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Gagging & Choking

Many parents are put-off baby-led weaning (BLW) because they are concerned about gagging or choking. If this sounds like you, you may be happier exploring a weaning approach, which brings you the benefits of BLW without the anxiety of serving foods that you may feel uncomfortable with. This is the method we advocate in our books and workshops and we haven't given it a name because labels are most unhelpful. 

We recommend this approach because everything we recommend, suggest or implement is backed-up by science. We have read hundreds, maybe even thousands of research papers and our philosophy is that successful and stress-free weaning depends on the relationship between you and your baby, so your needs are just as important as your baby's when you choose how to wean.

Your main focus when weaning is on allowing your baby to self-feed, rather than on what they eat. This means that you can offer solids or purees, or a combination of both, as your decisions will be based on what you feel comfortable giving your baby. Gagging is actually a normal part of learning to eat and is quite different from choking - read on to understand the difference between them!

What is Gagging?

While your baby is working out how to eat, they may occasionally gag and vomit. This is because their gag reflex is being triggered as they put food in their mouth. The gag reflex is there to prevent things from being swallowed that ought not to be. In younger babies, the gag reflex ‘trigger zone’ is a lot further forward in the mouth than it is in adults as a way of preventing them from swallowing toys and other objects, which often go in their mouth as a way of learning. With it being so far forward, it is therefore natural that spoons, little fingers and first foods will also trigger this reflex and so...

...gagging is likely to occur in early weaning.

The gag reflex in adults can be triggered as a way of trying to induce voluntary vomiting (‘sticking your fingers down your throat’). By adulthood the reflex has receded until it is quite far back (roughly the length of your index finger) but it took practice for that reflex ‘trigger zone’ to recede that far - your baby is working on that through weaning, as they repeatedly trigger the gag reflex and it receded over time.

It also takes practice for your baby to figure out how to move food to the back of the mouth with the tongue and also how to co-ordinate tiny muscles to swallow - your child will inevitably (and needs to) make mistakes as a natural part of the learning process. Eventually they will work out how to get the right-sized food to the correct part of their mouth and it will become easier to co-ordinate all of those muscles so that they can swallow without gagging. 

The gag reflex is therefore a protective mechanism that prevents your baby from swallowing things they shouldn't and teaches them how to manage food in their mouth. To ensure that the gag reflex is triggered, your little one needs to be sitting upright so that when food does hit the trigger zone it can be moved forward - either to be chewed some more - or spat out. This is also one of the reasons why sitting up with little or no support is a sign your baby might be ready to be introduced to solid foods (click here for more information on When to begin).

Avoid offering food to your child when lying back in a car seat or bouncer

because gravity will work against them, potentially preventing them from spitting food out or moving it around in their mouth. This can lead to choking.

What is Choking?

Choking is another matter entirely and involves the airway itself being (partially) blocked. This happens when the food has moved beyond the gag reflex and poses a threat to their breathing. Choking is not a natural part of the learning process and you want to take all sensible measures to avoid it happening. The texture of food will not influence the likelihood of your child choking, so they are no more likely to choke on a piece of solid food than on mashed up food. There is therefore no reason that your child should be more likely to choke with BLW, as long as you follow our Basic BLW Guidelines.


References:

Carruth, B.R and Skinner, J.D., 'Feeding behaviors and other motor development in healthy children (2-24 months)', Journal of the American College of Nutrition, 2002, Volume 21, Issue 2, pp.88-96.

Cameron, S.L., Heath, A.L., and Taylor R.W., 'Healthcare professionals' and mothers knowledge of, attitudes to and experiences with baby-led weaning: A context analysis study', BMJ Open, 2012, Volume 2, Issue 6, p.E001542.