Gagging or Choking : How to spot the difference when introducing solids

By Kristy Webb, BSc NutrSci

Starting solids is an important milestone for parents and babies, and it’s one I love having the opportunity to help with.

As a registered dietitian, I love food—eating it, talking about it, making it—and I love helping tiny humans develop their love for food almost as much!

Food is fun for babies, and watching them experiment with it is a great experience: the silly faces they make when trying a new flavour, the way they make a complete mess of themselves (and usually your floors!) … It’s new and exciting and a great time of learning for baby.

Alas, it is not all fun and games. With new foods and new textures often come new worries as well. I can’t even count the number of times I’ve spoken with moms who are panicked because their baby has choked on their food or seems to gag on all new textures—it can be stressful!

I like to approach this situation with a conversation about the difference between choking and gagging and how to react in each situation. Most babies gag on food at some point. This is actually a good thing, so don’t panic! Gagging is a protective mechanism that allows baby to experiment and fine-tune the coordination needed for mature eating. Although it may look alarming, it is not dangerous, nor does it mean your baby is rejecting the food.

Sometimes gagging can look a lot like choking. Here’s how to spot the difference:

If baby is red-faced and making noise they are likely gagging and are just fine.

Making noise means they are getting air. Stay calm, give a few gentle pats on the back and let them work it out.

Overreacting (jumping up, yanking baby from their high chair) can actually have a negative impact on baby in two ways:

1. When parents panic, babies follow suit. This makes eating a scary experience and can lead to baby developing a negative association with food. You do not want this.
2. Grabbing baby in a panic can cause the food to be knocked further down baby’s throat and induce actual choking.

If baby is white-faced and silent, this is an all hands on deck emergency!

Now is when you break out those skills you learned in your infant CPR class. (I always recommend taking one or at least checking out the technique in a YouTube video—there are many good ones available.)

What makes choking so scary is the silence. Never leave baby unattended while eating because you won’t be alerted in any way if they are truly choking.

Thankfully, if babies are given age appropriate foods, true choking is relatively rare and not something you should stay up at night worrying about as long as you follow some general safety guidelines:

• Always supervise your children while they are eating. This also means not letting them eat in the car.
• Be aware of your child’s chewing and swallowing skills. Are they typically fairly coordinated?
• Do not allow older kids to run and play during mealtimes. Food should be consumed while sitting still!
• Avoid offering foods that are likely to cause choking, e.g., anything small, round, hard or sticky. Chop grapes and remove pits from fruits. Avoid offering things like peanut butter on a spoon—a thinly spread layer on a cracker is safer.
• Know the foods that are not recommended for children younger than 4 years: hard candies or cough drops, gum, popcorn, marshmallows, peanuts or other nuts, seeds, fish with bones and snacks using toothpicks or skewers.

Also noteworthy: the food most commonly associated with fatal choking is the hot dog. Slice those bad boys lengthwise!

Keep your kiddos safe, and happy feeding!

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