Choking Vs Gagging: what every parent needs to know when starting solid foods

Choking Vs Gagging: what every parent needs to know when starting solid foods

When you introduce your baby to solid foods it is normal for them to gag for the first few weeks and sometimes to a lesser extent, for months.  But this is nothing to worry about as all babies gag in their eating journey.  It’s one way they learn how to eat.

Why do babies gag?

Babies can gag when they start out eating solids as they are getting used to the whole new skill of keeping the food in the right spot so they can taste, chew and swallow. The gag reflex is a clever little inbuilt tool that brings food forward into their mouth so they chew it before they swallow it. 

They may also gag if they don’t like the flavour, or the texture or they may be full.

It’s also possible they are gagging as they are not quite ready to take on this new skill and need a little more time. Interestingly, up until around 6 months old they have a reflex that causes them to thrust their tongue forward whenever the back of their throat is stimulated. So waiting another week or so before introducing solids again could be the trick.  But bear in mind, no matter how long you wait they will still gag on or push out those first spoonfuls of pureed food.

First foods & choking

Gagging is different from choking.  Gagging resolves on its own as mentioned above, it brings the food forward into their mouth so they can chew and swallow.   A choking baby cannot resolve it on their own and they need help. Fast.  Choking means that the food is blocking their airways which stops them from breathing properly if at all. You can tell if a baby is choking if they’re unable to cry, talk, or cough.

The difference between gagging and choking

There are ways that you can quickly work out if  your baby is choking or gagging.  Here’s how to recognize the difference between gagging and choking:

A child who’s gagging may push their tongue forward or out of their mouth and do a retching movement to try to bring food forward. Their eyes may water. They may cough or vomit. If this happens try to remain calm, stay with them, keep your eye on your child’s symptoms and let your child continue to gag and cough as they are able to breathe and it will resolve. It is important that you do not pat them on the back or put your finger in their mouth to try to grab the food. Doing either can push the food into their airway. whatever they’re gagging on to go farther down their airway.

A child who’s choking is unable to talk, cry, or cough because their airway is blocked. They may gasp or wheeze, make weird noises, or make no sound at all as they open their mouth. They may grab at their throat or appear panicked. A choking child might turn blue because they aren’t getting oxygen. They may need first aid for choking – back blows and chest thrusts (or, for children over age 1, abdominal thrusts) – to dislodge the blockage.

If you have done a baby First Aid Course then you are to follow your learnings on how to manage choking and administer first aid.  If you have not done this training then book a class as you will not regret learning what these courses have to offer. If your baby (or anyone is unable to breathe, talk, or make noise, call Triple Zero immediately.

Tips on introducing solid foods to your baby

Make sure your baby is ready for solid food.  The recommended age is 6 months.

When you think they are ready start by putting a small amount of food on a spoon. Tip the spoon to get a bit of the food on the front of their tongue, rather than putting the whole spoonful in their mouth, which may trigger the gag reflex.

Initially they will automatically push the food out with their tongue.  But after a few tries, they’ll start using their tongue to move the food to the back of their mouth.

If you’re introducing your baby to solid food through baby-led weaning, gagging is also a normal part of the process. Your baby’s learning to feed themselves so patience is key. Let baby work out the gagging on their own, but keep an eye on them to make sure they’re not choking.

To help keep your baby from gagging on finger foods, feed them soft, easy-to-swallow food that’s cut into bite-size pieces once they develop the pincer grasp which is around 8 or 9 months old.

If you’re doing baby-led weaning, you’ll give them big pieces of soft foods to hold and munch on. These foods should pass the squish test – they should squish easily between your thumb & forefinger or between your tongue and the roof of your mouth – so they’re easy for your baby to eat.

Do not give them choking hazard foods like like whole grapes, nuts, raw vegetables, large chunks of meat or cheese, popcorn, or other cylindrical foods that can block the airway (like pieces of sausage).

If your baby gags because they don’t like the texture of solid food, try giving them different types of food – and remember that it’s normal to have to give a baby a new food many times before they’ll accept it.

If your baby turns away or cries, they’re done eating. Resist the urge to push extra food on them or make them eat more once they’re done.

Your baby will most likely gag less as they start to figure out this whole eating gig but these things take time. If baby is still gagging about a month after starting solids, mention it to their GP or MHN. They will be able to give you some advice and check for problems, or may even suggest seeing a specialist, just to be sure.

If you would like more info on feeding, gagging and choking please find below links to fact sheets from the Royal Children’s Hospital

Safety: Choking, suffocation and strangulation prevention:

https://www.rch.org.au/kidsinfo/fact_sheets/Choking_suffocation_and_strangulation_prevention/

Reflexes Involved In Feeding

https://www.rch.org.au/feedingdifficulties/difficulties/Reflexes_involved_in_feeding/

First Aid Training

https://www.rch.org.au/kidsinfo/First_aid_training/

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