Q. My 15-month-old daughter swallows baby food without difficulty, but when I give her table foods (pasta, fruit cocktail or small pieces of chicken) she chews them and then spits them out without swallowing. Should I be worried?
A: Some children spit out new foods as they are adjusting to new food textures. This often is a very temporary response. Often by their first birthday, children are completely chewing and safely swallowing age-appropriate table foods such as pasta, fruit cocktail and small pieces of chicken.
If you have just started offering table foods, give her another week or so to adjust to the food texture difference. If she’s still spitting out food after that, and if you followed typical feeding milestones and you first offered her these foods sometime between 8 and 12 months, you may want to talk with your pediatrician as an evaluation may be indicated. She has had plenty of time to adjust and figure out how to chew these foods.
What does the food she spits out look like? Looking at the food can give you an indication of where she is having trouble.
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If the spit out food looks like a slightly smashed version of what she put in, it may mean that she has not yet learned how to chew. It is a good thing that she is spitting out the food. If she tried to swallow the food without chewing it well enough, it could get stuck in her throat, cause stomachaches and even block her airway.
If the food is chewed up pretty well, she may not have the coordination or skills to collect the food for swallowing. More mature skills are required to swallow chewed table foods than pureed.
No matter what the food looks like, when your daughter spits out the food, she is telling you that she doesn’t feel comfortable or safe swallowing the food. If you have already given her time to adjust to table foods and you are still concerned, she may benefit from a dysphagia evaluation and feeding therapy to teach her how to chew. It is best to get this addressed sooner than later. If you wait too long, she could develop feeding aversions, behavioral issues and picky eating.
Joan Dietrich Comrie of Carolina Pediatric Dysphagia (919-877-9800) in Raleigh has dedicated her entire career to studying, teaching and practicing in the area of dysphagia, specifically pediatric dysphagia.