Hi! I’m Sophie, a New Yorker in London, mother of 2 and founder of Mamamade – we’re a direct-to-consumer brand specialising in infant and toddler nutrition, with a focus on supporting parents. What started from my home kitchen in 2019 is now a community of over 40,000 – all of us sharing the highs and lows and offering a listening ear for everything life throws at us.
Weaning my two children couldn’t have been more different. Whereas my daughter breezed through - easily on 3 meals a day by 7 months - my son showed almost no interest in food until he turned 1.
Arthur was a very ‘gag-y’ baby - almost everything that touched his lips made him gag! - so I know first-hand how stressful it can be trying to figure out when to worry.
Hopefully, the below will help you spot the differences between gagging and choking so that you can respond confidently and appropriately to each scenario.
What’s gagging, and why do babies do it?
You’ve seen it before, most likely - it looks sort of like your baby’s about to vomit. And it is very common - completely normal, especially in the early days of weaning. When first starting on solids, 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.
OK so I shouldn’t worry - but should I do anything if I see my baby gagging?
Trust me, I totally get it. Gagging can be alarming, whether or not it’s your first weaning journey. You might feel reassured to know that babies aren't usually distressed by gagging. 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 try to remain calm. If you can see that they are gagging (and not choking) it's important to let the process take its natural course, as they usually work it out themselves. Try to stay calm and encouraging during 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!
Then what’s choking?
Choking is when your baby's airway becomes blocked by food or another object, and it 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) - and 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).
What should I do if my baby is choking?
There are no two ways around it. If your baby choking, it 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.
Back blows
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.
Chest thrusts
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 offering finger foods (also known as BLW) has a higher risk of choking than spoon-fed weaning. That said, it's still 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.
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.
I hope this has helped you identify the difference between gagging and choking.
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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