When it comes time to introduce solids to your baby, is the thought of your baby choking at the top of your list of worries?
How to prevent choking and how to handle allergenic foods are consistently the most worried about topics I hear from parents. And choking tends to become an even bigger concern if you are planning to start baby led weaning!
So let's talk about the risk of choking with finger foods. As well as how you can lower the choking risk around foods and how to prevent your baby from choking.
Baby Led Weaning and Choking Risk
Many people assume that baby led weaning, or giving finger foods, is dangerous and likely to lead to choking. Especially when compared to spoon feeding purees. Research doesn't support this though!
Baby led weaning is relatively new in the realm of research topics. Even though people have been feeding their babies similarly around the world for centuries! A few studies have been done, though, that specifically look at whether there is an increased risk of choking. (1, 2, 3)
In those studies, there is no difference in the amount of choking episodes that occurred with spoon feeding and those that occurred with baby led weaning.
Babies that used a baby led weaning style of feeding did gag more at 6 months than those who were weaned with spoon feeding. But at 8 months of age, babies eating finger food were gagging less than babies using a traditional style of weaning.
What is very interesting, though, is that by 12 months of age, 95% of the babies in the study, regardless of weaning type, had been offered high choking risk foods. (Ref)
It is important to know how to serve safe finger foods with baby led weaning. But no matter what approach you take to weaning it is vital to be intimately familiar with potential choking hazards. Safe feeding practices are key!
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!
Gagging vs Choking with Baby Led Weaning
While gagging is often loud and can be confused with choking, they are two different things. When you think of choking, you might even be thinking of gagging and not actual choking!
Choking is usually silent with little or no air getting through your baby's airway. Sometimes, there may be gasping when their airway is partially blocked.
Gagging, on the other hand, tends to be loud or dramatic. It can often be seen as a bit more of a retching motion, they may cough, and it can even lead to vomiting.
When your baby gags, it is actually a safety mechanism they have. It is there to keep a food from going down their throat when it shouldn't. Many babies will gag as they learn to use their tongue to manipulate food in their mouth.
One of the reasons babies gag more than adults is because a baby's gag reflex is located closer to the front of their mouth. As they get older, the gag reflex moves further back in your baby's mouth. Once this happens, they become less likely to gag.
You might see more gagging at the beginning of solids with a baby doing baby led weaning. They will usually quickly figure out how to manipulate food, though. With spoon fed babies, the gagging tends to come a bit later once solid foods are introduced to them.
Gagging is normal for babies! Even though it might be scary and dramatic. It can be almost inevitable for babies to lose a bit of control over the food in their mouth while they're learning to eat. Your baby gagging is a good thing in this case, as it is preventing them from choking!
How to Handle Choking in Babies
While choking is never something we want to see happen, there is a risk with eating. One of the best things you can do is know how to handle choking if it happens. You, or even all of the adults in your house or that are feeding your baby, should be infant CPR certified.
Getting trained in infant CPR is the best way for you to help your baby if they do choke. Because so often, our instincts to pat them on the back if they're coughing or other standard responses can actually make things worse! And kids under 5 are at a high risk for choking on food AND toys and other daily objects. Getting trained will allow you to quickly help them in the event of an emergency.
How to Prevent Choking for Babies
Beyond knowing how to respond if it does happen, knowing how to prevent choking is one of the most important things you can do. There are several things you can do to make it much less likely for your baby to choke.
Make Sure Your Baby's Food is Safely Prepared With No Choking Hazards
Here are a few guidelines to follow:
- Everything should be smooshable between your thumb and forefinger when first starting to feed your baby. Think of it as you want your baby’s tongue to be able to smoosh it against the roof of their mouth. Only advance this slowly as your baby gets more competent in eating.
- Never give your baby any round or circular item uncut. This includes high risk foods like hot dogs, grapes, and cherry tomatoes, for example.
- No hard candy or popcorn.
- No hard foods like whole nuts, hard vegetables like raw carrot or hard fruits like raw apples. (While a raw apple is something you might commonly see babies practicing a baby-led approach eating in pictures, research shows they are actually the number one food that causes choking! So make sure you don’t give a raw whole or cut apple to your baby.)
- Nut butter should be spread on a piece of bread or stirred into yogurt or oatmeal. Just giving a spoonful of a nut butter is a choking hazard.
More: For help on how to specifically prepare safe finger foods for babies, and for a deep dive into what foods are considered choking hazards for babies and how to modify them, be sure to check out the Starting Solids course.
Pay Attention to How Your Baby is Sitting
It's not only about the food! One of the best ways to keep your baby safe is to make sure they are sitting upright at 90 degrees when eating. Always!
That means having a proper high chair that positions your baby safely. It means not eating laying back or eating when not sitting upright.
It also means only feeding your baby when you are able to physically watch them directly.
Preventing Choking When Out of the House
Out and about without a proper high chair? Don't feed them moving in a stroller. You could hit a bump that causes them to choke, and you aren't able to fully watch them if you're walking with them.
You also don't want to feed them strapped into a car seat. They are inevitably leaning back in it, strapped in without proper eating positioning, and if you're driving while doing it you are unable to watch them or get to them if a choking event happens. You could also have sudden movements of the car that increases choking risk. It's just not a good, or safe, idea!
There are lots of different scenarios I could come up with. From toddling around the house or playground with food in their hand to riding in a stroller while watching something else. They're all situations that involve a distracted baby, lack of oversight, and improper positioning.
Fixing those by only feeding your baby when they are sitting still at 90 degrees, with you watching them, is one of the best ways to decrease your baby's choking risk exponentially!
Keep This In Mind to Help Prevent Your Baby from Choking!
At the end of the day, there is a lot we can do to prevent choking. Educating ourselves about how to provide safe foods and a safe setting goes a long way. Knowing the difference between your baby gagging and choking is also vital. And getting trained in CPR can help in an emergency.
