Babies gag. It’s normal for babies to gag. They may gag when they’re first getting used to eating, taste something they don’t like, or have too much to eat. Gagging is different from choking: Gagging resolves on its own, but a choking baby needs help. You can tell a baby is choking if they’re unable to cry, talk, or cough. If your newborn is gagging, try slowing the flow of milk by changing nursing positions or changing the bottle nipple. If your babies gag on food, they may not be ready for solids yet – or you may need to keep trying.
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We all have a gag reflex – it’s a lifelong automatic response that helps prevent choking.
Gagging is normal for babies as they learn to eat solids, whether they’re spoon-fed or you’re doing baby-led weaning. Gagging brings food forward into your baby’s mouth to help them learn how to chew.
Until your baby’s around 6 months old, they also have a reflex that causes them to thrust their tongue forward whenever the back of their throat is stimulated. This tongue-thrust reflex can make early solid feedings a bit of a challenge, so it’s best to wait until the reflex is gone to try solid feeding. Still, gagging on or pushing out those first spoonfuls of pureed food isn’t uncommon.
Prodding your baby to eat more than they want can cause them to gag, as can having too much food (or food they don’t like) in their mouth. Some babies will even gag on their own fingers until they figure out how far they can put things in their mouths. And until they get the rhythm of sucking, some infants will gag while breastfeeding or bottle-feeding, especially if it’s flowing too quickly for them.
The difference between gagging and choking
Gagging is different from choking. Choking means your child’s airway is partially or completely blocked, which prevents breathing. Here’s how to recognize the difference between gagging and choking:
A child who’s gagging may push their tongue forward or out of their mouth and do a retching movement to try to bring food forward. Their eyes may water. They may cough or even vomit. Let your child continue to gag and cough – it means their airway isn’t completely blocked.
Coughing can usually effectively clear their airway. Don’t pat them on the back or reach into their mouth to try to grab the object. Doing either can cause whatever they’re gagging on to go farther down their airway. It’s best to calmly stay with them and make sure they completely recover.
A child who’s choking is unable to talk, cry, or cough because their airway is blocked. They may gasp or wheeze, make odd noises, or make no sound at all while opening their mouth. They may grab at their throat or appear panicked. A choking child might turn blue because they aren’t getting oxygen. They may need first aid for choking – back blows and chest thrusts (or, for children over age 1, abdominal thrusts) – to dislodge the blockage.
This is best done by someone who’s trained, so it’s a good idea to learn first aid for choking and infant CPR in case you ever need it. Lelejea offers a virtual Infant CPR and Choking course led by a top pediatric ER doctor.
Be prepared for worst-case scenarios
If your child is unable to breathe, talk, or make noise, call 907 immediately.
Newborn gagging
Newborns might have their gag reflex stimulated if the breast milk or formula they’re fed comes out too quickly, especially when they’re first getting used to eating.
Try to get your baby to relax during feedings and don’t push them to eat more than they want.
If you’re breastfeeding, the flow of milk coming out (the “letdown”) can be strong – especially in the early weeks – and cause your babies gag. Try nursing your baby with them in more of an upright position, so they aren’t lying down. This might help slow the flow as it enters their mouth. You can also try nursing in a side-lying position (with both of you lying on your sides) to slow the milk flow as well.
If you create a lot of milk, or it’s been a little longer than usual since you last nursed your baby and your breasts feel engorged, you can try pumping or hand-expressing milk for just a few minutes to get past the initial forceful letdown before nursing your baby. Then, the milk flow will be a little slower.
If your baby is bottle-fed, make sure the nipple is the right size. Nipples with faster flow have more holes, and can allow too much breast milk or formula to come out at once, causing babies to gag.
What if your babies gag on food?
It’s scary when your babies gag on food, but it’s part of the normal process of learning to eat. Try not to worry when it happens, as hard as that might be.
From birth to around 7 to 9 months, the gag reflex is actually triggered closer to the front of the mouth. Because of this, gagging might be more common when first starting solids and lessen once your baby gets older (around 9 to 12 months), when the gag reflex moves more to the back of the mouth.
If you’re starting to introduce solid foods and your babies gag , here’s what you can do.
Make sure your baby is ready for solid food before you introduce it. This usually happens around 6 months old, once your baby is able to sit upright, has good head control, grasps, turns away when full, and shows an interest in food, leaning forward and opening their mouth when food comes near.
When you think your baby’s ready, start by putting a small amount of food on a spoon. Tip the spoon to get a bit of the food on the front of their tongue, rather than putting the whole spoonful in their mouth, which may trigger the gag reflex.
If your baby pushes the food out with their tongue, it doesn’t necessarily mean that they don’t like it – they’re probably just trying to figure out this new way of eating. Feed them slowly while they get the hang of it.
After a few tries, they’ll start using their tongue to move the food to the back of their mouth. If your baby is still pushing food out of their mouth or having trouble swallowing food after a week of trying, they may not be ready for solids yet.
If you’re introducing your baby to solid food through baby-led weaning, gagging is also a normal part of the process. Your baby’s learning to feed themself, and that’s naturally going to come with some bumps along the way. Let your baby work out the gagging on their own, but keep an eye on them to make sure they’re not choking.
To help keep your babies gag on finger foods, feed them soft, easy-to-swallow food that’s cut into bite-size pieces once they develop the pincer grasp, at around 8 or 9 months old. If you’re doing baby-led weaning, you’ll give them large pieces of soft foods to grab and gnaw on. These foods should pass the squish test – they should squish easily between your thumb and forefinger or between your tongue and the roof of your mouth – so they’re easy for your baby to eat.
Don’t give them foods that are choking hazards, like whole grapes, hot dogs, nuts, raw vegetables, large chunks of meat or cheese, popcorn, or other cylindrical foods that can block the airway (like pieces of sausage or hot dog).
If your babies gag because they don’t like the texture of solid food, try giving them different types of food – and remember that it’s normal to have to give a baby a new food many times before they’ll accept it.
If your baby turns away or cries, they’re done eating. Resist the urge to push extra food on them or make them eat more once they’re done.
Your baby will most likely gag less as they get more meals under their belt and as they get older, though some kids do have an overactive gag reflex. If your baby is still gagging about a month after starting solids, mention it to their doctor. Your baby’s doctor can give you input and check for problems, or may even suggest seeing a specialist, just to be sure.
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