Why do babies gag on food

Why babies gag themselves, and what to do if your baby's gagging on food

It's normal for babies to gag. They may gag when they're first getting used to eating, taste something they don't like, or have too much to eat. Gagging is different from choking: Gagging resolves on its own, but a choking baby needs help. You can tell a baby is choking if they're unable to cry, talk, or cough. If your newborn is gagging, try slowing the flow of milk by changing nursing positions or changing the bottle nipple. If your baby gags on food, they may not be ready for solids yet – or you may need to keep trying.

We all have a gag reflex – it's a lifelong automatic response that helps prevent choking.

Gagging is normal for babies as they learn to eat solids, whether they're spoon-fed or you're doing baby-led weaning. Gagging brings food forward into your baby's mouth to help them learn how to chew.

Until your baby's around 6 months old, they also have a reflex that causes them to thrust their tongue forward whenever the back of their throat is stimulated. This tongue-thrust reflex can make early solid feedings a bit of a challenge, so it's best to wait until the reflex is gone to try solid feeding. Still, gagging on or pushing out those first spoonfuls of pureed food isn't uncommon.

Prodding your baby to eat more than they want can cause them to gag, as can having too much food (or food they don't like) in their mouth. Some babies will even gag on their own fingers until they figure out how far they can put things in their mouths. And until they get the rhythm of sucking, some infants will gag while breastfeeding or bottle-feeding, especially if it's flowing too quickly for them.

The difference between gagging and choking

Gagging is different from choking. Choking means your child's airway is partially or completely blocked, which prevents breathing. 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 even vomit. Let your child continue to gag and cough – it means their airway isn't completely blocked.

Coughing can usually effectively clear their airway. Don't pat them on the back or reach into their mouth to try to grab the object. Doing either can cause whatever they're gagging on to go farther down their airway. It's best to calmly stay with them and make sure they completely recover.

A child who's choking is unable to talk, cry, or cough because their airway is blocked. They may gasp or wheeze, make odd noises, or make no sound at all while opening 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.

This is best done by someone who's trained, so it's a good idea to learn first aid for choking and infant CPR in case you ever need it. BabyCenter offers a virtual Infant CPR and Choking course led by a top pediatric ER doctor.

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If your child is unable to breathe, talk, or make noise, call 911 immediately.

Newborn gagging

Newborns might have their gag reflex stimulated if the breast milk or formula they're fed comes out too quickly, especially when they're first getting used to eating.

Try to get your baby to relax during feedings and don't push them to eat more than they want.

If you're breastfeeding, the flow of milk coming out (the "letdown") can be strong – especially in the early weeks – and cause your baby to gag. Try nursing your baby with them in more of an upright position, so they aren't lying down. This might help slow the flow as it enters their mouth. You can also try nursing in a side-lying position (with both of you lying on your sides) to slow the milk flow as well.

If you create a lot of milk, or it's been a little longer than usual since you last nursed your baby and your breasts feel engorged, you can try pumping or hand-expressing milk for just a few minutes to get past the initial forceful letdown before nursing your baby. Then, the milk flow will be a little slower.

If your baby is bottle-fed, make sure the nipple is the right size. Nipples with faster flow have more holes, and can allow too much breast milk or formula to come out at once, causing babies to gag.

What if your baby's gagging on food?

It's scary when your baby gags on food, but it's part of the normal process of learning to eat. Try not to worry when it happens, as hard as that might be.

From birth to around 7 to 9 months, the gag reflex is actually triggered closer to the front of the mouth. Because of this, gagging might be more common when first starting solids and lessen once your baby gets older (around 9 to 12 months), when the gag reflex moves more to the back of the mouth.

If you're starting to introduce solid foods and your baby gags, here's what you can do. 

Make sure your baby is ready for solid food before you introduce it. This usually happens around 6 months old, once your baby is able to sit upright, has good head control, grasps, turns away when full, and shows an interest in food, leaning forward and opening their mouth when food comes near.

When you think your baby's 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.

If your baby pushes the food out with their tongue, it doesn't necessarily mean that they don't like it – they're probably just trying to figure out this new way of eating. Feed them slowly while they get the hang of it.

After a few tries, they'll start using their tongue to move the food to the back of their mouth. If your baby is still pushing food out of their mouth or having trouble swallowing food after a week of trying, they may not be ready for solids yet.

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 themself, and that's naturally going to come with some bumps along the way. Let your 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, at around 8 or 9 months old. If you're doing baby-led weaning, you'll give them large pieces of soft foods to grab and gnaw on. These foods should pass the squish test – they should squish easily between your thumb and forefinger or between your tongue and the roof of your mouth – so they're easy for your baby to eat.

Don't give them foods that are choking hazards, like whole grapes, hot dogs, nuts, raw vegetables, large chunks of meat or cheese, popcorn, or other cylindrical foods that can block the airway (like pieces of sausage or hot dog).

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 get more meals under their belt and as they get older, though some kids do have an overactive gag reflex. If your baby is still gagging about a month after starting solids, mention it to their doctor. Your baby's doctor can give you input and check for problems, or may even suggest seeing a specialist, just to be sure.

Feeding Development and Difficulties : Ava

  • Gagging or choking - Challenges increasing textures in the diet

    • Development of oral motor skills enables children to manage foods with an increasing range of textures.
    • Gagging is a reflex action that helps to prevent choking.  It can be triggered by fingers, food, a spoon or toys touching the back of the mouth.  The gag reflex diminishes at around 6 months of age coinciding with the age at which most babies are learning to eat solid foods.  Some children have a hypersensitive gag reflex and will gag more easily.
    • Gagging is a common response when infants are making the transition from smooth to lumpy foods or when learning to chew.  It is best managed by providing graded food textures that support or match the development of oral motor skills.  Exploring of the mouth with hands and toys and encouraging feeding independence helps with diminishing the gag reflex.
    • With positive reinforcement gagging can become a learnt behaviour.  To prevent this avoid overreacting to the child’s gagging response. Simply remove the piece of food and provide reassurance.
    • Gagging is not the same as choking where the airway becomes blocked preventing breathing.  Unlike gagging where the child will make retching noises choking is silent.   Babies and young children should always be supervised when eating.

    Case scenario

    Ava aged 14 months is referred for assistance with feeding.  Her parents are concerned that Ava has a swallowing problem as she will only eat smooth puree foods.   If she is given any lumps in her food she will gag and usually vomit. 

    Remember to consider your own response before viewing suggested answers.

    Question 1

    What are the key elements of your assessment of Ava’s feeding difficulty?

    Key elements of your assessment include:

    • Parent’s perception of the problem.
    • Medical, developmental, growth and social history.
    • Dietary assessment.
    • Observation of feeding.

    Your assessment reveals the following details:

    Parent’s perception of the problem

    • Ava’s parents report, “Ava started solids when she was almost 6 months old.   She seemed ready.  She was very interested in watching her sisters eat.  However she didn’t really seem to enjoy the foods I gave her.  She would spit a lot out.  She liked the commercial baby foods better than the foods we made for her.  They seem smoother and she managed them better.
    • “When I tried her on the next stage foods with the lumps but she gagged and looked like she was about to choke.”   
    • “We waited a while before trying again but she still gags on the tiniest lumps.  It is getting worse and now she vomits if she finds a lump. We are sure she has a swallowing problem.”

    Medical, Developmental, Growth and Social History

    • Ava was born at term.  There are no concerns regarding her development and her growth has tracked consistently around the 25th percentile.  She has not had any significant illnesses.
    • Ava lives with both her parents.  Mum does not work and is the primary carer for Ava and her two older sisters.  Dad is employed full time.

    Dietary assessment

    • Ava has smooth infant cereal for breakfast.  Lunch and dinner typically consists of smooth commercially prepared foods that include meat and vegetables.   This is usually followed by puree fruit with yoghurt or custard.  She is either fed by mum using a spoon or self feeds by sucking food directly from the ‘pouch’.   
    • Sometimes Ava will mouth toast or biscuits until they go soggy but she doesn’t appear to swallow any.
    • Ava was breast-fed until around 10 months of age. She then commenced infant formula and is currently having 3 small bottles per day. She also has water from a cup.

    Mealtime Observation

    • Ava is well supported in a high chair.
    • She is offered lunch as described above.  She is observed to be happy and interactive when being spoon fed and enjoys the independence of feeding herself from the pouch.
    • Mum agrees to offer Ava some fork mashed fruit so that the observer can make an assessment of Ava’s response.
    • As mum predicts Ava gags and vomits.  The observer notes that mum fusses over Ava when she gags.   She has a bowl ready at the table to ‘catch the vomit’ and prevent a mess.
    • It appears that mum has a low tolerance for mess as Ava is also not encouraged to use a spoon to self-feed.

    Next Question

Child chokes on food | Mamovediya

Although the reluctance to swallow solid food is a natural response in many situations, and not just those involving food, infants and young children should not constantly choke.

If your child is constantly choking, or the face starts to turn red, or the skin around the lips turns blue, take your child to the doctor. In rare cases, this may indicate a problem requiring medical attention. nine0005

Although your father may be alarmed that you choke on the first spoonful of solid food, this happens quite often when the child starts eating. You have to learn to eat solid food.

In the sucking reflex, babies move their tongue to the front of their mouth and then up to the palate. They make 10 to 20 sucking movements, and then a big gulp follows. With solid food, however, the tongue must almost reverse, sending the food to the back of the mouth. nine0010

Learning to swallow solid foods is not easy for an infant. And during the learning process, he may choke if food is directed to his windpipe instead of his stomach.

You can, however, make eating a much easier exercise when the baby does not choke. To do this, you need to master new feeding techniques.

Here are some expert tips.

Wait until the child starts to sit up. If your child is constantly choking on food while eating, it is possible that he has not yet reached the stage of development at which he is ready for this. Your baby must be at least four or five months old before you start solid food. nine0003

What is the advice? Give the child solid food when he has already learned to sit more or less confidently. When your child eats while seated, gravity will help guide the food from the mouth into the esophagus.

Start with liquid food . When your baby is really hungry, breastfeed or give him a bottle first to satisfy his appetite a little. If your child is not so desperately hungry, he will be able to handle the difficult task of swallowing solid food more easily. nine0003

Eat rice. Rice grains are an ideal first food for children because children are rarely allergic to rice and can be thinned by mixing with plenty of milk.

Your baby will have less difficulty eating porridge if the consistency is more like liquids he is used to swallowing. Once your baby has learned to swallow rice porridge, you can gradually move on to thicker, coarser foods. nine0003

Let the first feedings be small . The first solid food feedings are for practice, not for real nutrition. An infant who is learning to eat only needs a few tablespoons of solid food a day to practice eating. The main nutrition should come from breast milk or artificial bottle feeding.

Start with a small amount of food . When your child opens his mouth, place a pea-sized portion of food on the front of his tongue. A large portion of food will make the whole process of swallowing more difficult for him, and if you put it on the back of the tongue, your child is likely to choke on it. nine0003

Do everything calmly, carefully and slowly. Take your time if your child is having difficulty with a new food.

If your child chokes on a particular type of food, such as potatoes or minced meat, pediatricians recommend not eating the food for a few days, then trying it again in a thinner consistency.

Do not overfeed your baby. If your baby vomits or chokes on every feed, it is possible that you are giving him more than he can handle. nine0003

In the first year of life, the baby cannot properly control the intake of food, so your task is not to overfeed him.

Watch for signs that the baby is full. He may begin to turn his head away or close his mouth when the spoon comes close to his lips.

What to do if a child chokes (these actions can save his life) | Lifestyle

Source: Daria Shevtsova from Pexels.com

What to do if a newborn child chokes

Newborn babies don't have access to adult foods, toys and small items, but that doesn't mean they can't choke. Often children of this age choke on breast milk (when sucking, spitting up) or water.

Usually, the ingestion of milk or water into the respiratory tract does not have serious consequences for the crumbs: the foreign liquid easily comes out with a strong cough.

It is much less common for fluid to get stuck in the airways. To understand that the baby is suffocating, you can by the following signs:

  • The child has a hoarse voice or it is completely absent
  • The child begins to swallow air through his mouth, his stomach rises and falls strongly
  • The child has wide eyes
  • The child cannot breathe normally or cry.
  • The skin turns red at first and then turns blue.
  • In critical situations, the child loses consciousness

In this case, the child risks choking to death. What to do if a baby is choking? Immediately call the doctors, and while they are on their way, provide first aid. nine0003

To begin, lift the child's arms up. This method is little known, but it works. This posture expands the airways and normalizes breathing.

If this does not work, proceed to the next manipulation. Place the child with your stomach on your hand, with the edge of the other hand, make five pats between the shoulder blades. Pay attention: all movements should be sharp, but not strong, so as not to damage the internal organs of the baby.

If this method does not help, put the child on his back with his head turned to the side. Press your fingers on the area between your upper abdomen and lower chest. Do this towards the throat, as if pushing a foreign object out. nine0003

Source: Alesya Fartushnyak from Pixabay. com

To avoid such cases, it is very important to follow a few simple rules:

  • Breastfeed in the correct position. The child should be fully turned towards you, and his head should be at the level of your chest, but higher than in the supine position.
  • After eating, let the baby spit up air and excess milk. Hold it vertically with a "column"
  • Monitor the condition of the crumbs during feeding. He can choke severely even with a very small amount of milk in the respiratory tract

What to do if an older child chokes on food

Older children often choke on food. In no case do not try to get a piece of food stuck in your throat with your fingers: you risk pushing it even further. And there without surgical intervention it is no longer possible to cope.

Better use Helmitch method to remove the foreign object :

  • Stand behind the baby (for comfort, you can stand on one knee)
  • Place your arms around the baby's waist. nine0070
  • Make a fist with one hand and place it on the area between the navel and the child's ribs. Place the other hand with your palm on top
  • Now spread your elbows to the sides and sharply press on the baby’s stomach from the bottom up, as if pushing out a foreign object
  • Perform this movement until a piece of food comes out

What to do if it is stuck in the throat bone

The most common foreign objects that doctors remove from the throat of children are fish and chicken bones. nine0003

Fortunately, in this case, the clinical picture is so pronounced that it allows you to act without diagnosis. As a rule, a bone stuck in the throat is accompanied by pain in the larynx, which is aggravated by swallowing. For this reason, the child simply stops swallowing saliva, which is why in babies it flows out of the mouth, and older children try to spit it more often.

In addition, the condition is accompanied by paroxysmal severe coughing and vomiting, as the body tries to get rid of the foreign body in the throat on its own. nine0003

In this case, don't try to act the old fashioned way by giving the baby a piece of bread. Bread will drive the bone even further into the throat and it will be even more difficult to get it out of there. Immediately call an ambulance, whose specialists will cope with the task in a few seconds.

What to do if a small child chokes on a small object

A small object may not close the airway, but fall into the glottis and linger in the trachea. In this case, the consequences can be no less threatening than if a foreign object did not allow the child to breathe. nine0003

At first, the foreign object in the trachea does not manifest itself in any way, then the child begins to cough.

Over time, a so-called capsule can form around a foreign object in the trachea, which will make it difficult to breathe and cause inflammation in the bronchi. The danger of finding a foreign body in the trachea is that not every mother can associate an unexpected cough with playing Lego. Most likely, she will write it off as a cold.

Source: Nathan Legakis by Pixabay.com

But a foreign body that stays in the trachea and bronchi for a long time can lead to chronic inflammatory processes in the lungs and even fit into the clinical picture of cancer.

Don't leave your little one alone with building blocks and other small items. Even a relatively adult and intelligent child can play too much, and then the consequences will be disastrous. If trouble nevertheless happened, urgently consult a doctor who, using bronchoscopy, will detect and remove a foreign object. nine0003

Prevention of trouble

To avoid having to urgently remove objects from the child's respiratory tract every time, take precautions.

  1. Keep a close eye on your child while playing. Before you have time to look back, he is already dragging a button found on the floor into his mouth.
  2. Thoroughly remove stones from fish, chicken, fruits and vegetables. For a small child who has not yet erupted all of his milk teeth, chop the food well, making sure that there are no large pieces left. nine0070
  3. No games or table talk. While eating, the child should calmly eat, without being distracted by anything.
  4. Never force feed your baby. By stuffing food into his mouth when the child resists, you can provoke food particles to enter the respiratory tract.
  5. Toys with small parts are only suitable for children over three years of age. We advise you to wait with them for a couple more years, when the child, in principle, stops exploring the world, dragging everything into his mouth.
  6. If you buy soft toys for your child, carefully inspect the pile - it should not be too long. In addition, it must be pulled out with effort.

Something got in the nose

A child stuck a button or a cherry stone in his nose. What does every mother do? He immediately tries to remove the foreign object, which further aggravates the situation by pushing the object deeper into the nasal cavity.

Learn more