Baby gags while bottle feeding

Help! My Baby Is Choking on Milk!

Many parents look forward to feeding time with their baby. It’s a chance to bond and also gives you a few minutes of peace and quiet.

But for some, bottle feeding or breastfeeding can lead to gagging or choking sounds, which are alarming if you’re a new parent. Fortunately, there are things you can do to help prevent your baby from choking on milk or formula.

If your baby seems to gag a lot while eating, don’t panic. “Choking and gagging during feeding is common in young infants,” says Robert Hamilton, MD, FAAP, a pediatrician at Providence Saint John’s Health Center in Santa Monica.

Hamilton says babies are born with an exaggerated but protective “hyper-gag reflex,” which can cause gagging while feeding. Plus, babies gag easily due to their own neurologic immaturity.

“Babies are growing and learning new ways to use their body (and mouths) every day,” says Amanda Gorman, CPNP and founder of Nest Collaborative, a collection of International Board Certified Lactation Consultants.

“Often, just stopping the feed and positioning the baby upright with good head and neck support will give them a few seconds to manage the problem.”

Gina Posner, MD, a pediatrician at MemorialCare Orange Coast Medical Center, says if your baby begins to choke, let them stop feeding for a little bit and pat their back. “Typically, if they’re choking on liquids, it will resolve quickly,” she says.

The most common reason a baby chokes during breastfeeding is that milk is coming out faster than your baby can swallow. Usually, this happens when mom has an oversupply of milk.

According to the La Leche League International (LLLI), common signs of oversupply include restlessness at the breast, coughing, choking, or gulping milk, especially at let down, and biting on the nipple to stop the flow of milk, among others.

You might also have an overactive let down, which causes a forceful flow of milk into your baby’s mouth. When your breasts are stimulated by your baby suckling, oxytocin causes the let-down reflex that releases the milk.

If you have an overactive or forceful let down, this release happens too fast for your baby to respond appropriately, causing them to gulp or choke while breastfeeding.

How do I prevent my baby from choking on milk when breastfeeding?

One of the first things you can do to help prevent your baby from choking while eating is to change the feeding position.

“For breastfeeding mothers who appear to have overactive let down, we typically recommend they nurse in a laid-back position, which reverses gravity’s effect and allows baby to have more control,” says Gorman.

Posner recommends pulling your baby off the breast every once in a while to help them catch their breath and slow down. You can also take your baby off the breast for 20 to 30 seconds when your milk first lets down.

In addition to a laid-back position, the LLL recommends lying on your side so your baby can allow milk to dribble out of his mouth when it flows too quickly.

Furthermore, expressing milk for 1 to 2 minutes before bringing your baby to your breast can help. Doing so allows the forceful let down to happen before baby latches. That said, be careful with this technique, as pumping for too long will tell your body to make more milk and worsen the problem.

When your baby gags when drinking from a bottle, it’s often due to the positioning. Lying your baby on their back while bottle feeding will lead to a faster milk flow, making it harder for your baby to control the rate of feeding.

“Tilting the bottom of the bottle higher than the nipple increases the rate of milk flow, as will a nipple with too large of a hole for the infant’s age,” Gorman advises. Tilting the bottle too high can lead to involuntary increases in intake and contribute to problems like reflux.

Instead, when bottle-feeding an infant, try using a technique called paced bottle-feeding. “By keeping the bottle parallel to the ground, the baby remains in control of the milk flow, as they are at the breast,” Gorman says.

This technique allows your baby to actively pull milk out of the bottle using their sucking skills and lets them easily take a break when needed. Otherwise, gravity is in control.

For babies who are bottle-fed by multiple caregivers, Gorman says all of the people who administer feeds should be educated on paced bottle-feeding.

Finally, you should never prop the bottle up to feed your baby and walk away. Since they can’t control the flow of the milk, it will keep coming even if your baby is not ready to swallow.

“The mechanism of swallowing is complicated and requires several muscle groups working together in concert and in the right time sequence,” Hamilton says. Fortunately, gagging usually diminishes as children get older and become better at swallowing.

Still, if you’re a new parent or caregiver, it’s smart to take infant cardiopulmonary resuscitation (CPR). While rare, a choking episode that caused your baby to turn blue or lose consciousness would be an emergency.

If you’re having problems related to breastfeeding, contact a LLL leader or International Board Certified Lactation Consultant (IBCLC). They can help you with your baby’s latch, positioning, oversupply issues, and forceful let-down problems.

If you’re having problems related to bottle feeding, contact your child’s pediatrician. They can help you with bottle and nipple selection, as well as feeding positions that prevent choking on milk or formula.

If your baby continues to choke even after slowing down the rate of feeding, you should contact your pediatrician to rule out any anatomical reasons why swallowing may be challenging.

When you hear your baby gagging or choking during feeding, don’t panic. Take baby off the nipple and prop them up to help them clear their airway.

Often it will take a little time for your baby to learn suckle with ease. In the meantime, try keeping your baby upright during feedings and make the flow of milk slower, if possible. Soon enough, feeding time will be a sweet snuggle session!

What You Need to Know About Baby Gagging (+ Expert Tips)

Your baby gagging can be terrifying. Learn about the gag reflex in babies and what to do when babies have a sensitive reflex and gag on food or their bottle.

It’s a terrifying moment as a parent.

You know the one, because we’ve all been there, if only fleetingly.

It often happens as your baby is learning to eat.

They’ve taken a piece of food into their mouth, and we sit watching with big (sometimes fake) smiles on our face as if to offer encouragement. We watch closely, wondering if our little babe can pull off swallowing safely, and suddenly there’s a split second of silence. Their eyes pop out of their heads, they lunge forward, and they gag.

In that same split second, your heart is thumping so hard in your chest it feels like it’s going to bust through. You also leap forward, unsure of what you should even be doing. Your baby gags again and again. Something must be done, so you try to get that overcooked little piece of carrot out of their mouth. You succeed, collapsing into the chair, and pull the food away from your baby because, well, you need a second.

As you sit there, arms still twitching, as the adrenaline slowly dissipates, you wonder, “Is that normal?”

Or, as is the case for some babies, the baby gagging has become all too frequent, and you just don’t know how to stop it from happening.

That is just one of many instances that can play out in our homes with baby gagging. And, to be perfectly honest, sometimes it’s completely normal for a baby to gag as they’re learning to eat or on the nipple of their bottle.

And, sometimes it’s not.

To ease your fragile parent heart (I’ve got one too), we’re going to cover what the baby gag reflex is, when you need to worry about baby gagging, how to decrease baby gagging, and more! You’ll also find more tips in My Baby Won’t Eat Solids and How to Transition to Table Foods.

The Baby Gag Reflex

Believe it or not, babies are designed to gag on objects entering their mouth from the moment they come out of the womb. It’s a real reflex that’s there to protect them from actually choking on something, because as new infants, they have no skills to get an unexpected item out of their mouth.

This baby gag reflex is a very good thing.

When babies are first born, and for the first few months of life, this gag reflex is very sensitive and is triggered very easily. Meaning, something doesn’t have to get very far into a baby’s mouth to prompt the gag reflex and cause them to gag. (Find a total guide on Feeding Milestones.)

As they grow, get bigger, and start to put random objects into their mouth, their gag reflex moves further back in their mouth. The baby gag reflex becomes less sensitive, harder to elicit.

This is also a very good thing because it’s around the time babies learn to start eating real food. It would be very hard to eat if that gag reflex was still sensitive, which of course is the case some of the time…

A Sensitive Gag Reflex in Babies

Some babies seem to have a hyper-sensitive gag reflex, and this may be apparent very early on as bottles are introduced. You may be reading this right now because your baby consistently gags on a bottle.

This is even more likely for babies that are exclusively breastfed because they aren’t used to the feeling and texture of a bottle. The nipple may be bigger or go into their mouth further and trigger the baby gag reflex. Read tips here for getting a baby to take a bottle.

Other babies do just fine with bottles and nursing, but as in the example I started with, they frequently gag when trying to eat foods. Sometimes making it impossible for them to eat. This often occurs because the gag reflex is still too far forward in their mouth.

When Does Baby Gagging Occur

As I mentioned earlier, it is normal for all babies to gag sometimes. That gag reflex is present, and even if it isn’t that sensitive, you’re likely to see it happen on occasion. Let’s take a closer look at the times that will most likely be:

Baby Gags on Bottle

Some, not all, babies will gag when a bottle is put into their mouth because it goes a little too far back or the texture of the nipple feels a little different to them. Although it can be disconcerting, it’s typical behavior from an infant if it doesn’t happen all that often.

Baby Gags When Mouthing Toys

It’s even more common to see your baby gag when they are beginning to put teethers, various toys, and the keys they dug out of your purse into their mouth. They are literally desensitizing and moving that baby gag reflex further back into their mouth. Your baby is priming the pump for food usually weeks or months before they ever take a bite of food. (Read more about how to start feeding baby.)

Babies that chew on a lot of toys typically don’t have a sensitive gag reflex.

Baby Gagging on Food

Nearly all babies gag on food at some point. Eating is a highly coordinated event that we take for granted because it’s old hat.

Most babies will gag on foods because they are either too thick, as in the case with pureed baby food, and they have difficulty moving it back to swallow properly. Or, if they’re eating table foods, they may lose track of the food and it hits their gag reflex before they can get it in place to swallow correctly.

Again, this is a good thing, because if a piece of food haphazardly hits the back of the tongue and slides down their throat, there is a much higher likelihood that they could choke or aspirate on it (that’s when food goes into the lungs instead of the stomach, not a good thing). The gag helps project the food they lost track of out of their mouth, keeping them safe.

When baby gagging is excessive, there is likely one of two causes:

1.A baby’s ability to move their tongue and jaws around together to eat efficiently are called their oral motor skills. When their oral motor skills aren’t coordinated or the muscles like their tongue are weak, it’s very difficult to chew and swallow. If your baby gags AFTER trying to eat food, this is likely the cause. (Read more in oral motor exercises)

2. If a baby gags instantly after food touches their tongue, or perhaps just from looking at food, it’s a very good indicator that they are sensitive to the texture of the food. This is related to their sensory system and how their brain is understanding what the texture will feel like. (Read more in sensory issues with food)

Lastly, there is one factor that DOES NOT affect baby gagging on food, and that’s if your baby has teeth or not. It’s a popular misconception that babies need teeth to eat. They do not.

The first and only teeth that most babies typically have for months are their front teeth, which are not used for chewing. The front teeth are used to bite off pieces of larger foods, and most babies are eating small pieces of food.

But, even if your baby is taking bites off of food, their gums are strong enough to do the job.

Some babies won’t get any teeth until after their first birthday, waiting until then could lead to a whole host of feeding problems. The moral of this story is not to worry about your baby eating or gagging on food if they don’t have teeth yet.

If you’re concerned about when to give what foods, that’s a valid question and there are some guidelines to follow, which help decrease gagging. Check out When can babies eat cheerios to find the top foods that parents have questions about!

Grab a seat to learn about other feeding mistakes that parents are often told in my free online workshop. You’ll learn what to avoid so that your baby gets over gagging and on to eating table foods. I’ll send the link right to your inbox:

Click here to get a seat in 5 Big Feeding Mistakes that are Stopping Your Baby/Toddler from Learning to Eat

How to Respond to a Baby Gagging

It’s very easy to respond to your baby gagging with hysterics or even concern, because it’s scary. But, our response, even just once, can really leave an impression on a baby. At these early ages, our babies watch our reactions constantly and may learn from them. They can pick up on how we’re feeling and the last thing we want them to do is link the danger feeling they’re sensing as related to eating.

It can become ingrained in them quite quickly that eating is a bad thing, even though they aren’t able to articulate that.

When your baby does gag, appear calm and reassuring. Even act like its not a big deal. If you have to fake it, goodness knows I have many times, even slapping a smile on my face as I say, “You’re okay, would you like a drink?”

If your baby continues to gag on food in their mouth, then gently lean them forward. This will either help the food fall out of their mouth or bring the food to the front of their mouth, so they can swallow it safely.

If they still continue to gag, make a hook with your pinky finger and put in to one side of their mouth and sweep it to the other side, sweeping any food out. You may have to do this a few times.

I realize that I’ve probably just petrified you! If you’re feeling very nervous about your baby choking, it would be helpful to take an infant CPR class. You can also read more here.

Affiliate links used below. See our full disclosure.

How to Decrease Baby Gagging

Yes, there are actually some steps you can take to help decrease baby gagging!

For Baby Gagging on a Bottle:

You’ll want to try small nipples and experiment with different flows. Some babies may gag because the milk is taking too long to come out and others because it’s way too fast for them to manage.

Also, make sure baby is in a semi upright position and that their head isn’t tipped too far back. Put the nipple to their lips first and let them feel it for a second. Then, slowly put it into their mouth.

If the gagging still continues, use a pacifier or your pinky finger to rub on their gums and the sides of their tongue three to four times a day to help desensitize the sensitive gag reflex.

For Babies Gagging on Food:

Make sure they have tons of opportunities to chew on teethers, safe toys, and even large pieces of whole foods they can’t get pieces off of. Think about a whole raw carrot or stalk of celery (if they can get pieces of it off, most can’t, then don’t use it). If they don’t seem interested, demonstrate and show them. This two pronged teether is one of my favorites because it reaches just far enough into their mouth and really works at desensitizing.

I also love vibrating teethers, because they vibrate and give lots of sensory input when they bite down. I used this one with all my kids.

You can also brush your child’s teeth, or rather their gums, and the sides of their tongue. Allow them to hold and bite on the toothbrush. This is a perfect little toothbrush for babies. The teeth/gum brushing also works to desensitize the gag reflex, improve oral motor skills, and improve sensory processing!

Read more here on how to teach your baby to eat finger foods. These steps will also be helpful to decrease gagging.

When Do You Need to Worry About Baby Gagging

First of all, it’s very important to know that baby gagging is different than a baby choking. Choking means something is already in their throat and they can’t get it out. Gagging is something in their mouth, or even nothing in their mouth, if they are just put off by a texture of food.

Many of us gag when we smell something absolutely putrid, some babies and children do that with foods they aren’t familiar with or don’t prefer.

If your baby is gagging so much, it’s difficult to feed them and your legitimately concerned about their growth because they aren’t eating or drinking enough, I’d recommend getting a feeding evaluation. If you live in the states, you can get that free through early intervention, or you can seek out feeding therapy from other sources.

And, if you want to make the most out of mealtimes in your home as your baby grows, download the 9 Steps to Improve Eating, I’ll send it right to your inbox! These are my top tips for raising a child that has a healthy relationship for food. Get this free printable here!

Before I end, I wanted to give a big shout out to the folks at Feedspot for naming Your Kid’s Table one of the best kids food blogs on the web! You can check out the whole list here.

More on Baby Gagging

How to Transition to Table Foods

What to Do When Baby Won’t Eat Solids: 7 Simple Steps

Mega List of Table Foods for Your Baby or Toddler

Feeding Red Flags for Babies and Toddlers

Did you pin this?

Use the button below or scroll to any picture in this post, tap it, and you’ll see the pin it button appear! You can stick in your favorite board for safe keeping!

Alisha Grogan is a licensed occupational therapist and founder of Your Kid’s Table. She has over 14 years experience with expertise in sensory processing and feeding development in babies, toddlers, and children. Alisha also has 3 boys of her own at home. Learn more about her here.

The child chokes when feeding: what to do?

Nikulina Anastasia Anatolyevna

pediatrician

A newborn chokes when feeding for various reasons. Some of them the mother can eliminate, while others depend on the health of the baby. The pediatrician Anastasia Anatolyevna Nikulina will explain the causes and solutions to this problem.

— Anastasia Anatolyevna, at what age do children most often choke while feeding?

— In the first weeks of life, when the swallowing reflex is still very weak, it is difficult to dose milk supply from the breast. From the bottle, the flow of formula is controlled by the opening in the nipple and the tilt. If the hole in the nipple is not age appropriate, it is tight, then the newborn swallows air. Excess air with the mixture will enter the intestines, causing discomfort to the baby.

Why does the baby choke while breastfeeding or bottle feeding

Baby position or bottle angle not optimal. in the optimal position. In the right position, the hand of the woman who holds the child lies on the support. Hold the baby by the back and shoulders, directing the head to the chest. You can’t press hard on the head - the baby will recline it back reflexively.
Anatomical features of the mother's breast, in which a woman produces enough breast milk, but it is difficult for a child to suck it out, to eat. Before feeding, the mother needs to express some of the milk or massage the breast: it will become soft, and it will be easier for the baby to suck.
Large nipples are difficult for a baby to grab - to solve the problem, there are special nipple covers through which newborns are fed. You can feed your baby with expressed milk through a bottle and a nipple that is correctly selected for age.
Hyperlactation. Pressurized breast milk squirts into the baby's mouth. Before feeding, some of the foremilk is expressed, and the following, more fatty, does not form a strong flow. Breaks in the sucking process also help.
Frequent breastfeeding. The absence of long breaks between attachments to the breast prevents children from hunger and, with it, the rush to feed.
Incorrect bottle delivery method. The neck of the bottle must be completely filled with milk: this way there will be no air in the milk. The nipple is selected taking into account the age of the baby.
Disease. Nasal obstruction or cough interferes with feeding. Relief of the symptoms of the disease will improve nutrition. For some children, problems can be caused by improper swallowing or reflux.
To understand why the baby is having difficulty swallowing, you need to gradually eliminate each of the possible causes. Even the environment matters. During feeding hours, it is desirable for a woman to be alone with the child, nothing should distract him from the process. If the mother finds it difficult to identify the cause, a pediatrician will help her.

— What should I do if my child chokes on milk or formula?

- Spontaneous cough is the main symptom that appears when the act of sucking and swallowing is disturbed. The baby is crying and refuses to eat.

First aid for choking children

If you can’t cough up excess milk on your own or the baby chokes on saliva and starts to choke, you need to do the following, dosing the force of your actions:

Place the baby on one hand with the belly down, with your free hand apply pressure on the area above the navel (on the area of the baby's stomach), supporting the chin.
Tilt the child slightly forward, lightly pat on the back. This will increase the cough and help restore breathing.

- Can I continue feeding after the baby clears his throat, or should I take a break?

- Feeding can be continued after the baby clears his throat. It is advisable to vilify it with a column for two to three minutes, so that excess air comes out, and then resume feeding.

- Does increasing the interval between feedings help with the problem?

- On the contrary, the prevention of flooding will be frequent feeding. With numerous attachments, less milk accumulates in the woman’s breast, it becomes easier for the mother to feed.

If the child is choking, feeding should be interrupted. The baby will cough, rest and continue to suck. If the situation recurs frequently, be sure to consult your pediatrician. Your doctor can help you find the best breastfeeding or formula-feeding method for you.

* Breast milk is the best food for babies. WHO recommends exclusive breastfeeding for the first 6 months of a child's life and continued breastfeeding after complementary foods are introduced until the age of 2 years. Before introducing new products into the baby's diet, you should consult with a specialist. The material is for informational purposes and cannot replace the advice of a healthcare professional. For feeding children from birth. The product is certified.

#Tips for Mom #regurgitation 7-12 #regurgitation 12 plus

Baby won't take the bottle | Philips Avent

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In most cases, switching a baby from breastfeeding to bottle feeding does not cause any problems. If your breastfed baby refuses a bottle, don't worry. This is a common occurrence in many babies who are used to breastfeeding. Obviously, this can create certain difficulties for moms, especially if you need to return to work in the near future.

3 Philips Avent bottle feeding products:

So why is your baby refusing to bottle and crying? There are many ways to quickly and easily teach a breastfed baby to a bottle. Here are important tips on what to do when your baby refuses a bottle.

Is the baby refusing the bottle? Take a step back

If your baby cries while bottle feeding, the first thing to do is to start over and rethink your feeding approach and technique. Try the following steps when bottle feeding your baby: ^[1]

Lift and tilt your baby's head forward. Before inserting the pacifier into the baby's mouth, make sure that the baby's head is raised and tilted over his body to avoid choking: so that the baby does not choke and have the opportunity to burp during bottle feeding.
Insert the pacifier. Bring the pacifier to the baby's lips and gently guide it into the baby's mouth. In no case do not try to press the nipple on the baby's lips and try to push it into his mouth. After touching the pacifier to the baby's lips, wait for the baby to open his mouth and take the pacifier.
Hold the bottle at an angle. Tilt the bottle at an angle so that the nipple is only half full. So the child can eat at his own pace.
Let the baby burp during and after feeding. It can be useful for a child to burp not only after feeding, but also approximately in the middle of the process. This will help reduce gas or tummy discomfort that your baby may experience from swallowing too much air.
Stop in time, do not overfeed the baby. If the baby begins to turn his head away from the bottle or closes his mouth, then he is full and you need to stop feeding.
The flow of milk from the nipple to the baby may be weak or, on the contrary, too fast, so he is naughty and refuses the bottle. Try changing the nipple to a nipple with a different flow.

Other tips if your baby refuses the bottle

If you've followed the steps above and your baby still refuses the bottle, don't worry. There are other ways to help bottle feed your baby. Here are some simple tricks you can add to your bottle feeding process. ^[2]

1. Remind your child about mom.

Sometimes a child can be fed by someone other than his mother - dad, grandmother or, for example, a nanny. If your baby fusses while bottle feeding, try wrapping the bottle in something that smells like mommy, like a piece of clothing or some fabric. This will make it easier to feed the baby when the mother is not around.

2. Try to maintain body contact while bottle feeding.

Some babies need contact with their mother, so try bottle feeding while leaning against you. However, some babies are better at bottle feeding when they are in the exact opposite position than when they are breastfed. For example, there is a position with bent legs. Lay the child on your bent knees, facing you, pointing the child's legs towards your stomach. During feeding, the baby will be able to look at you and contact you in this way. If your baby refuses a bottle, experiment to see which works best.

3. Move while feeding.

Sometimes all it takes is a little wiggle or a walk to get your baby to take the bottle. The next time your baby starts crying while bottle feeding, try moving around a little rhythmically to calm him down.

4. Try changing the milk temperature.

If the baby still does not want to take the bottle, check if the milk in the bottle is too hot or too cold. Before feeding, put some warm breast milk on the inside of your wrist to check the temperature. Milk should be warm, but if it seemed hot to you, just place the bottle for a short while under a stream of cold water.

Choosing the right bottle for your baby If you plan to combine bottle feeding with breastfeeding, it is advisable to choose bottles with a nipple that will have a wide base as the bottle will grip closer to the breast.

Also pay attention to the fact that the nipple is firm and flexible, the child must make an effort to drink from the bottle, as well as from the breast. Give preference to nipples with an anti-colic valve that vents air out of the bottle.

Natural bottle allows you to combine breast and bottle feeding. 83.3% of babies switch from a Natural bottle to breastfeeding and back.*

If you choose a bottle for artificial feeding, then traditional bottles are fine for you, but it is desirable that the nipple is made of a hypoallergenic material, such as silicone, has an anti-colic valve and did not stick together when bottle fed. In case your baby spit up often, then use special bottles with anti-colic and anti-reflux valve, which reduces the risk of spitting up and colic.

Bottle with unique AirFree valve reduces the risk of colic, gas and spitting up. With this bottle, you can feed your baby in an upright or semi-upright position to reduce spitting up. Due to the fact that the nipple is filled with milk and not air during feeding, the baby does not swallow air, which means that feeding will be more comfortable.

Both bottles are indispensable if you want to breastfeed, bottle feed or just bottle feed your baby.

"My baby refuses to breastfeed but bottle feeds - help!"

Sometimes a baby gets used to bottle feeding and refuses to breastfeed. Therefore, it is important to use bottles that are suitable for combining breastfeeding with bottle feeding. If, nevertheless, you are faced with the fact that the child refuses to take the breast, try using silicone nipple covers to make the transition from the bottle to the breast and back more imperceptible.

Remember that if you want to combine breastfeeding and bottle feeding, it is worth waiting at least a month before offering a bottle, so that you are lactating and have time to get used to each other and develop a breastfeeding regimen.

Breastfeed and bottle feed your baby with pleasure

Remember that it takes a while for your baby to get used to bottle feeding. This is completely normal. If you have to go to work, be sure to set aside enough time to bottle train your baby beforehand.

Remember that every child is different, so what works for one may not work for another. With a little time and patience, you will find out what works best for your baby when he refuses a bottle.

You will identify your child's unique needs. However, if your baby still refuses the bottle after all the steps above, check with your pediatrician.

Articles and tips from Philips Avent

References:

^{*O.L. Lukoyanova, T.E. Borovik, I.A. Belyaeva, G.V. Yatsyk; NTsZD RAMS; 1st Moscow State Medical University THEM. Sechenova, "The use of modern technological methods to maintain successful breastfeeding", RF, 02.10.2012 3} llli.org - The Baby Who Doesn't Nurse

llli.org - Introducing a Bottle to a Breastfed Baby

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