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Fear of baby choking on food


What Parents Should Know — Malina Malkani

Baby-Led WeaningPediatric NutritionStarting Solids

Written By Malina Malkani

Most parents, grandparents and caregivers I talk to tell me that their greatest source of stress around food and feeding babies and kids is fear of choking. In fact, I’m often told that fear of choking is the biggest barrier preventing people from starting their babies on solids with baby-led weaning.

I get it. Like so many other aspects of parenting, offering foods to your infant can feel really scary at first.⁠ No one can guarantee that your baby won't ever choke on a piece of food - but instead of focusing on the risk, it's more positive and life-affirming to educate yourself on the available research that helps us all keep our babies safe, while continuing to confidently and safely offer a wide variety of foods.

Instead of avoiding finger foods out of fear, learn what you CAN do to feed your baby safely, offer opportunities for him/her to grow and learn to eat, and make sure all your baby's caregivers are well informed and certified in infant first aid and CPR. ⁠

The truth is, baby-led weaning (BLW) does not increase choking risk when caregivers know how to offer foods that are of the appropriate size (adult pinkie finger size if baby uses a palmar grasp and chickpea size once baby starts using a pincer grasp) and texture (soft and easily squished between your thumb and forefinger). However, many parents confuse gagging (a normal, built-in safety mechanism and an important part of learning to eat!⁠) and choking, which are very different.

For an infant, learning how to eat involves figuring out how to chew, swallow, and breathe all at the same time, which is an entirely new experience. Gagging often happens very frequently in a 6- or 7-month-old baby depending on the size and texture of the food offered. This noisy, built-in safety mechanism (while sometimes disturbing to watch) is protecting baby’s airway and simply part of the process of bringing up food that baby is not quite yet ready to swallow.

Example of an 8 month old (6.5 corrected) baby gagging on watermelon. Thank you to her wonderful parents for allowing permission to share.

Here are some helpful things to know about gagging: 

  • Early in infancy, the gag reflex is strong.

  • As baby grows, the gag reflex shifts further back into the mouth until (usually by around 9 months of age), it becomes similar to that of an adult. 

  • For most babies, frequent gagging subsides as they grow. 

  • Some babies and kids have a more sensitive gag reflex than others.

  • Some babies bite off larger bites than they can handle at first and gag more frequently as they learn to manage the food in their mouths. 

  • If gagging doesn’t seem to be causing baby distress, it’s usually not a cause for concern.

  • If certain textures seem to be causing more gagging than others, it can make a huge difference to simply wait a week and then try offering the food again, as babies may develop new feeding skills even within the span of 1 week during infancy.

  • Don’t stop offering the texture or food altogether unless advised by a medical professional, as babies need to practice!

  • If you have a baby who takes huge bites, you can encourage smaller bites by offering only 1-2 pieces of food at a time, eating with baby, and role modeling smaller bites.

  • As a parent or caregiver, the best way to help a baby who is gagging is to stay calm and positive, and encourage baby to chew and swallow. Sometimes it helps to also offer a little water.

  • If you have any concerns about gagging or feel that it’s excessive and/or causing baby distress, bring it up with your pediatrician. Pediatric occupational therapists, feeding therapists and speech-language pathologists can work wonders with babies who may be gagging excessively as a result of sensory issues or oral motor developmental delays.  

Choking, on the other hand, is a silent, serious event that happens when a bigger piece of food becomes stuck in the airway, blocking the air flow. A baby who is choking may become upset, turn blue, and/or grab at the throat. Intervention is usually needed to remove the blockage from the baby’s airway.⠀

Comforting research about baby-led weaning and choking:

However, while BLW may not increase choking risk in infants, choking is indeed a risk for all babies (whether fed using BLW or conventionally via purees and spoon-feeding) and children under the age of four.

The best defense against choking in babies and kids is:

  • Knowing which foods are choking hazards

  • Avoiding choking hazards

  • Knowing how to prepare foods for babies and kids in a way that is safe and of an appropriate size and texture

  • Educating yourself on what to do in the event of a choking episode

  • Whole nuts

  • Whole grapes

  • Whole cherry tomatoes

  • Whole or sliced raw carrots

  • Whole seeds or seed kernels

  • Whole or large sections of hot dogs, sausages, and meat sticks

  • Hard or sticky candies (including jelly beans or gummy bears)

  • Chunks of peanut butter or other nut/seed butter (it's fine to thinly spread peanut butter on a cracker or bread)

  • Chunks of cheese

  • Chunks of raw vegetables

  • Popcorn

  • Fruit chunks (especially apples)

  • Raw leafy greens

  • Citrus fruit membranes

  • Whole corn kernels (even if cooked)

  • Red Cross adds foods that break into small pieces quite easily, such as teething biscuits and cookies

Foods with common characteristics that make them higher risk for choking:

  • Any cylindrical/round/oval-shaped foods such as grapes, hot dog pieces, whole nuts and seeds (these foods should be quartered before serving)

  • Airway-sized foods (1. 25 to 1.75 inches in diameter)

  • Spongy, or compressible foods that pop back into shape after being squeezed, such as hot dog pieces, marshmallows, gummy bears, and cheese chunks

  • Thick, viscous foods like spoonfuls of nut butter that can conform to the size of the airway and effectively seal it (thinly spread on toast is fine)

Important choking prevention safety tips include:

  • Cutting food for babies and kids under 4 into pieces no bigger than ½ an inch 

  • Encouraging chewing

  • Always supervising at meals and snacks

  • Insisting that babies and kids sit down while eating (never allow running, walking, playing or lying down with food) 

  • Making sure that all parents and caregivers are well-informed, trained in infant first aid and CPR, educated on how to prevent choking episodes, and familiar with the steps to take in the event of one. 

Helpful resources for choking prevention:

  • Get trained by a nationally certified Red Cross and Lifesaving Society First Aid Instructor using this EXCELLENT, 2-hour, self-paced online course from Safe Beginnings that teaches you everything you need to know to prevent and manage infant and child choking, CPR and first aid-related emergencies. Use my code for 20% off: MALINA. (I may receive a commission for qualified purchases). This course is perfect for parents, grandparents, babysitters, nannies and anyone else who will be caring for babies and kids.

  • Red Cross’s printable PDF on Steps to Help in a Child and/or Infant Choking Emergency 

For even more specific safety tips on safe food textures and food sizing during BLW, check out my book, Simple and Safe Baby-Led Weaning, and to hear about one mom’s experiences in helping her babies and toddlers overcome excessive gagging, check out this post. With knowledge comes confidence!

And if you’re getting ready to start your baby on solids, or if your baby has recently begun his or her feeding journey and you need guidance on food sizing, balanced baby meals, introducing the top allergenic foods, and making sure baby is getting the important nutrients needed for growth and development during infancy, check out my new online course for parents, based on my best-selling book which will walk you through the whole process of starting solids using a baby-led approach.

Thank you to my dietetic intern, Annie Hanes for her research and contributions to this post!

GaggingChoking

Malina Malkani

Overcoming The Fear Of Gagging & Choking In Baby-Led-Weaning


Getting started with baby led weaning can feel super daunting, and the #1 fear is that your sweet baby will gag or choke on food. To help you overcome this fear I’ve invited Edwena Kennedy of My Little Eater to share a FREE resource to help you overcome these fears.

Edwena is a registered pediatric dietitian and mom of two boys from Halifax, Nova Scotia who LOVES to help parents raise healthy little eaters with confidence! She created My Little Eater and her online courses as a simple, straightforward way for parents to get the information, guidance and support they need to take their child along the entire feeding journey without the overwhelm or confusion. She’s helped thousands of family find the confidence they were looking for and help turn them into their own feeding experts!

GET THE FREE GUIDE: Overcoming The Fear Of Gagging & Choking 

What is Baby Led Weaning?

Your baby is leading the way in the whole feeding process. The baby is self-feeding. Parents are not using spoons to coax them to eat or trying to get bites into baby’s mouth. Babies are also eating whole, finger shaped foods. This concept begins around 6 months of age. The process begins with soft and mushy foods. This approach is so different to how many of us were raised as starting solids!

Why does BLW scare people?

This is a new concept that is a little more intentional than popping open the jar of a baby food. This concept sounds scary to parents because it seems like babies can easily gag or choke on solids. This fear factor is the number one emotion Edwena hears from parents. Parents can be extra terrified to start finger foods if baby hasn’t started teething. How can they chew or bite if they don’t have teeth?!

Before pre-made baby food was developed, babies were simply were already mashed whole foods, or parents would softly chew a piece of food and hand it to their baby.

Purees in the 1920s started the industrial led feeding concept. Doctors thought babies as young as 3-4 months needed solids for nutrition, which we now know isn’t the case! We have become so accustomed to the concept of purees for babies since then!

Babies Don’t Have To Start With Purees

“But my baby doesn’t have teeth!”  >> But let me ask YOU….do YOU chew with all of your teeth? Nope! We’re chewing with our molars to grind and chew our food. These molars aren’t emerging until 2 years old!!! So we aren’t going to wait until 2 years of age to start solids.

Baby teeth sit right under the gum-line, and if you feel inside your baby’s mouth you will find how hard their gums actually are! There is a lot of power in their gums!

If you’re starting with safe textures, your baby will not have any issue with starting solids through the Baby Led Weaning way.

Gagging Will Happen On Purees & BLW

Gagging is your baby’s body’s way of protecting themselves from choking. It will happen on purees or on whole, solid foods. If you’re doing feeding safely, the risk of choking is the same from purees and baby led weaning.

Know the difference and educate yourself on gagging & choking through Edwena’s guide here!

What Are “Safe” Textures?

You want to offer something that is squish-able! Take your thumb and your index finger and apply pressure to the food. Can you smush it? It’s the right texture for baby. If you can also offer baby significant chunks of the food so they can safely hold it, while you supervise them start to notice how they are getting food in and learn to take bites.

If you wait too long to offer your baby whole foods the risk of gagging and choking actually increases because they aren’t used to this!

What About Milk?

Formula and breastmilk is so important! Between 6-10 months your baby has been so used to new textures and foods that by the time they hit 10-12 months they are used to eating normal foods. Which means that when baby turns one your baby is not struggling with only using milk as the main source of nutrition.

The practice your baby gets from 6-10 months will set them up for success for the 3 meals a day by 12 months old.

Conclusion

The biggest barrier to starting baby led weaning is the fear of gagging and choking. Knowing we want to advance your baby, Edwena’s free guide will help you overcome the fear that your baby will choke on new foods. Inside this new guide for your family you will learn:

Step 1: Understand Gagging (it’s very different from choking!) As A Safety Mechanism

Step 2: Know What Gagging Looks Like

Step 3: How To Desensitize The Gag Reflex

Step 4: Understand How To Respond To Choking

DOWNLOAD THE FREE GUIDE HERE!

 

90,000 I'm afraid that the child will choke ... who had it like that ??

I'm afraid that the child ...

21 answers Remove

#1

#2

66

#3

#4

#5

As for the purees that are too thick, try diluting them to the desired consistency.

#6

in theory, the child will spit out everything perfectly that he does not like the taste or texture.

first introduce more liquid, and not potatoes, but zucchini, for example.

and about incorrect swallowing up to 4 years, well, this is some kind of nonsense. From the age of 2, the child eats at the common table.

if a child has a good appetite, then he will quickly learn to chew normally, and by the age of one and a half he will sell his homeland for a piece of sausage:) and if he has a bad appetite, then he will spit everything out very high quality. so you have no reason to worry. Are you serious?!!!!!!!!!! !!!!!!!!!!!!!!!

who taught you THIS?

#9,0003

#10

#11 9000

#12

#13

8, why do you think that you can't do this?

#14

#15

she was so frightened that now she is afraid to eat,

tell me how to calm her down, and God forbid, if she suppresses what to do? 10 July 2011 !!!!!!!!!!!!!!!!!!!! Who taught you THIS?

#17

#180003

#19

#20,0003

Valya

Girls, I read your stories, I have 1 and 9 months, I was choked once, but that was enough for me, now I give everything in pieces (cookies bread fruits) I don’t give food to my hands. Tell me how it went for you and when the food improved.

#21

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90,000 I am afraid to choke

I am afraid to swallow food, . ..

28 replies

Last - Removing

#1

#2

Totario77

began to help,

#3

#4

You need qualified help.

#5

#6

#7

#8

#9

Yozha

And you don't eat! At all! You will starve for a couple of days, then the survival instinct will be stronger and you will want to eat something! Eat a little, you will see that nothing has happened to you, you are alive, and there the fear will pass!

#10

#11

#12

on a grunt lunch For example * . *

#13

Well, this has never been a problem for me. Yes, on holidays and general feasts I often had to be content with bread and compote (since nothing else suited me), but I always had many friends and they were surprised only when they met, and then they got used to it and did not pay attention. People gather for the holidays, not for the sake of zhr@chki, but for communication!!!

Moreover, when I became a vegetarian (like many of my relatives and friends), the hardening I received as a child helped me overcome the difficulties of public opinion without any problems - in fact, nothing has changed for me in this regard. It's even easier to explain to people - it's easier for them to accept vegetarianism as a kind of system than the fact that I JUST do not eat certain foods just because I DON'T WANT to eat them.

So you don't have to worry about public opinion - it's enough to say that, for example, a gastroenterologist prescribed you to eat like this, and then your friends won't even think to be offended.

#14

#15

13

and still, Author, try to add freshly squeezed juices - they and liquid and liquid and liquid and liquid and liquid and liquid and liquid and liquid and liquid and liquid and liquid and liquid and liquid and liquid nutritious. In addition, there is an opinion that you can at least eat only them all your life and this will only benefit your health. Read, for example, about liquidatorism (well, or something like that - liquid nutrition, in short - type in a search engine). Maybe it’s just that your body is ready for the transition to something like this and you don’t have anything to worry about at all?

#16

Understand, your problem is in your head! In fact, it's all an invented fear! The main thing to remember is that there are people like you too, you are not the only one!

try drinking some alcohol before your next meal, it will relax you. I'm serious, you will most likely feel better! less focus on it.

and don't expect anyone to help you yet. Really, only you! and remember that you are NORMAL! just a fright, then a twist in the head, then they focused their attention and off they went.

don't worry, you'll get over it!

next time before you eat, think "come what may, I'd rather choke again than live like this" I really, it should help you!

#17

#18

2012, 18:30

#20

#21

slavik

my name is Slavik I live in the city of Borisoglebsk and I am 15 years old. bread or meat, nothing but broth and juice, there is nothing I can’t do, help someone who can, can advise what or better to contact a doctor

RACHKA

tanya leave me your phone number and we will solve this problem together, everything is the same for me the same as yours. WAIT

#22

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#24

Paradise

Tanya, leave me your phone number and we will solve this problem, I'm the same way as you are.

#25

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#27

Guest

Tanya, have you tried to eat in the company. If you choke, then those around you will definitely help. There is nothing to be afraid of :)

#28

lala

everything is written so chaotically. I didn't understand anything. I just realized that you have mental problems with swallowing food. go to a psychotherapist

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