Baby gagging

Baby gagging on food is an automatic response that helps prevent choking. Some babies and children have problems taking and swallowing food that is not smooth. Until your baby’s about 4 to 6 months old, your baby has a gag reflex that causes him to thrust his tongue forward whenever the back of his throat is stimulated. This tongue-thrust reflex can make early feedings a bit of a challenge. Gagging or pushing out those first spoonfuls of cereal isn’t uncommon. If your child gags when given pureed foods that are not smooth, it may be because of a sensitive gag reflex.

Gagging is a normal reflex babies have as they learn to eat solids, whether they are spoon-fed or you’re doing baby-led weaning. Gagging brings food forward into your baby’s mouth so he can chew it some more first or try to swallow a smaller amount. Your baby should gag less often as he develops and learns to regulate the amount of food he swallows.

Some children will gag or vomit when they are given pureed foods that are not smooth. This is often caused by a very sensitive gag reflex. Offering only smooth foods and hoping that the problem will go away does not always work.

There are a few things you can do to help make your child’s gag reflex less sensitive.

These children will often do well with smooth pureed foods, such as commercial first baby foods in jars. When they are given pureed foods that are not smooth, they will often gag and sometimes vomit (throw up). As a result, their parents will often go back to the smooth purees, which the child likes.

These children continue to eat only smooth pureed foods and do not have the chance to learn to eat foods with texture. They also do not have the chance to learn to chew. Some children will be able to tolerate food with lumps in their mouth but will gag if they try to swallow lumps. As a result, these children will spit out lumps and only swallow the smooth part of food.

If your baby pushes the food out with his tongue, it doesn’t necessarily mean that he doesn’t like it — he’s probably just trying to figure out this new way of eating. Feed him slowly while he gets the hang of it.

After a few tries, he should start using his tongue to move the food to the back of his mouth. If your baby is still having trouble swallowing the food after a week, he’s probably just not ready for solids yet.

Once your baby’s ready for table food, keep an eye on him so that he doesn’t choke while feeding himself. Cut his food up into bite-size pieces no larger than 1/2 inch and avoid foods that are choking hazards, such as whole grapes, nuts, and popcorn.

Most likely your baby will gag less as he gets more meals under his belt. If he continues to gag on pureed foods, mention it to his doctor. She can check for physical problems, just to be sure.

How can I tell if my baby is gagging or 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 is gagging may push his tongue forward or out of his mouth and do a retching movement to try to bring food forward. His eyes may water. He may cough or even vomit. Let your child continue to gag and cough because that’s the most effective way to resolve the problem.
• A child who is choking is unable to cry, cough, or gasp. He may make odd noises or no sound at all while opening his mouth. You may need to do back blows or chest thrusts to dislodge the blockage.

Choking prevention

Choking can be prevented. Food accounts for over 50% of choking episodes.

But, also be alert for small objects that can cause choking, such as coins, buttons, and small toys. Check under furniture and between cushions for small items that children could find and put in their mouths.

Toys are designed to be used by children within a certain age range. Age guidelines take into account the safety of a toy based on any possible choking hazard. Don’t let young children play with toys designed for older children.

Keep items that are choking hazards away from babies and young children. These include:

• Coins
• Buttons
• Toys with small parts
• Toys that can fit entirely in a child’s mouth
• Small balls, marbles
• Balloons
• Small hair bows, barrettes, rubber bands
• Pen or marker caps
• Small button-type batteries
• Refrigerator magnets
• Pieces of dog food

Choking hazard foods

Some foods can cause choking. Keep foods such as grapes, hot dogs, raw carrots, or peanuts away from babies and young children. Cut food for babies and young children into pieces no larger than one-half inch. Encourage children to chew food well. Supervise meal times. Insist that children sit down while eating. Children should never run, walk, play, or lie down with food in their mouths. Be aware of older children’s actions. Many choking incidents are caused when an older child gives a dangerous toy or food to a younger child.

Keep the following foods away from children younger than 4 years:

• Hot dogs
• Nuts and seeds
• Chunks of meat or cheese
• Whole grapes
• Hard or sticky candy
• Popcorn
• Chunks of peanut butter
• Chunks of raw vegetables
• Chewing gum

What causes baby gagging?

Children who gag when trying to eat foods that are lumpy or have texture often have a very sensitive gag reflex. The gag reflex helps you to expel food that your body feels is unsafe for you to swallow. The gag is usually triggered somewhere on the tongue.

Children with a very sensitive gag reflex tend to gag more easily than other children on food that is not smooth. This often looks very scary, as the child can turn red and appear quite distressed. Sometimes the gagging will lead to vomiting.

The difference between a sensitive gag reflex and a swallowing problem

It is common for parents to think that gagging when eating is caused by a problem with swallowing. However, there is a difference between a sensitive gag reflex and a swallowing problem:

• Children who have a very sensitive gag reflex will gag when new foods are still in their mouth, before they have tried to swallow the food. This can occur when the food is near the front, middle or back of the mouth.
• Children with a swallowing problem have trouble after the food has been swallowed. They may gag or choke.

Chewing problems can also cause gagging

Children can have problems with textured food because they have trouble chewing:

• Some children have difficulty chewing solid food in order to make it safe to swallow. These children will try to swallow a piece of food before it is properly broken down. This can cause them to gag and sometimes choke. This is often seen when children are first learning to chew.
• Children who have delays in their motor skills will often also have delays in their chewing skills as well.

If your child is gagging with some solids, make sure they can properly chew the food that they are being given.

How you can help your child with a very sensitive gag reflex

Children who have a very sensitive gag reflex usually need some help to improve. Just going back to offering only smooth foods and hoping that as the child gets older, their feeding will improve, does not always work. Most children with very sensitive gag reflexes need to experience the feeling of texture in their mouth and throat in order to make their gag reflex less sensitive.

Smooth foods with lumps, such as yogurt with pieces of fruit, are often the most difficult for children with a very sensitive gag reflex. This is because the child feels a smooth texture and then the lump is a surprise. This can cause the child to gag.

Tips to help your child tolerate textured food

To make the gag reflex less sensitive and help children tolerate food in their mouth that is not smooth, you can try the following:

• Try to get your baby to relax during feedings and don’t push him to eat more than he’s inclined to. If he’s bottle-fed, make sure the hole in the nipple is the right size. If it’s too large, too much milk or formula may come at him at once.
• Add texture to the food, but still keep it all the same texture. That is, you can make the food more grainy but with no lumps. You can do this by taking the smooth food that the child likes to eat and adding something like wheat germ or graham cookie crumbs. This will make the food less smooth, but there will be no surprise lumps. You can start off by adding only a very small amount of the wheat germ or graham cookie crumbs. As the child improves, you can add more. This will help the child slowly get used to the feeling of texture in their mouth and throat. If your baby pushes the food out with his tongue, it doesn’t necessarily mean that he doesn’t like it — he’s probably just trying to figure out this new way of eating. Feed him slowly while he gets the hang of it.
• Also make sure he’s ready for solids before you introduce them. He should be at least 4 to 6 months old and able to sit upright with support. When you think your baby’s ready, start by putting a small amount of food on a spoon. Tip the spoon and place a bit of the food on the front of his tongue, rather than putting the whole spoonful in his mouth. This way, your baby can suck the rest of the food off the spoon without feeling it at the back of his throat right away.
• If your child is able, allow them to feed themselves for all or part of the meal. Children with sensitive gags often do better if they can feed themselves.
• Even if your child is not able to tolerate lumpy or textured pureed foods, they may be ready to try solids that dissolve easily, such as baby crackers or cookies. Children with sensitive gag reflexes often do better with solids that dissolve easily, rather than lumpy pureed foods.
• Brushing your child’s teeth will also often help to make their gag less sensitive.
• If your child enjoys putting toys in their mouth, provide teething toys that have bumps and different textures.

If your child continues to have trouble swallowing textured foods, speak to your child’s doctor.