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Gagging & Choking

Posted by felicity Saturday, October 25, 2014

Many parents are drawn to the idea of serving-up purees and put-off introducing solid food to their children because they are concerned about gagging or choking. If you choose to offer your child purees then we support your decision, but we hear many parents making that decision without accurate information. We are all about empowering you to make an informed decision, so we recommend you arm yourself with the facts and make your own decision based on what's right for your family.
Gagging and choking are different.
Gagging is a normal part ofexploring food and
choking requires urgent medical attention.
The Gag Reflex
Whilst your baby is working out how to eat he may occasionally gag and vomit. The gag reflex is there to prevent things being swallowed which ought not to be. In younger babies the gag reflex ‘trigger zone’ is a lot further forward in the mouth than 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 natural that spoons, little fingers and first foods will trigger this reflex and so gagging is likely to occur in early weaning.
The gag reflex in adults is often triggered as a way of trying to induce voluntary vomiting (‘sticking your fingers down your throat’). The reflex is quite far back (roughly the length of your index finger) but it took practice for that reflex ‘trigger zone’ to recede all that way and your baby is working on that through weaning.
It also takes practice to figure out how to move the food with the tongue to the back of the mouth and co-ordinate tiny muscles to swallow and your child will make mistakes. But that’s how we learn. Eventually they will work out how to get the right-sized food to the correct part of their mouth and it will get easier to co-ordinate all of those muscles. 

Trigger Zones
Avoid offering food to your child when she’s lying back in a car seat or bouncer.  To ensure the gag reflex is triggered, your little one needs to be sitting upright so when food does hit the trigger zone it can be moved forward either to be chewed some more or spat out.
Choking is another matter entirely and involves the airway itself being (partially) blocked – so the food is now beyond the gag reflex. There is no reason that your child should be more likely to choke with BLW, so long as you follow the basic guidelines.

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 Nurition, 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 content analysis study', BMJ Open, 2012, Volume 2, Issue 6, p.E001542.


Read more about introducing solids and other ways to support your child with their eating in our latest evidence-based book Worry-free Weaning.

Dr Anna Walton is a chartered counselling psychologist and Felicity Bertin is a registered paediatric osteopath. They work together supporting families with children who have fussy eating habits.