Is your baby gagging on their food? Not sure what is normal or how to handle it? Let's talk about it!
A common question I receive from parents is about how much gagging is okay when a baby is first starting solid foods. The amount of gagging that happens depends on several different things. They range from the type of food you are giving, if you are doing baby led weaning or spoon feeding purees, how much practice they have had manipulating things in their mouth, and so many others.
At the end of the day, every baby will be different. It's wise to expect a bit of gagging with all babies at sometime or another when you are introducing solid foods. But how much is too much?
More: For more help with baby led weaning and how to help your baby succeed with eating, be sure to check out this article with a comprehensive guide to baby led weaning and first baby foods!
The Difference Between Gagging and Choking: A Reminder
Gagging is a normal part of the learning process when you introduce solid foods. No matter if they are finger foods or pureed baby foods.
Your baby's gag reflex is much closer to the front of your baby's mouth than an adult’s. That means it is much easier for them to gag on food. And it means that they have a very sensitive gag reflex. Gagging means your baby is learning, and is not necessarily a bad thing.
Choking, on the other hand, can be very serious. Choking means food has gotten lodged in a baby’s airway. Their airway is completely blocked, which causes them to have trouble breathing. Choking is life threatening.
Know that it is rare for babies to truly choke, but that is why it is important that you practice safe feeding habits and are always monitoring your baby with food. Someone in your house should also be up to date on infant CPR. This is not specific to baby led weaning, but really, any type of feeding! Safety should always come first.
Your baby is likely to have multiple gagging episodes once they start feeding. Many times these gagging episodes will appear to be very close to your baby choking. Sometimes, you may hardly even notice when your baby gags. Gagging usually decreases after a few weeks of solid food, and is much lower in older babies that have done baby led feeding. (Ref)
If you are feeding your baby purees, you may see gagging a bit later. Traditionally weaned babies gag more frequently later on as they are starting to eat soft foods that aren't pureed.
For more helpful tips on starting solids, grab my
First Foods Printable!
Handling the Inevitable Gagging Instances
We've talked about it being perfectly normal and expected when babies gag. Now let's talk about what you can do when it happens.
A few tips:
1. Hold back your fear.
Easier said than done, but give your baby time to work out how to handle the food by themselves. Sometimes, it may be that your baby bites off too much food and doesn't know how to handle it. Other times, it can be the result of them losing control of a food in their mouth as they try to manipulate it with their tongue.
You being outwardly concerned and loud when it comes to your baby gagging can cause them to be scared going forward. In the case of the more intense forms of gagging (including at times vomiting-think about what happens if your gag reflex is strongly activated!), it can cause more harm than good.
Many babies will look to their parents or caregivers after a strong gag. Babies learn how to respond to gagging on food by looking at their parents. They learn whether they should be scared, or if it is normal and they are okay.
We want them to know that gagging happens, and it is okay!
So bottom line is take a deep breath, pause to fully assess, and then act.
2. Check the food.
Sometimes, we need to reassess what we are giving. I recently found that I was in this boat. Even though I do this for a living and know all the safety rules!
My daughter gagged a few times on a food and then wasn’t interested in trying it again the next time I served it. I was running through the potential issues when I picked up the food and realized that while I thought I was serving it properly, it was actually much too hard for her to manage!
When babies are starting, make sure that you can smush whatever food you provide between two fingers. Under 12 months of age, there are many more choking hazard foods than people realize. Things from skins of foods and leafy greens to even bread.
Your baby's chewing skills are immature, and they are just learning how to manipulate foods in their mouth. Most infants will have a hard time when they eat solids that are not specifically modified to reduce the choking risk. Frequent gagging is a sign to check your food!
As they get older, you can start to make food harder, as long as you continue to listen to your baby and assess if the texture is right for them.
More: For help with choking hazards for babies, including the reasoning behind recommendations and how you can modify them to work for your own baby, grab the Starting Solids course. Learn all about what food to serve AND how to serve it to establish a great relationship with food for life.
3. Modify the food.
One thing many parents find reassuring is having a resource that provides the appropriate textures and sizes for foods, especially when you are first getting started. Unfortunately, I can tell you all day that a food should be safe and cause no issues, but every baby is different. A resource for food preparation is incredibly beneficial, but you still need to modify for your own baby.
An example might be that from a safety standpoint, a certain type of bread is perfectly acceptable for a baby my daughter’s age. But when I give it to her, she tends to gag a lot and has a hard time managing it.
The best thing to do would be to either modify how it is served, or hold off on serving it for a week or more to allow her skills to develop. You don't want to completely avoid foods, but you do want to listen to your baby's non-verbal cues.
How Much Gagging Is Okay?
It depends on your baby. Are they consistently gagging on the same food? If yes, then check the steps above.
Are they gagging on most foods? Check the texture you’re serving to make sure it’s appropriate for their age and development. When they gag, is it in the front of their mouth or all the way back towards their throat? Oftentimes babies take a little bit of time to learn the best way to manage a mouthful of food and to chew properly. As long as the food you are serving is safe, it is likely ok to keep going.
Food management is a skill and not something your baby will just have. Make sure you are taking a breath and pausing to evaluate what is actually going on.
In rare circumstances there might be something deeper at play if your baby is gagging on all foods consistently. If you think that is the case, contact your child's pediatrician for an evaluation or a consultation with a feeding therapist. It is unlikely to be related to whether you are following baby self-feeding or traditional weaning if something deeper is at play.
How to Prevent Choking
While in most cases gagging is normal, we don't want it to progress to choking. Head here for more tips on how to prevent choking. At the end of the day, the best way to keep your baby safe is to set up safe feeding practices.
Have your baby in an upright position at 90 degrees in an appropriate high chair at all times when eating. Do not let them walk or crawl when eating, or eat in a moving vehicle or stroller.
Make sure you understand the difference between gagging and choking. If your baby gags, patting them on the back or doing back blows could actually cause your baby's gagging to turn into choking. You could lodge the food farther back in their throat.
Gagging is a normal part of learning to eat, and is bound to happen. Knowing what foods are safe and appropriate for your baby at each stage is vital. Practice safe feeding practices to prevent gagging from turning into choking.
Once you are familiar with safety practices, listen to your parenting intuition and seek help if safe food is still causing your baby to gag frequently and more than you would expect.