Baby or Toddler Gagging on Food? When to Worry

Your baby might exercise their gag reflex when starting solids, especially if you choose to do baby led weaning. Most times, gagging on food isn't anything to be concerned about. Here's what parents need to know, and when to be concerned.

Why is my 2-year-old suddenly gagging on food?

Most of this article is about babies who are new to solids. If your toddler has been eating well and suddenly starts gagging, the cause is sometimes simple. The bite may be too big, the food may be tougher than they're used to, or they may be eating on the move. Have your child sit down for meals and snacks, cut food into pieces no bigger than about half an inch, and stay with them while they eat.

A sore throat or swollen tonsils can also make swallowing uncomfortable. Young children often don't complain about a sore throat, so turning down favorite foods may be the only clue. Call your pediatrician if the gagging keeps happening or your child seems to have trouble swallowing.

When swallowing trouble starts suddenly in a healthy child, something may be stuck in the food pipe (esophagus). Get medical help right away if:

• you think your child swallowed an object, such as a coin, a small toy or a button battery
  
• your child choked and still has a cough, drooling, gagging, or trouble swallowing or breathing afterward
• your child has great trouble swallowing liquids or their own spit

Call 911 if your child can't breathe, can't cry or make any sound, or is turning blue.

What is gagging in babies? 

You might notice a baby gag naturally on new foods. Gagging occurs frequently during a baby's food journey.

Most babies gag during the eating experience as they explore food. When food enters a baby's mouth, it takes time to explore the new tastes and textures. Gagging doesn't necessarily mean your baby has too much food in their mouth, or they are choking - they are just learning to chew properly.

Although not all babies gag on solid food, it is very common.

Is it normal for babies to have very sensitive gag reflexes?

The gag reflex can help an infant learn to move food forward in their mouth and prevent choking. An infant's very sensitive gag reflex can help an infant learn to chew and swallow solid foods. Although it can be nerve-wracking to watch, some gagging is normal when a baby begins to eat solid foods.

Gagging helps babies learn to eat solids.

Typically, a baby's gagging is nothing to worry about. Babies learn to eat and chew by experimenting with bites of food, and sometimes this causes gagging.

The gag reflex allows a baby to push food forward in their mouth, especially when they accidentally try to chew pieces of food that are too large for swallowing. Experimenting with textured foods and soft foods helps build a baby's confidence in taking bites of food, chewing, and swallowing.

Put simply, gagging is the body's natural protective reflex to prevent choking.

Babies doing baby-led weaning may gag more at first, then less later.

When babies learn to eat by having thin, watery puréed food or baby food pouches, their tongue gets less sensory stimulation than babies who do baby-led weaning. While you might see a baby gagging on purees, it is more common for parents who try introducing solid foods through the process of baby-led weaning to see their baby gagging.

All babies are likely to gag when they try finger foods for the first time. When parents introduce solid foods, a baby's brain engages a sort of alarm that tells them something seems "off." Baby self-feeding can help them experience new tastes and textures, it is natural for them to exercise their sensitive gag reflex.

Introducing solid foods is a big milestone, but parents should rest assured that whether they try spoon-feeding or baby self-feeding, their infant will eventually outgrow their sensitive reflex to gag.

Gagging and choking are not the same thing. 

Some gagging is perfectly normal for infants, especially when they start to eat table food. A baby's gag reflex is more sensitive than an adult's. If your baby is gagging when they eat food, it typically isn't cause for concern.

How to tell gagging from choking

Gagging is loud. Your baby may cough or retch, and their face may turn red, though that's harder to see on brown or black skin. Their eyes may water, and they may push their tongue forward or vomit. Stay close and calm and let the gag reflex do its work. Don't reach into your baby's mouth to grab the food.

Choking is quiet. The airway is blocked, so your baby can't cry or breathe properly. On lighter skin the lips may look blue. On brown or black skin, check the gums, the inside of the lips or the fingernails. Choking is an emergency: call 911, or have someone call, and start infant choking first aid right away.

Babies need different choking first aid from older children, and it's best learned hands-on before you ever need it. The American Academy of Pediatrics (AAP) recommends that parents and caregivers take a certified CPR and first aid course. You can find one through the American Red Cross, the American Heart Association or a local hospital. To lower the risk in the first place, see our guide to choking hazards for babies and toddlers.

What qualifies as excessive gagging? 

Gagging is a natural way of protecting your baby's mouth and airways from choking and is completely normal for infants when they experience new tastes, smells, textured foods, and temperatures.

Normal full-term infants will gag on something unfamiliar if it touches the back portion of the tongue. As babies grow, they experience different textures and tastes, and the gag reflex shifts further back in the mouth. Babies not only experience gagging during their solid food journey, but also as they explore with toys and their own fingers.

Some infants will gag with certain foods. Others will always gag when they try new solid foods. Typically, gagging is harmless, and there is no need to be concerned if your baby is gagging.

When to talk to your pediatrician about gagging

Some gagging is expected while your baby learns, and with daily practice most babies gag less. Talk to your pediatrician if it isn't easing over time, or if you notice any of these:

• gagging at most feeds
  
• coughing or choking during or after eating or drinking
  
• a wet or raspy-sounding voice during or after eating
  
• arching or stiffening during feeds
  
• refusing to eat
  
• slow weight gain or weight loss

Your pediatrician can check for a swallowing or feeding problem. If your child needs extra help, speech or occupational therapy can teach feeding techniques that make swallowing easier.

Why frequency of gagging matters: 

Gagging is an uncomfortable experience for newborns, infants, and older babies. Kids who go through frequent gagging are more likely to develop food aversions or have an unpleasant association with eating pureed food, table food, and other complementary foods.

Learning to eat solid foods is a normal part of development, and normal gagging is to be expected. Just like newly walking babies stumble and fall a lot, they are experiencing the developmental process of learning a new skill. Eating is the same way - the first few weeks and months of eating solid food is a time when babies work to use their oral motor skills to practice chewing, taking baby bites, and swallowing properly.

Excessive gagging might lead to food aversions or resistance to eating regular food. Starting solids is a big milestone, and not all babies are ready at the same months of age. It is important for parents to consult with their child's pediatrician about the optimal time for starting solids.

Is vomiting with gagging normal? 

Yes, occasional spitting up or vomiting when eating solid foods is normal. Some babies are just more sensitive and more forceful with their reflexes. If your baby gags and then throws up often, try to give them soft foods that are less likely to trigger their reflex. Good "first foods" include pears, bananas, sweet potatoes, and squash.

When vomiting with gagging may be concerning

If older babies continue to gag and vomit when eating solid food, it might be time to consult a doctor who can recommend feeding therapy. Mealtimes should be fun, not stressful, for infants as they learn to eat new foods! Vomiting can be a sign of a developmental issue or even an allergic reaction. If vomiting comes with trouble breathing or swallowing, or swelling of the lips or tongue, call 911. These can be signs of a severe allergic reaction.

Some babies gag on food going up. 

Some babies have gastroesophageal reflux (GER), which is when the stomach contents rise up into the throat, which can cause pain and vomiting.

GER often occurs during mealtime but can be seen throughout the day, especially when a baby is lying down or in a reclined position. Spitting up is common in babies, and most full-term babies outgrow it by 9 to 12 months. Call your pediatrician if your baby refuses feeds, cries or arches during feeds, isn't gaining weight, or has spit-up that is forceful, green or bloody.

Symptoms of GER include:

• Arching the back when eating

• Choking, gagging, or issues swallowing

• Irritability when eating

• Refusing to eat or loss of appetite

Using the KeaBabies silicone suction plates 

One of the best investments you can purchase when your baby starts eating finger foods is the KeaBabies Prep Silicone Suction Plates. These durable, beautiful plates come in 3-packs and many colors.

These plates are perfect for babies who eat finger foods. They are made of non-toxic, 100% food-grade materials and are even dishwasher-safe. They have a non-slip grip through 4 suction cups on the base, so your little one can't lift the plate and make a huge mess. The plates fit most high chairs' shapes and are easy to use.

These safe, stain-resistant plates are freezer-safe, microwave-safe, and dishwasher-safe. They were designed with parents in mind, to make their baby's food journey easier.

The plates are ideal for infants to practice self-feeding and feature modern designs and a variety of colors to suit all styles! 

How can I help my baby gag less?

Parents can help their baby work through the difficulty of eating textured finger foods and solid foods by being patient. Gagging usually eases with practice, and most times, parents don't need to worry as long as they are serving foods in safe, healthy ways.

Gagging on food is a normal part of learning to eat solids. Excessive gagging can be a sign of more intense health issues, but typically, parents do not need to worry.

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Meet Our KeaMommy Contributor: Kaitlyn Torrez I’m Kaitlyn Torrez, from the San Francisco Bay Area. I live with my husband and two children, Roman and Logan. I’m a former preschool teacher, currently enjoying being a stay at home mom. I love all things writing, coffee, and chocolate. In my free time, I enjoy reading, blogging, and working out.