Gagging vs choking: What are the signs?

Let’s talk about gagging and choking especially as it closely relates to starting solids. This is one of the biggest fears and anxieties parents have when it comes to starting solids with their baby. And rightfully so. So I have put together a blogpost for you of everything you need to know to help alleviate some of that anxiety and teach you about the differences between gagging and choking and what to look out for.

We all know that starting solids is such a fun and exciting time in yours and your baby’s life, but with that also comes some fear and anxiety surrounding feeding your baby. Parents often worry about their baby choking or gagging on their food and this can be very nerve-wracking for them. 

Let’s talk about gagging first.

Gagging

Babies have what is known as the gag reflex. Let’s talk about what that is…but first, I want to say a few things about gaging to ease your mind about it since parents often panic when they see their baby gagging.

Gagging when starting solids:

Gagging is normal, so no need to panic if your baby gags on their food and spits it out. We’ll get into that more this week. Babies have an amazing built in mechanism called the gag reflex that prevents them from swallowing large items and choking.  

• Gagging is Involuntary 

• Gagging is normal 

• Gagging is a protective mechanism to prevent choking 

• The intensity of gagging is different for every baby.

Signs your baby is Gagging:

• Airway is clear

• Makes noises like crying

• Coughing or gagging

• Baby make faces and sticks out his tongue

• Face may turn red from coughing

• Eyes may water

• Gagging may lead to vomiting

If your baby is gagging, they will be making all sorts of sounds, they will be sticking their tongue out, coughing a bit, their eyes may water a bit, they are moving around a lot unlike babies who are choking, but the most important part is that their airway is clear, they are still breathing.

From birth to around 6-9 months, the gag reflex is triggered toward the front of the mouth. At this age, the reflex is still very sensitive, triggered easily and serves as an important safety mechanism that prevents objects (food or anything else) from being swallowed. Anything other than a thin liquid can quickly trigger the gag reflex if your infant isn’t used to it.

Sometime around 6-12 months old, the gag reflex slowly desensitizes and at this point, your baby can tolerate more textures and foods which can now get much closer to the throat before the body recognizes something is too big to swallow and tries to push it back out.

Some babies even gag on purees especially since they are only used to a liquid diet. baby’s brain kicks in telling its protective mechanism to prevent swallowing the purées, which triggers the gag to push that food out.

But don’t give up! Keep offering them these foods to help desensitize the gag reflex and help your baby build up a tolerance for more thickness, texture and finger foods.

Keep in ming that kids who are fed textureless foods for long periods of rime can have a stronger gag reflex till much later.

When to worry about gagging:

Lastly for now, if you’re worried about your baby’s gagging and continues on well after you’ve introduced solids or If they are unable to tolerate any foods or textures after weeks of of trying, please bring it up to your pediatrician to rule out anything else that may be going on.

Choking

Signs that your baby is choking:

• Airway is blocked

• High-pitched sounds

• Panicked or blank stare/ looks distressed

• Difficulty breathing

• Inability to cry

• Skin pulls into the chest

• Lips & skin can turn blue

If your baby is choking, then their airway is blocked and they have difficulty breathing, they will not be coughing or retching, they will be making high pithed sounds, sounding like wheezing, they will look panic stricken, their lips and skin may turn blue or purplish in color and they are much more still than they are when they are gagging on something. 

Make sure you are up to date with infant CPR and call 911 right away if your infant is choking. Safe beginnings offers a great infant CPR class that you can take so you are always prepared in case of your infant choking.

Keep in mind that choking is a silent event and can easily go unnoticed, so make sure never to leave your baby unattended when while they are eating.

Is your baby ready for finger foods but you are worried about her potentially choking?

To prevent choking, make sure your baby’s food is: 

1. Soft-textured

2. Easy to swallow

3. Easy for them to move around in their mouth and move off the spoon

4. Cut into small pieces

5. Big enough to pick up but not too big to obstruct their airway

Some examples of baby food with soft soft textures and small enough to eat are cut up banana, little pieces of scrambled eggs, soft pasta; well-cooked, finely chopped chicken and vegetables, snacks that melt in your baby’s mouth, like baby wafers, bamba, etc…



Some babies can handle these foods sooner than other babies and it’s normal for there to be a range. 
By 8 months to 10 months, many babies can already handle a larger variety of finger foods including small portions of finely chopped soft fruits, vegetables, pasta, cheese, well-cooked meat, baby crackers and dry cereal.

Make sure your baby is sitting upright when feeding. Not lying down in a bouncer or hunched over their high chair. Hunching over makes it hard to properly swallow.

To read the full blogpost about starting solids, read here.

I hope you found this helpful!

If you have questions and concerns about your child’s sleep, feel free to send me a message or book a free discovery call so that I can answer all of your questions.