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Pediatrics/20 month old gags and sometime vomits on textured food


QUESTION: My 20 month old girl is
-Very active
-Very healthy
-NO medical conditions
-NO food allergies

The only concern I got is that she vomits (everything she had) ONLY during textured food feeding.
She can go without vomiting for a week or two, before it begins again.
I have tested the same pureed food and she does good without any vomiting for several weeks.
She has NO molars yet, just got her canine tooth last week (total of 8 teeth).
She vomits when she is NOT chewing and she gulps her food.
Our pediatrician said she will 'grow out of it' eventually.

Once she vomits , I'm able to continue with her feeding without a second vomit.

Is it Normal for a 20 month OLD to have problems with textured food?

Is this what everyone calls 'sensitive gag reflex'?

ANSWER: Hi zenturyz,

Yes, this is "sensitive gag reflex" and kids outgrow it eventually. Textured foods should NOT be avoided for fear of vomiting.

Best wishes,
Dr. Puneet Kumar,
Kumar Child Clinic, Dwarka,
New Delhi, India


[an error occurred while processing this directive]---------- FOLLOW-UP ----------

QUESTION: Thanks for the quick response.

Just one last question.
Is there any specific duration that this might last?

Being the parents of our first child, we get concerned by looking at other kids of same age having textured food without any problem.
We still continue to give her textured foods such as rice/pasta etc.

Hi zenturyz,

Many (in fact, most) children have relatively sensitive gag reflex (as compared to adults) and thus vomit rather easily. You would notice that frequency of vomiting will continue to decrease every year and will become rare after 4-5 years of age.

Best wishes,
Dr. Puneet Kumar,
Kumar Child Clinic, Dwarka,
New Delhi, India


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Dr. Puneet Kumar


I would be happy to answer general queries on prevention and treatment of ailments in newborn, infant, toddler, child or an adolescent. Needless to say, it will not be possible to answer any query that requires diagnosing, since it is not possible to examine a child online.


I have worked in various capacities (medical officer, resident, senior resident, consultant) in public as well as private sector in Pediatrics and Neonatology. Today, I have over 17 years of experience in the field.

Currently, I am running my own clinic (Kumar Child Clinic) in Dwarka, New Delhi and am attached to Lifeline Hospital, Dwarka as consultant pediatrics and neonatology. I am also developing my clinic website into a comprehensive child health/ parenting website (

(a) Chapter "National Immunization Schedule" in Frontiers of Social Pediatrics, Jaypee Publishers: 2nd edition, 2016. (b) Article, "All about Pertussis vaccines" in special issue of Indian Journal of Practical Pediatrics, July-Sept 2015 (c) Three chapters (DTP vaccines, Pneumococcal vaccines and Poliovirus vaccines) in "Textbook of Pediatrics for Post-graduates" First edition: 2015. (c) Chapter: "Alternative delivery methods of vaccines" in IAP textbook of Vaccines, First edition, 2014 (published by IAP/ Jaypee Brothers) (d) Special Article: "50 years of Immunization in India: Progress and Future" in January 2013 issue of Indian Pediatrics (e) Four chapters in "FAQ: Book on Vaccines and Immunization Practices" First edition, 2011 AND 2nd edition, 2015 published by Jaypee Brothers. (f) Three articles in special issue of Journal of Pediatric Sciences on “Controversies and Challenges in Pediatric Vaccination Today" in Sept, 2010. Co-edited the series also. (f) Regular column, “How do I treat” in Pediascene ( (g) Review article, “Role of Anti-Poliovirus Agents in Polio eradication and beyond” in Polio Pulse, April, 2008. (h) Chapter on “Acute Infectious Diarrhea” in Textbook of Infectious Diseases in Children. (An IAP Publication), 2007. 2nd edition in 2011. (i) Book-Review (IAP Pediatric Drug Formulary, 2004) in Pediascene, March 2005 ( ) (j) Case-report on Osteopetrosis. Jharkhand Journal of Pediatrics, Dec-2002.

After MBBS, I have done DNB residency in Pediatrics.

Awards and Honors
Winner of IAP practising pediatrician's quiz in 2001.

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