Safety at Mealtimes for Infants and Toddlers – Gagging v’s Choking

“I’m worried my baby might choke if their food isn’t smooth”

As parents, you may be nervous about introducing solid foods and worried about your little one gagging or choking. We want to support you to feel more confident at mealtimes and provide your with simple steps that you can follow to manage gagging and prevent choking.

 


Gagging

Gagging is something that many families worry about, particularly when introducing new textures and fingers foods. Firstly, just know that gagging is completely normal and can happen quite a lot during weaning. Here is the reason why:

  • Children’s gag reflexes are much more sensitive than ours- it’s quite far forward on their tongue
  • Gagging is actually a safety mechanism to reduce the risk of choking- as the motion of gagging helps to bring food back to the front of the mouth
  • You’ll find that the more exposure and experience your baby has to different textures, the further back the gag reflex becomes on the tongue!
  • That’s also why it’s important to move your baby on to thicker and lumpier textures so they get more confident to bit, chew and swallow.

What you might notice if your little one is gagging on food:

  • Eyes might water
  • Face may go red
  • Tongue moves forward (or out of their mouth)
  • You may hear coughing and spluttering
  • They might bring the food forward in their mouth — they might make a retching movement, or they may vomit.

What should I do if my baby gags when eating?

  • If your baby does cough or gag when eating, it’s important that you stay calm and reassure them
  • More often than not, your baby will carry on eating, but if they become upset don’t force them to carry on and simply try again at the next mealtime
  • Afterwards, give them a smile, some reassurance and a sip of water if needed.

Remember to always stay with your little one while they are eating!

Top Tips

  • To help your baby get used to different textures and tastes quickly, try moving on to mashed and finger foods (from purées or blended) as soon as they’re ready. This helps them learn how to chew, move solid food around their mouth and swallow solid foods.
  • Give your baby a spoon and let them try feeding themselves – you might need to stick a mat under the highchair though!
  • Babies take different amounts of time to get used to lumps, but it’s an important skill they need to learn. Just keep offering them lumpy textures from around 6 to 7 months, and stay with them so you can be sure they are swallowing it safely.

You can get lots more advice and support on introducing solid foods by signing up to one of our FREE Weaning Webinars or taking a read of our FREE e-guide, Feeding your Baby in the First Year


Choking

Choking is something that a lot of parents worry about, but it’s reassuring to understand that it’s very uncommon.

  • We advise parents to always stay with their little ones while they are eating or drinking
  • It’s important to consider the eating environment to ensure children are in a sitting position to allow them to swallow the food safely or spit it out, if required
  • Avoid distractions at mealtimes to support little ones to focus on the texture of the food and to co-ordinate putting it to their mouth to bite or chew and swallow safely
  • It is also important to think about how foods are prepared (see below)
  • Textures of food can develop as children become more confident eaters
  • It’s important to encourage, role model and support children at mealtimes to manage foods safely.

Eating Environment Tips

  • Babies/toddlers should never be left alone at mealtimes when eating and drinking – it is always important to supervise them
  • Ensure babies are ready for the introduction of solid foods. This is usually around the age of 6 months when the following signs are seen together- firstly baby will be able to sit up unaided and hold their head steady, they will be able to coordinate their eyes, hand and mouth meaning they can look at food, pick it up and put it to their mouth and they will be able to swallow food and be less likely to spit the food out. You can find more information on the Start4Life website
  • Ensure baby is in a sitting position in a high chair and strapped in safely at mealtimes. This means they can swallow the food safely and also spit the food out easily if required. Toddlers should also be sitting up well, with their feet on the floor
  • Try not to have any distractions at mealtimes so your child can focus on the food they are eating.

 Food Preparation

Choking can be a cause of injury in young children, mainly because their small airways are more easily obstructed. Follow these tips to reduce the risk of choking:

  • Think about how foods are prepared. For babies, if offering finger foods, it’s important to make sure that foods are cut into soft, manageable strips/ pieces that are easy for little ones to grip, a good guide is to make them about the size of our index fingers in a stick or chip kind of shape, finger food should be soft, so test to see if the finger food is “squishable” between your thumb and forefinger and just make sure that they don’t contain any pips, stones, tough skin or stringy bits
  • Don’t give pieces of sausage, chunks of meat or cheese- again cut them into small manageable strips
  • Cut round foods such as cherry tomatoes or grapes into small pieces
  • For babies peel the skin off fruit, vegetables and sausages
  • Avoid giving chunks of raw vegetables or fruit- cut them into manageable soft finger foods pieces
  • Remove bones from meat or fish
  • Avoid giving hard foods such as whole nuts and hard sweets
  • Avoid sticky foods such as marshmallows and raw jelly cubes
  • Foods (such as cereal or rusks) should never be added to a baby’s bottle as this can cause choking.

Some families, just to give them a little bit more confidence, like to take a short paediatric first aid course. The NHS and Red Cross also have some helpful videos to find out more.

Leave a Comment