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Understanding Baby’s Gag Reflex

By Melanie Potock, MA, CCC-SLP

It can be alarming for parents to see their baby gag! Gagging is not a pleasant experience, and the more we gag, the more we anticipate and try to avoid the uncomfortable feeling. But for baby, those first experiences with the gag reflex are typically mild, and the occasional gag is to be expected. Gagging is a natural part of the learning process as babies explore toys and food with their mouth. In fact, that gag is designed to protect baby by stopping any piece of food or foreign object from traveling back toward the throat and potentially blocking the airway. When the reflex is triggered, the tongue elevates and thrusts forward, attempting to expel the culprit food or object. Note: Gagging is not foolproof and will not prevent choking 100 percent of the time. Understanding your baby’s gag reflex and how it differs from choking is essential to keeping baby safe.

How much gagging is too much?

If you notice baby gagging at mealtimes and observe his mood change after gagging, then it may be occurring too frequently. Learning to eat a variety of tastes and textures should be a joyful experience! The occasional gag is like the occasional slip or fall when trying to learn to ice skate. But if a child falls frequently, they’ll quickly avoid the ice. The same is true with introducing new tastes and textures. Expect a few gags as baby learns to manipulate the food in his mouth and adjust to the new sensation. Watch his expressions and his willingness to give it another try. If baby begins to avoid the new foods or fusses, he may be experiencing too many sensations that he finds unpleasant, including the gag. Frequent gagging can lead to food aversions and an extremely hesitant eater over time.

When baby does gag, observe him with a pleasant look on your face. Be careful not to appear alarmed. Baby will notice your energy and remain calm if you remain calm. Occasionally, if the gag is strong, baby may spit up. Clean up any mess in a gentle, caring manner, but try not to give it much attention. We want baby to understand that sometimes spit-up happens. It’s not anything to worry about unless it occurs repeatedly, and then, it’s time to consult baby’s doctor.

A gag can also warn you that a choking episode may be about to occur if baby is unable to propel the food/object forward in his mouth.

What is the difference between gagging and choking?

While gagging is reflexive and may or may not occur just before a choking episode, it’s also a natural part of the learning curve when babies first try new foods. Choking is frightening and is the number one cause of injury and death among children.[1] Choking appears very differently than gagging, which is a reflexive movement in time and from which baby typically recovers quite comfortably.

Most often, choking has little to no sound because the object that is blocking the airway is also preventing air from vibrating through the vocal folds (vocal cords). That is why it’s vital that you always watch your baby while he’s eating. Turning your back, even for a few minutes, could result in turning your back to a baby who is struggling to breathe. Signs of choking include an open-mouthed and wide-eyed expression, sudden drooling, bluish coloration around the lips and eyes and a panicked look on baby’s face. Faint noises or gasps for air may indicate a partial obstruction.

What are signs that indicate my baby is at risk for choking?

  • Frequent gagging followed by a look of discomfort, panic, fear or irritability.
  • Lack of interest in eating
  • Wet, “gurgly” voice quality
  • Consistent coughing during or after eating/drinking
  • Multiple episodes of chronic low-grade fever
  • Strong preferences to certain foods for more than three weeks
  • Swallowing foods whole or with minimal chewing
  • Weight loss or poor growth[2]

To learn more about safe foods that will minimize choking risks, read 4 Tips to Help Baby Learn to Chew and 12 Surprising Tips to Help Baby Transition to Finger Foods. To learn more about choking and the relationship to feeding aversions, refer to the article, What Is a Pediatric Feeding Disorder? To learn more about gagging and strategies to help, read Early Signs That Baby Is Picky — and What to Do About It.

It is essential that every person who cares for your child be trained in both baby and child CPR. Review the steps for CPR outlined by the American Red Cross or find a class in your area by visiting their website.


References and Sources

  1. Choking is a leading cause of injury and death among children
  2. Gagging: What You Need to Know About Feeding Baby

DISCLAIMER

The content provided in this article is intended for informational purposes only. It is not recommended as a substitute for professional medical advice, diagnosis or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem without consulting a qualified healthcare professional. Always seek the advice of a qualified healthcare professional regarding any medical questions or concerns. See additional information.