Fear of choking can be a major source of anxiety for parents with babies starting solids. If your little one is beginning solids - whether baby led weaning or traditional weaning - it's important to know the difference between choking and gagging. Here's what you need to know.
As parents, starting solids can be very nerve wracking. One of the biggest fears is that baby will choke. Especially if you're doing baby led weaning and skipping purees altogether, anxiety around choking can be high, even if it's not you who is nervous (looking at you, grandmas!).
One way to calm your fears around choking is to understand the difference between choking and gagging. If you know the signs of gagging, and know that it is actually a protective reflex, you can relax a little more at mealtimes and not jump to perform CPR with each cough and hiccup.
Jump to:
Is Gagging Normal?
First things first. Gagging is very normal for babies just starting solids. The gag reflex helps to protect baby from choking as she learns to manipulate food in her mouth and swallow. It is triggered much more easily in younger infants, and gets less sensitive as babies get older.
When the gag reflex is activated, the tongue automatically pushes the food forward and away from the airway. It may be associated with a coughing reflex, which similarly is triggered to protect the airway.
Gagging is a helpful part of the process of learning to eat. Baby uses it to learn the appropriate size bite and oral motor control. I recommend watching a few videos of babies gagging while eating to help familiarize yourself so you recognize when it happens. Here are some examples (jump to 1:50):
What To Do If Baby Is Gagging?
If your baby gags, it is important to let her handle the situation. As long as she is sitting upright and can hinge a little bit forward at the hips, she will very likely push the food out and carry on as normal.
You may be able to help coach baby to spit the food out of her mouth. You can also offer water from a straw cup after the food is cleared.
It is very important NOT to stick your fingers in your baby's mouth, as this can push the food further back and into the airway.
Choking vs Gagging in Babies
As mentioned, gagging is normal. It's important to recognize the signs of gagging to distinguish it from choking.
Common signs of gagging include:
- watering eyes
- retching
- coughing
- sputtering
- cheeks flushing
- baby will still be able to make noise
On the other hand, choking is dangerous. Choking means the airway is blocked and requires immediate attention to dislodge whatever is blocking it.
Signs of choking include:
- Inability to cry or make noise
- Difficulty breathing: heavy wheezing or gasping
- Inability to cough or very weak/ineffective cough
- Look of panic or terror
- Tugging at chest
- Blue tint of skin or lips
- High pitched noise
What To Do If Baby Is Choking?
A baby who is choking needs immediate intervention to clear the object out of the airway. Like with gagging, do NOT stick your fingers in the baby's mouth, as you could push the object further into the airway. Once you've confirmed that baby is actually choking (CPR can make things worse if the airway is only partially blocked), ask someone to call 911 if possible, and perform infant first aid: back blows followed by chest compressions. Here is a great article explaining how to perform choking first aid to babies in more detail.
I highly recommend any new parent take an infant CPR class from a qualified professional, regardless of feeding method, just to be more prepared.
Does Baby Led Weaning Increase Risk of Choking?
Studies show that baby led weaning does NOT increase the risk of choking. In fact, baby led weaning babies may choke even less on finger foods and lumpy purees than spoon fed babies. Regardless of method, it's important to always follow safety guidelines any time you feed your baby, and to avoid foods that pose a high choking risk.
Read More: Top Choking Hazard Foods To Avoid
Choking Vs Gagging Chart
To summarize, here is a chart showing the difference between choking and gagging. Knowing the difference can help you be prepared and stress less when starting solids!
| Gagging | Choking |
|---|---|
| Airway is clear | Airway is blocked |
| Can breathe | Unable to breathe or heavy wheezing/gasping |
| Baby can cough, cry and make noise | Baby is quiet and unable to cry |
| Red or flushed face, watery eyes | May have pale or blue tint to skin |
| Sputtering and retching | Look of panic or terror |
| Do not intervene; let baby clear the food | Requires immediate intervention by infant first aid |
Remember the safest way to serve anything to your baby is to ALWAYS have an adult present and attentive at mealtimes!
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