One of the most frightening moments of my life involved a choking incident when my son was a baby. I was in the kitchen and heard a strange noise coming from the living room. I entered the room to find my child red-faced and clearly in distress but unable to cry. He was choking.
Thankfully, I had completed infant first aid training, so I knew how to place him over my lap and apply some hard thrusts between his shoulder blades. After several hard slaps, a coin came shooting out of his mouth, and he immediately began gulping in air. The whole experience was horrible, but I’m so thankful that I knew what to do. Having a good understanding of what gagging and choking are will help you recognize when there is cause for concern so that you can act quickly if you ever need to.
What is the gag reflex?
Gagging is basically the opposite of swallowing. It’s a reflex that occurs in the back of the mouth, activated when the body senses a need to protect itself from swallowing something it shouldn’t.
When a person gags, there are muscles at the back of the mouth that shut off the entry to the throat. It’s interesting to know that the baby gag reflex is further to the front of the mouth than in older children or adults. In infancy, a touch to the midsection of the tongue triggers gagging, but this gradually moves back in the mouth from 4-6 months. By around 9 months, gagging will be triggered by touch to the back section of the tongue rather than farther forward. This means that babies have a hypersensitive gag reflex that will decrease in sensitivity as they grow.
The tongue thrust reflex is present at birth and is stimulated with touch to the lips or tongue, causing it to stick, gag, or push out the first spoonfuls of food at the start of weaning—a sign that your baby isn’t quite ready for solids. Along with the gag reflex, it lets the baby expel any solid food if they’re not ready for it. The tongue thrust reflex (or extrusion reflex) is usually present until 4-6 months, after which it gradually fades.
Is gagging a problem for babies?
In most cases, gagging is considered completely normal in children under the age of 4.
Why do babies gag? Babies and young children are prone to gagging as a biological response to protect them from choking. We all know that babies and young children are very sensory-orientated, so it’s normal for a baby to put objects in their mouth as they explore and learn about the world around them.
As a baby grows older, the gag reflex becomes less sensitive. By the time the child is 4 years old, they have usually outgrown the more sensitive gag reflex that babies are blessed with.
Baby gagging vs. choking
When parents begin to introduce their baby to solid food, a common concern is the threat of choking. While it’s a very real and valid concern, it can be easy to confuse gagging with choking and then experience anxiety about giving your baby any kind of solid food.
Firstly, it’s important to know that your baby’s gag reflex is there to protect them and serves as a defense mechanism against choking. Coughing, gagging, and spitting out food are common occurrences when babies are being weaned and introduced to solid foods, so you need to give your child time to work through this on their own. Gagging isn’t usually cause for alarm and, in general, it isn’t a source of distress for a child.
Choking occurs when an object or piece of food partially or completely blocks the windpipe. If your baby or child is choking, you need to intervene immediately and dislodge the object.
How do you know if a baby is choking? Some of the signs include:
- Choking noises
- Rattling breathing sounds
- No breathing
- Turning blue
- Loss of consciousness
If you observe your baby doing any of these things, you should act immediately. If you’re still feeling unsure about the differences between gagging and choking, check out the following clip:
How to help a choking baby
If you think that your baby is choking, the recommended first aid practice involves applying a series of back blows and chest thrusts to help dislodge the object. Unless you can clearly see it, avoid using your fingers to remove the object as you risk inadvertently pushing it further into the throat. If the baby or child becomes unconscious, you should commence CPR and call for an ambulance immediately.
It’s a great idea for all parents to attend CPR and first aid classes to learn what to do in this kind of emergency. While everyone hopes they’ll never have to deal with a child choking, knowing what to do could save your baby’s life. You can find some detailed information about how to respond to a choking baby here.
Choking risks for babies and toddlers
Any object that could get caught in a child’s throat and block their airway is considered a choking hazard. Food is a common one, especially for babies who aren’t yet able to chew their food very well before swallowing. The foods considered the most hazardous are those that are round and hard, like grapes, nuts, and candy. Other foods are dangerous because they could potentially be inhaled, for example, popcorn. Basically, any food that is small and firm is a potential choking hazard.
There are also many objects around the home that can pose a choking hazard, such as buttons, beads, marbles, the tops of ball point pens, and the polystyrene balls found in bean bags and toys. Many toys have small parts that can break off and become a choking hazard; popped or uninflated balloons are particularly dangerous.
How can I prevent choking?
Cutting food into pieces no bigger than half an inch will make it far safer for your baby. It’s also important to teach your child that they should be sitting down to eat. It’s also best to avoid feeding children in the car because those under the age of 4 should always be adequately supervised when eating.
Cooking hard vegetables and fruits (such as carrots, apples, and pears) will make them much safer for your baby or toddler. Meat should be minced or cut into small pieces after all bones have been removed. Also, never leave your baby propped up to drink from their bottle.
One of the most dangerous times for a baby in terms of choking is when they become mobile. As a baby begins to crawl or walk, they have greater access to various objects around them. Since babies and toddlers are built to explore, they will discover all kinds of interesting things, often placing them into their mouths as a natural part of their sensory development. Baby proofing is important for preventing choking incidents at home.
If you are unsure whether or not something is a potential choking hazard for your baby or young child, you might like to consider purchasing a Safety 1st Small Object Choking Tester. This simple yet effective tool allows you to test the safety of small toys, toy parts, and other small objects, and it has been designed by the Consumer Product Safety Commission.
Knowing how to respond to choking and gagging is important for every parent. Understanding what is and isn’t normal will help parents recognize when a situation has become serious and then act quickly. Any kind of medical emergency can be frightening, but a choking baby can be terrifying. I know for sure that I’ll always be grateful for the first aid training that proved vital when my baby was choking.