Q: My eight-year-old daughter gags and often vomits when she smells something she doesn’t like. This isn’t a new problem; whether it was latching to my nipple or drinking from a bottle, she’s always had trouble with food. She can’t stand the smell of vegetables and she hates trying new foods. I can tell it’s very hard on her. I ask her what she does at school, and she says she goes to the washroom and throws up. Is there anyone who can help us?

A: A hyperactive gag reflex is not uncommon and, in most cases, decreases by itself with time or with the addition of specific small exposures or other behavioural changes. My concern is that your daughter’s gagging started at the breast. This makes me think that its origins may be physical and not related to smell. As you might expect, breastmilk is the smell babies love above all else. I would ask your doctor for a paediatric ENT (ear, nose and throat) referral to rule out any abnormalities with her entire swallowing mechanism. If all is OK, I would get the expert advice of a paediatric occupational therapist who could work with your daughter to change this behaviour.