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The difference between gagging and choking

Baby boy in high chair waiting for a meal of solid foodWhen my children started eating solid food there were three things I had to make sure of first.

I had to make sure they weren’t wearing good clothes, I had to make sure I wasn’t wearing good clothes and I had to make sure my mother was NOT in the room.

You see, my mother would freak right out each time the baby would gag even slightly. In her defence, I choked a few times as a young child so she was obviously scarred by those experiences. And it can be frightening to see a baby gagging on their food. That’s why it is important to learn the difference between gagging and choking.

The difference between choking and gagging

Basically, choking is life-threatening and gagging is a very handy reflex our bodies have to prevent it. The gag reflex is your body’s way of moving food from the back of your throat to the front, to AVOID choking.

What is choking?

If a baby is choking they’ll be distressed, silent and unable to breathe.

Ever heard the expression “that went down the wrong pipe!”? There are two passages at the back of your mouth – the trachea (or windpipe) and the oesophagus (food pipe). Air is taken to your lungs via the windpipe and food goes to your stomach via the oesophagus. If food accidentally heads down the windpipe, which in this case is the ‘wrong pipe’, then it can obstruct the trachea and prevent breathing. If the airway is partially blocked your child may cough, wheeze or make a whistling noise, be obviously distressed and unable to talk. If the airway is completely blocked your child will be unable to make any noise, will be trying to breathe and start to turn pale or blue.

Choking requires immediate action – another good reason parents should do a basic first aid course.

What is the gag reflex?

If a baby is gagging on their food they’ll be making noise and looking like they’re dry heaving or about to bring up their food (and occasionally they will!).

The gag reflex is the body’s way of preventing choking. When food moves too far back, your body’s natural reaction will be to try to push it forward again. Babies will often gag when they’re getting used to eating solid food – although some will be more sensitive than others. It is a normal part of starting solid food and while it can be distressing to see as a new parent it is important that you watch carefully to see how their body manages to manipulate the food back into a safe position. You can also then watch as they spit it out and pick it back up for a second try! Yeah, pretty gross.

READ: You can read more about starting solids in our Starting Solids hub

How to help prevent choking

When your baby is starting on solid food there are some precautions to take to help prevent choking.

  • Avoid foods that are choking hazards – hard raw fruits and vegetables (apples/carrots), whole nuts, whole grapes or cherry tomatoes, hot dogs and sausages for their first three years.
  • Always closely supervise your child while they are eating – think about this if considering given your children snacks in the car.
  • Make sure your child is seated, sitting upright and not distracted while eating.
  • Also, identify choking hazards around the house and put them out of a child’s reach – coins, buttons, small rocks etc. Throw away broken toys with loose parts and know that if an item is recommended for child aged 3+ then it is most likely because of small parts that pose a choking risk.

It is also important for parents to do basic first aid training. Choking requires your immediate action so it is vitally important that you know how to react if your child is choking.

How to deal with gagging

Some babies gag more than others and some mums are more anxious than others. It is important to understand that gagging is a normal part of starting solid food, a reflex to prevent choking and something that is bound to happen while babies get used to the process of eating.

  • Try to stay calm if your baby is gagging. You don’t want your baby to pick up on your stress and become anxious or distressed while their body is trying to prevent choking.
  • Make sure your baby’s first foods are of a texture appropriate to their stage of development. Start with a puree and increase the texture to a fine mash then a course mash over a few weeks (or as your baby gets the hang of it). When your baby starts finger foods, make sure they are soft enough to easily squish between your fingers and long enough for baby to hold – like steamed carrot sticks or banana.
  • Understand that sometimes a baby will bring up the food that caused them to gag. Some babies have a more sensitive gag reflex than others. If your baby does this often chat to your health care provider for advice.
  • Also supervise your child closely while eating and watch carefully for the signs of choking. Know the difference and know what to do if your baby DOES choke on food.

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