The fear of choking is the number one concern for new parents during weaning, which explains why they can be left feeling alarmed and on-edge when their baby gags.
It's important for parents to be able to spot the differences between gagging and choking so they can respond confidently and appropriately to each scenario.
We've outlined the differences between both, and what actions should be taken when either situation arises.
Why do babies gag?
Gagging when weaning is very common and completely normal. During weaning, your baby will probably gag a lot! This is because babies have highly sensitive gag reflexes that are triggered very close to the front of their mouths, especially at the start of weaning. The gag reflex will move further back as they get older and they'll gag less.
Gagging occurs because their eating skills and oral muscles aren't developed yet. They don't have the skills to control chewing and moving food to the back of their mouths to swallow, so babies gag to stop food going down the wrong way. The gag reflex is their protective mechanism against choking and is not something to be afraid of!
What should I do if my baby is gagging?
While gagging can be alarming to new parents who are on their first weaning journey, babies aren't usually distressed by this. When a baby gags, he or she will probably push food out of their mouth, and will make retching sounds as though they're going to be sick (and usually, they aren't actually sick!).
If this happens try not to panic, and remain calm. If you can see that they are gagging (and not choking) it's important to let the process take its natural course. Try to stay calm and encouraging during the mealtime. By doing this you're helping them learn how to use their oral muscles and keeping mealtime a positive experience. A bit of gagging doesn't mean mealtime is over!
How can I tell the difference between gagging and choking?
Choking is when your baby's airway becomes blocked by food or another object, and is very different to gagging. When your baby is choking, they will be unable to cry, cough, breath or make any noise. If your baby is choking you may see their face and lips turn blue (if they have a lighter skin tone), or gums, inside of lips or fingernails may turn blue (if they have a deeper skin tone) - it can be quite frightening to parents.
When gagging, your baby will still be able to cough, make retching noises and may also go red in the face. However, they aren't usually bothered by this and will usually return to eating as normal once the gagging episode is over (usually after 10 seconds or so).
- Airways are clear
- Baby is retching, coughing and can make sounds
- Baby is breathing
- Face is a normal colour or slightly red (if they have a lighter skin tone)
If your baby is gagging, try to stay calm and wait for them to stop. Continue the mealtime after.
- Airways are blocked
- Baby is silent
- Baby is not breathing - chest and ribs may be pulled in as baby struggles to breathe
- Face and lips may turn blue (if they have a lighter skin tone) or gums, inside of lips or fingernails may turn blue (if they have a deeper skin tone)
If your baby is choking, this is a medical emergency. You must start first aid immediately and seek medical help.
What should I do if my baby is choking?
Seeing your baby choking is a very scary scenario for a parent, but a basic understanding of first aid for babies can help parents feel confident in dealing with this situation, if it arises.
If you can see the object that is blocking your baby's airway, you can try and remove it with your finger and thumb to dislodge the blockage. It's important not to poke around with your finger in your baby's mouth incase the object is pushed further into their throat.
If the airways are partially blocked and they are coughing, encourage them to keep coughing as this can help bring up what they're choking on.
If you can't remove the object, then sit down and hold your baby lying face-down along your forearm, supported by your thigh, with their head supported.
Use the heel of your hand to give up to five blows in the middle of their back, between your baby's shoulder blades. Effective back flows usually cure most choking incidents.
If the blockage is not dislodged, and your baby is still unable to breathe, try chest thrusts.
Lay your baby face up on their back and their breastbone. This is where their lowest ribs join in the middle, just below the nipples. Place two fingertips about a finger's width above this spot.
Push sharply downwards to give five chest thrusts (pushes) compressing your baby's chest by about a third. Try to dislodge the object with each thrust. Only do all five if needed.
Repeat the sequence until help arrives
If you've tried back blows and chest thrusts and the object still hasn't dislodged and your baby is still conscious, repeat the sequence of back blows and chest thrusts and call out or send for help if you're on your own.
Get somebody else to call 999 and keep repeating the cycle until help arrives. It's important to get medical help even if the object comes out, as part of it may have been left behind or your child may be affected by the procedure.
If your baby becomes unconscious from choking, put them on a firm, flat surface, shout for help and call 999 on speakerphone so your hands are free. Open your child's mouth. If the object is clearly visible then remove it, and start performing CPR.
What can I do to prevent choking?
There is no evidence to suggest that BLW has a higher risk of choking than spoon-fed weaning. However, it's important to remember to cut and serve foods appropriately for your child's stage of development to reduce the risk of choking.
We've outlined How To Cut Foods Safely for Baby-Led Weaning in one of our recent blogs which we encourage parents to read this.
You can also download our Free Weaning Guide which contains lots of great tips, including weaning safety advice and foods to avoid giving weaning babies.
Sometimes medical emergencies occur no matter how many precautions you take to prevent them, so it's also a good idea to attend a baby first aid course so you're prepared for this possibility. They are available online and in-person across the UK by the British Red Cross, St John's Ambulance and NCT. Both the NHS and the British Red Cross also have baby first aid apps available to download, so advice is always easily accessible and to hand.
It's very important for parents to recognise the difference between gagging and choking and the different ways each scenario should be treated.
Remember that gagging is a normal reaction that weaning babies have as their gag reflex is triggered while learning to eat. Choking is when their airway gets blocked, and requires immediate first aid and medical attention.
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