Gagging and choking. **cringe**

Two of the most concerning topics for most parents of babies ready to start solids. And rightfully so! Like most parents, you probably have a long list of questions such as – how do I prevent my child from choking, how can I tell when my baby is gagging or choking, what do if any of these happen, and the list goes on and on! As parents, our minds whirl around endlessly with the “what ifs” and “how to’s” on this topic, and to be honest, mine did too when starting solids with my babies! So, let’s clear the air, and let me help you ease your thoughts a little, as educating yourself and understanding the what, why, and how of each of each gagging and choking is key to making mealtime as stress free as possible!

What is Gagging?

So first, let’s define gagging. Gagging is a protective mechanism that we are all born with to help prevent food from entering the back of the throat where your airway is, or in other words the ‘danger zone’. Although gagging may seem scary or uncomfortable for your child, it’s a normal and natural response when babies are transitioning to solid foods. Gagging allows babies to move food from the back of their throat where it could actually cause choking, to the front of their mouth where they can better maneuver the food in their mouth. Think of it as a good thing! In the early stages of starting solids, your baby’s gag reflex is initially located at the front 1/3 of their tongue and then as your baby gets more and more practice with various foods, the reflex moves further towards the back of their tongue, until it sits right at the top of the throat, where most adults’ gag reflex is.

Why do babies gag?

There are a few reasons why a baby may gag, and you may be surprised with some of them! First off, gagging doesn’t necessarily mean your child doesn’t like a particular food or that your baby choking. It could be that your child is experiencing a texture or size of food they aren’t used to or perhaps it’s a very familiar food type and size, but they are just having a hard time moving it around in their mouth. Most babies who are doing baby led weaning gag quite frequently in the beginning, since the food sizes or textures are more challenging, but their reflex quickly diminishes after a couple months of practice. With puree feeding, gagging seems to happen less in the beginning (although it can still definitely happen!), and then once babies begin getting more advanced textures and bite sized pieces of food, the gag reflex emerges a lot more frequently! So really, it’s unavoidable with both methods, so getting comfortable with it is key!

Signs of gagging

We want to be able to identify when a baby is gagging very easily so you can ease your mind that your baby is ok. So with that, let’s take a look at what it looks like:

Baby gagging

Your baby may have:

– Watery eyes (tears are normal!)

– Red face (from straining to push the food out!)

– Open mouth with tongue thrust forward

– Some type of noise being made from mouth (It could be coughing, crying, belching etc. – all these are great signs that your babies airway is NOT blocked!)

*Note: Gagging my sometimes lead to vomiting. This is a normal response and is usually more traumatic for parents than babies themselves.

Click here download a gagging and choking symptom cheat sheet for free! I recommend printing one of and putting in on your fridge to remind and educate the whole family.It’s perfect for a quick reference on what to look for and what to do in each case.

What do you do when your child is gagging?

Although this is really hard to do, it’s best not to over react when your baby is gagging. This means trying avoid panicking in front of baby, as this may scare them and can cause mealtime to be more stressful for both of you. For the most part, babies are pretty unphased by gagging, so let’s keep it that way. Try to sit back and just let your baby work through it. Which brings me to my next point. Never interfere with a gagging baby! Interfering such as sticking your fingers in their mouth to get the food out or picking baby up out of the high chair as they gag will only increase the risk that the food gets pushed (or falls) back further into their mouth and can cause actual choking! When babies are gagging, they are in control and so the chances of them figuring it out on their own is much higher. Let them stay in control. The incident count take a few seconds or a couple minutes (I know.. poor things), but their bodies do a great job of protecting themselves so let’s not interfere and possibly make things worse.

Speaking of worse…

What is choking?

Choking is when food moves past the gag reflex and into the airway causing partial or full obstruction of the airway, allowing no or little oxygen to get to the lungs. Choking is much more serious than gagging and requires immediate intervention. The most commonly choked on food for children under five are grapes, hotdogs and hard candy. Believe it or not, the risk of choking is the same for babies who are puree fed vs those that are doing baby led feeding. The key in both situations is doing each safely and reducing the risk of choking is the same in each situation (read a few paragraphs down for how to do this)

Signs of Choking

Now again, we really want to be able to immediately identify the signs of choking (vs. gagging) so we can act (or not act) quickly.

Signs of choking include:

– A blank stare or panicked look

– Blue skin or lips (lack of oxygen to the lungs!)

– Silence or a sometimes a high-pitched wheezing sound if only a minute amount of air is getting through (Babies will not be able to cry or make deliberate noise!)

Because the signs of choking can’t be heard, it’s extremely important to always watch your baby when they are eating so you can catch the signs quickly.

What to do when child is choking?

If your child is choking, you will want to interfere right away and begin infant CPR. I highly recommend taking a local class on infant CPR prior to starting solids with your baby to know exactly how to respond in this situation. You can also find an infant CPR demo from a certified Canadian Red Cross specialist in my online course, Baby Led Feeding – a baby led approach to introducing solids.

How do I decrease the risk of choking?

Some things to ensure a safe and happy baby are:

  • To offer appropriate foods (whether puree feeding or baby led weaning, food that’s offered in an appropriate shape and texture is key!)
  • Making sure your baby is developmentally ready for solids
  • Have baby sitting upright during mealtime
  • Minimize distractions as much as possible (think tv., toys, etc.)
  • Always be present when your baby is eating
  • Never put finger foods in babies mouth yourself or never attempt to fish food out of their mouth
  • Take an infant CPR class

Ok – so I really hope this helps set the stage for the basics on gagging vs. choking. If you are looking for more information on what and how to offer appropriate foods, videos of babies gagging (watching videos like these really helped ease my mind) or how to know when your baby is ready, my online course Baby Led Feeding – a baby led approach to introducing solids covers all this and more!

Let me know if you have any questions and I’d be more than happy to help!

Talk to you soon,