Getting Started: Gagging v. Choking

Welcome – we’re excited you’re starting your solids journey with us. Before you jump in and bring your baby to the table for the first time, please read the guide below to learn the difference between gagging and choking – an important lesson as you start.

While gagging can look scary, you’ll likely experience it at some point when transitioning to solids—it is normal and not an emergency. Choking on the other hand, while very rare, is a medical emergency, and you must act fast. 

Gagging

Gagging is what we call a protective reflex. Reflexes are something that happens automatically in response to a sensation. The gag reflex is the body’s way of protecting itself—the breathing tube closes to keep things out, and the swallow reflex is inhibited as the food tube squeezes things upwards. The only direction for things to move is out. 

Gagging happens for many reasons, but oftentimes due to new textures or flavors, or how things move in a baby’s mouth. When a baby gags, you will see an open mouth and cupped tongue, and often, babies will turn red or even a little purple in an intense gag. Some babies make retching sounds, while others are more quiet. It’s often followed by coughing and sometimes throwing up. Gagging is safe, expected, and normal when your baby starts solids.

Choking

True choking is a medical emergency—the breathing tube is blocked, and the baby is having trouble, or can’t breathe at all. Choking is silent or accompanied by wheezing, and if a baby is coughing, they are not choking—coughing means air is flowing through the breathing tube to make the cough happen. 

Signs of a baby choking can include:

• inability to cry

• difficulty breathing or wheezing

• skin tugging into the chest

• look of terror

• high-pitched sounds

• skin color changes (ranging from blue to purple to ashen-like)

Kary Rappaport, Infant Feeding & Swallowing Expert, discusses the differences between gagging and choking.

If you suspect baby is choking, immediately administer infant choking first aid with alternating back blows and chest thrusts and call 9-1-1 or local emergency services on speakerphone so your hands are free.