The gag reflex is designed to be a normal response of the mouth and throat, to prevent your baby from swallowing foreign objects or getting food trapped in the airway. When a child gags, the reflex pushes the food off the back of the tongue and forward out of the mouth. Infants usually have an automatic gag response when the back of the tongue is touched, as part of this natural protection nature provides. Yet ideally, as the child progresses from liquids to strained foods to solids, the gagging reflex diminishes. For some children with disabilities, however, the gagging continues long after it should and begins to interfere with normal healthy drinking and eating. This can cause parents a whole lot of distress and worry. Is my child getting enough to eat? How can I make meals less stressful for my son or daughter?
What causes hypersensitive gagging?
Sometimes children with sensory integration dysfunction are oversensitive to touch, which includes the sensations of the tongue and mouth. Simply due to the way their brains perceive sensory input, the feelings of certain textures, heat or cold, etc., are overpowering and can cause an exaggerated response. So their mealtime refusals and food spitting may be a problem that is biological in nature, rather than the child just being difficult.
When children have repeated difficulties at mealtime, they can begin to develop a reaction which goes beyond hypersensitive gagging and becomes more of an emotional response. They may scream, wail, cry, push food off their plates, and flat-out refuse to let you feed them. If you insist upon spooning food into their mouths, they might not only gag, but vomit out of sheer emotional upset. They might even gag as a way to exert their control over mealtime, using it as a way to manipulate.
What can be done?
- Get a medical evaluation. It’s possible that your child has an abnormal structure of the throat or mouth which is contributing to the problem. For example, if the esophagus is too narrow, or doesn’t function effectively, your child is going to have a hard time swallowing. Your child’s pediatrician, or an ears-nose-throat specialist will explain the next steps of treatment, which may consist of therapies or medications. You will likely be referred to a feeding specialist, who will work out an individualized program to help minimize your child’s gag reflex.
- Work to decrease oral sensitivities. If your child has no physical problems with the mouth or throat and is hypersensitive to taste, there are things you can do to help acclimate him or her. Throughout the day, play face-touching games with a stuffed animal, koosh ball, or warm washcloth. Don’t force it—use gentle play and back off if it becomes stressful. You want your child to slowly tolerate facial sensations and make a positive association. Let the child touch your face, or dolly faces, as part of the play. You may need to start somewhere besides the face, like the upper arms, and then work toward involving the face in desensitization. Try letting your child play with a toothbrush, or bite on chew toys.
- Backtrack to easier food textures. Store-bought baby foods jump from strained to chunky without the more subtle transitions your child might need. You might want to experiment with blending foods yourself and finding the consistency that works best for your child. Then slowly, slowly, transition your child to thicker and lumpier foods. Make trying new foods a fun activity.
- Listen to your child. Gagging can often be a way your child communicates stress and frustration. Don’t be forceful and angry, or it will exacerbate the problem. If your child gags or vomits, have a very low reaction—in fact, barely acknowledge it. Clean up the mess with no emotion. Use distraction, talk to your child about something fun or pleasant, play soothing music, or quietly eat beside your child. Offer foods that are interesting. Make the setting calm and tranquil.
Gagging can be an extremely frustrating issue, so hang in there. A team approach may be necessary with doctors, dieticians, and specialists to help you tackle this problem. It will take time, but with patience and experimentation, you are bound to see improvement.
Kristyn Crow is the author of this blog. Visit her website by clicking here. Some links on this blog may have been generated by outside sources are not necessarily endorsed by Kristyn Crow.