month ago, still on completely pureed food. I'm giving him variety in food, so he gets used to different tastes and textures as i know now he'll just spit it back out because he can't swallow it.

It may well be worthwhile paying for a month of Losec as a trial to see if it helps things. There is a possible relationship between ENT issues and GORD. Some of our babies had problems with Dr Reddy's Omeprazole. What you are saying though about the eating and adenoids makes sense.

Good on you for persisting with the variety in foods. It is all about experience and one day, it will hopefully get swallowed.

Wow SC sounds like you are doing a great job under challenging situations! We too had a child that found lumps a real issue, she never suffered from the ENT issues your bub is dealing with, the swallowing issues were related to her reflux. It took so long to sort out her reflux that she had become scared to eat anything that might cause pain.

She was on very smooth purees for many many months while we got the reflux sorted out and I spent a lot of time explaining to people, at preschool for example, the situation. After that I was able to deal with the food, with different flavour combinations and new textures as often as I had the stamina to do so and things did improve.

Now as a 3 year old she eats a wide range of foods and is quite open to giving new things a try (although there may always be somethings she will refuse to eat, yogurt with fruit in it and raisins, as they might have "bits" in side them).

Persist with getting the medical aspects of the problem sorted, that way you can move onto the food issue with confidence. In the mean time keep up the variety of flavours you offer in the purees.

Two things we tried were ginger nut biscuits, could be sucked on till they become very soft, and ice blocks made from very watered down fruit juice. Getting the losec down was always and issue, at various times we administered it in a spoon full of glucose syrup or liquid malt, both thick but not lumpy.

Good luck - keep up the excellent work!