Feeding FAQ: 6-9 months – Weaning/Solids

At 8-months-old my son gags and chokes on finger foods and lumps

My son will not eat food with lumps of any size nor will he eat finger foods. When this is tried, he gags and coughs until he violently throws up what would appear to be his feed and any previous feeds. As soon as he feels something of a slight lump on his tongue he starts to gag.
I have tried banana in very small pieces, yogurt with small bits, cheese strings, bread and toast with the same result of gagging and making himself violently sick. He has mild reflux and has just been prescribed Ranitidine and Domperidone which he is to be started on. I have been in touch with a couple of baby food manufacturers but neither do food in between puree and lumps.
As I cannot cook, I use jars to ensure he gets the vitamins required.
When he was first weaned he refused baby rice and other mixes, clamping his mouth shut or throwing up. He took to fruit and veg puree (jars) straight away. I am getting to the stage where I am afraid to give him finger foods or foods with lumps as the amount of vomit that he brings up seems excessive. When he has thrown up he is always very hungry at his next feed as if he has emptied his stomach. The nursery staff are also experiencing the same problems with him throwing up, as it was thought that if he saw other children eating things he would copy them. They do try and give him cooked food mashed down without lumps. He has been experiencing problems with being congested and mucus-y for approx 8 weeks and his weight has been up and down with a very low weight gain during this time (approx 5oz), but I have been told that as long as he’s getting fluids in him not to worry too much about food. So I am wary about him gagging and throwing up on lumps at present, if this makes any sense. My son is normally a happy smiley baby and doing very well in all other areas of development.
At present he has a jar of breakfast food or weetabix after having 4-6 oz milk at 7am, at 11.45 he takes a jar of baby food (meat) and a jar of fruit or yoghurt. He takes 3-4 ozs of milk at 3pm and at 5.15pm has a jar of baby food sometimes followed by 1/2 jar fruit. At 6.30pm 4-7 ozs milk.

As your son has problems with reflux, how you get him used to slightly lumpier food and finger foods must be done very carefully. Is there any guidance from your GP or health visitor as the best way to proceed? It may be worth asking them to refer you to a specialist who can help your son to get more used to the feeling and texture of slightly more dense food than jar purees. Possibly a referral to a speech therapist would help as they are specially trained to deal with swallowing, sucking and any problems connected with the mouth and how it develops, as well as actually dealing with “speech” problems. Not only will your son be able to enjoy a wider variety of food, and be able to feed himself but getting him to chew and swallow lumps is linked to his speech development. Some babies may have delays in learning to talk if they are kept on pureed foods for too long. You are certainly doing well to keep trying with him despite the vomiting, which must be distressing for you both, but getting him used to slightly more textured food than first stage jars should be your aim. It would seem that he does not like the feeling of anything slightly textured on his tongue. As he has had jars for several months now, getting him used to the next stage could take some time. It may be best to proceed at a very slow rate, gradually introducing the next stage of food little by little.
One way to do this would be to mix a small amount of a stage two jar in with his stage one. Begin with the smallest amount, about half a teaspoon to a least two or three teaspoons of stage one. Another idea would be to add a very small amount of baby rice or Ready Brek to some fruit puree and gradually add more as he becomes used to it. Try this at the beginning of a meal when he is hungry. At the beginning only offer him one or two spoons of the two stages mixed together before giving him the rest of his meal from his usual jar. Very, very gradually increase the stage two food and reduce the stage one. Although you say you are unable to cook, possibly you could make some home made purees of vegetables and fruit and introduce these to him in the same way, adding a small amount to his usual jars and increasing slowly. The texture of home made food is different to jars as well as the taste. Look in The Complete Book of Weaning for recipes to follow when making vegetable and fruit purees.
Getting a baby used to finger foods takes time and patience. It is important to find food which will easily dissolve in the mouth and have no grittiness, grain or crumbs on which he can choke. It would be a good idea to have a go at trying the foods you wish to offer him yourself, and see how easy it is for you to use your tongue to move the food to the roof of your mouth, then squash it using a jab like movement. As he may only have a few teeth, this is how he needs to cope with food which is not a runny puree. As he has only had purees he will need to be given time to get used to having different textures in his mouth. Once you are sure that what you are offering him does “mush” quite easily when in the mouth then scatter four or five pieces onto his feeding tray or bowl and let him try to pick them up himself. If given too much at one time, babies are apt to swipe all of the food onto the floor, or try to cram too much in. Let him feel the food with his fingers and try to feed himself. Just give him a few pieces before each meal and show him what to do, not by putting them into his mouth for him, but picking a piece up and eating it yourself. If he doesn’t try them don’t worry too much, just clear them away and offer him his meal, but keep trying at each meal. Accept that this can be a messy phase, especially if he likes to pick up the food with his hands and squash it. It is all part of his learning about different textures and perhaps if he tries to feed himself, he may be less likely to gag too much when he feels the texture on his tongue.