Gagging, Coughing & Choking: Everything you need to know

Introducing solid foods to your baby is an exciting time. However, for some of the parents I work with it can also be worrying for fear of gagging and choking. Below is some useful information to help you feel more confident when weaning your baby to solid foods.

·       Gagging is a normal protective reflex that is highly sensitive when weaning starts. This is because its designed to stop your baby from choking. Observing your child gagging when solids are first introduced is quite normal. It indicates that they haven’t yet mastered the oral motor control they need to prepare the food for swallowing – and so they gag to stop it going down the wrong way. If you want to know more about what to expect when starting solids take a look at my online weaning course

·       Gagging looks like your baby may be about to be sick, they will open their mouth and push the tongue forward as part of the gagging mechanism. It may be silent or there may be a retching noise that goes with it. Before and after a gag your child will be able to vocalise normally.

·       As the weaning process progresses and your baby gets more used to eating solids and develops the skills of chewing, the gagging will reduce.

·       If you see your baby gagging try not to panic or your little one could sense your alarm. Stay calm, count silently to 10 and remember it’s a sign that your baby’s body is doing what it is meant to do.

·       Coughing/spluttering occurs when your baby or child struggles to co-ordinate the oral motor and swallowing phases of eating or drinking. You may remember your baby coughing occasionally when first moving on to a bigger teat size or during a fast let down when breast feeding. Coughing can also commonly occur when weaning, particularly as your little one gets used to drinking water from a free-flowing beaker.

·       Partial choking typically happens with food or a foreign body such as a small toy enters the airway. Symptoms include intense coughing, changes in breathing, distress and panic.

·       Choking is usually silent or very quiet. This is because during a true choking episode a piece of food (or other object) will become lodged in the airway and stop the air from the lungs from travelling up and out of the mouth, making it difficult to make sound or breathe.

·       Signs of choking may also include, changing colour of the face and lips to grey/blue, a look of panic, and an older child may flap or wave their hands in the air.

 Michelle Eshkeri, a baby/child first aid trainer from the North London based company Parent Partner, advises that:

·       For partial choking, the recommended treatment is to turn the baby/child over so that their head is lower than the stomach. This allows gravity to help the body expel the foreign body. Coughing should also be encouraged.

·       For a fully blocked airway, the recommended treatment is to turn the baby/child over and deliver up to 5 back blows, checking for the foreign body between each blow. If this is not successful, deliver up to 5 chest/abdominal thrusts, again checking in between each manoeuvre to see what is happening. Back blows and thrusts are then alternated in groups of 5 until such point as the casualty loses consciousness, at which point CPR should be commenced. 999 should be called immediately or if the first aider is alone, after 1 set of back blows/thrusts have been delivered (10 manoeuvres).

 There is no substitute for practicing the correct techniques in first aid and Michelle recommends that all parents and carers attend a baby/child first aid course every 2-3 years.

 If coughing/spluttering and gagging persists with eating or drinking it could be a sign of a swallowing difficulty and it may require an assessment from a feeding and swallowing specialist speech therapist.