Gagging vs. Choking
Gagging is a normal, protective reflex that helps babies learn to eat solids, but it's often mistaken for choking. Here's how to tell them apart, what to do when baby gags, and how to keep mealtimes safe.
Key Points
Gagging is normal when starting solids
A baby’s gag reflex is sensitive for a reason: it contracts the throat and briefly closes the airway to push food forward, acting as the body's built-in safeguard against choking.
Choking looks different from gagging
Gagging is often loud and active, with coughing, retching, and a flushed face. Choking is typically silent with difficulty breathing and skin color changes around the mouth.
Get trained in infant rescue before starting solids
Gagging is normal as babies learn to eat new textures, and there is no need to intervene when it happens. Choking, on the other hand, is an emergency and you need to take action quickly.
It is normal for babies to gag when starting solids, and typically, gagging is not a cause for concern. Choking, however, is an emergency that requires immediate medical care. Our pediatric pros explain the difference—and how to safely respond.
What is gagging?
Gagging happens instinctively when food is in the mouth and the brain doesn’t think it should be there. It can also happen when the tongue loses control of food. Gagging is the brain’s way of saying, “Something isn’t right here. I don’t want to choke on it.”
Gagging is protective reflex that helps prevent choking. When the gag reflex kicks in, the throat contracts to help push food forward and stops the body from swallowing it. At the same time, the breathing tube closes briefly to prevent anything from going into it.
Gagging is part of learning how to eat real food. All babies gag as they start solids, whether they begin with purees or finger food. With consistent opportunities to practice eating a variety of textures, babies gag less over time.
What is the difference between choking and gagging?
Choking happens when the airway is blocked, and the body has trouble breathing. Gagging is often misinterpreted as choking. It’s not uncommon to hear an adult say, “Baby was choking!” when actually, baby was coughing or retching and still able to breathe.
Gagging | Choking |
|---|---|
retching, and sometimes vomiting | inability to cry or cough |
coughing | difficulty breathing |
crying | skin tugging into the chest |
open mouth | look of terror |
cupped tongue | high-pitched sounds |
red or purple color of the face | skin color changes, typically around the mouth (blue, purple, or ashen-like) |
Choking is generally silent because the airway is blocked. Choking is a life-threatening emergency that requires immediate intervention.
If you suspect baby is choking, use a speaker phone to call 9-1-1 or local emergency services. This way, your hands are free to perform infant rescue. If another adult is present, one of you should immediately perform infant rescue while the other calls for help.
What to do if baby gags?
Gagging is not an emergency. When we gag, we hold our breath, and the airway briefly closes. This prevents vomit from entering the breathing tube when gagging causes the body to throw up. Sometimes gagging looks like breathlessness, but observe closely: you’ll notice baby takes a breath in-between gags or after gagging.
Do not stick your finger in baby’s mouth when they are gagging. This can push food further into the mouth and increase the risk of choking.
When gagging happens, take a deep breath and let baby push food forward on their own. If baby is having difficulty gagging food, kneel next to them so they look down at you (this lets gravity do its work) and offer gentle, calming words. See our article, How to Help Baby Gagging on Solids for more tips.
Baby gagging on food is normal
A baby’s gag reflex is sensitive, and easily activated by toys, their hands, and food.[1] [2] [3] When a baby with no chewing skills puts a piece of food in the mouth, and that food moves in unexpected ways, gagging helps baby safely push food out of the mouth. This is part of learning how to eat. When something new is introduced in the mouth, the brain works to figure out what it is and how to move it around the inside of the mouth. When mistakes happen, the gag reflex is there for protection.
Gagging is not a sign that baby is not ready for solid food, or a signal that you should stop offering solid food. Gagging helps baby push the food away from the throat and lets them try again. Every time a baby gags, they are building skills to safely eat real food. For more information, see our article, How Babies Learn to Chew.
For Households with Multiple Caregivers
In many families, grandparents, aunts and uncles, and other family members share in daily caregiving. Some may have been taught to respond to gagging in other ways. For example, they may share outdated advice that it helps to pat firmly on the back, to sweep the mouth with a finger, or to stop offering solid foods after a single gag.
Their opinions come from a place of love and concern for baby’s wellbeing. We share the latest evidence-based guidance, not to criticize how anyone was raised, but to help explain the purpose of the gag reflex and how it actually helps protect baby as they learn to eat. Sharing this article and its videos with caregivers can help start a conversation about how gagging is normal and safe. Check out more tips for talking to family about baby-led weaning.
Gagging helps prevent choking
If food is in baby’s mouth and they don’t have good control of it, or food makes its way towards the back of the throat without being chewed, the gag reflex kicks in. When this happens, the throat contracts to help push food forward, and stops the body from swallowing. Baby naturally opens the mouth when gagging, many times, leading to the food coming out of the mouth. While this is happening, the breathing tube quickly closes as extra protection. Gagging is a natural response that is designed to keep food (and objects that baby picks up and puts in the mouth) from entering the breathing tube.
Some food textures lead to less gagging
If you would like to help baby build chewing skills while minimizing gagging, offer food teethers or fibrous foods like a large broccoli floret. These foods tend to cause less gagging because they don't scatter in the mouth. Instead, they hold their shape while firmly touching the tongue and insides of the mouth. This touch communicates information to the brain that helps baby learn. Babies who start with finger foods tend to gag more in the beginning and less later on as they learn how to move the food around in the mouth.
Some foods make babies gag more easily. This includes foods that scatter in the mouth, like rice or other grains, and soft, mushy foods like ripe avocado and soft banana, which can stick to the tongue or the roof of the mouth and make baby gag while they learn to use their tongue to move it. The same thing can happen with atole and other corn porridges, congee and rice porridge, fufu and ugali, khichdi, and many other traditional first foods worldwide.
While this experience is helpful for learning how to manage these textures, it can be hard to observe. Some families choose to puree these foods to minimize gagging; however, babies who are spoon-fed purees tend to gag more later on when they start exploring finger foods.
See our article How to Help Baby Gagging on Solids for more information.
Let baby practice feeding themselves
One of the most important ways to decrease the risk of choking is to let a baby feed themselves. This way, baby sees, smells, and touches food as they bring it toward the mouth. These senses signal to the brain to prepare the body to bite, chew, and move the food around in a controlled way to swallow.
When food is placed in the mouth by another person, the tongue is not ready to coordinate the movements needed to safely move the food around. Tricking a baby to open their mouth or forcing food in their mouth increases risk in the same way. The research is clear that placing food in a baby’s mouth increases the risk of choking.[4] [5] [6]
See our article What Is Baby-Led Weaning? for more information about the safety benefits of self-feeding.
While a serious choking incident is rare, it can happen
Take these steps to help prevent baby choking:
Only introduce solid foods when you see all signs baby is ready.
Create a safe eating environment when offering solid foods to baby.
Make sure baby is seated, properly positioned, and supervised when eating.
Learn how babies learn to chew real food.
Let baby feed themselves and never place food in baby’s mouth.
Offer safe food shapes and sizes for baby’s developmental ability.
Regularly offer foods to build chewing skills so baby can practice.
Regularly check the floor (and other surfaces where baby spends time) and remove small objects that baby can grab and put in the mouth.
Get trained in choking first aid in the unlikely event of an emergency.
Be prepared in case of an emergency
One of the most important things you can do to protect your baby is get trained in rescue procedures. Some resources:
Our Infant Rescue Guide and Toddler Rescue Guide include visual pictures and step-by-step instructions on how to perform choking rescue maneuvers.
When to seek help
Speak with your pediatrician and ask for a referral to a feeding and swallowing specialist if:
Baby continues to gag at most meals after 2 to 3 weeks of purees.
Baby continues to gag at most meals after 1 to 2 months of finger foods.
Baby is consistently upset after gagging (regular crying, tantrums, vomiting).
Baby is vomiting at most meals, even on an empty stomach.
This article is for informational purposes only, and it is not a substitute for professional advice from or consultation with a pediatric healthcare professional. This information has been created with typically developing infants and children in mind. If your child has underlying medical or developmental differences, discuss your child's feeding plan with their primary medical provider. Please review our Terms and Conditions of Use.
Frequently Asked Questions
Gagging is often loud and active—you'll notice coughing, retching, or crying, and baby's face may look flushed. Gagging can also be more quiet, but you’ll see a cupped tongue.
Choking is typically silent because the airway is blocked. Baby may be unable to cry or cough, and they may look terrified and show signs of difficulty breathing like skin tugging at the chest. Their skin around the mouth may turn blue, purple, or ashen.
If you think baby is choking, use a speaker phone to call emergency services. This way, your hands are free to perform infant rescue.
Most babies have a sensitive gag reflex, and that’s good. It protects them as they learn how to move food around in the mouth. Regular practice with a variety of textures leads to less gagging. One way to help baby build chewing skills while minimizing gagging is to let them practice with food teethers like an asparagus spear, corn on the cob, a mango pit, or watermelon rind.
If baby’s gag reflex is especially sensitive, they are frequently gagging to the point of throwing up, or they seem especially bothered by gagging (crying or difficult to soothe) check out how to help baby gagging on on solids for more tips and strategies.
There's no exact age, but most babies gag less frequently after a few months of regular practice with solids. If they’re still gagging most of the time after a few weeks of practice with a variety of foods, talk to your pediatrician. They may refer you to a feeding specialist for support.
No—gagging is part of learning to eat. It is not a sign to stop offering solid food. Each time baby works through a gag, they're building the oral-motor skills needed to eat safely. Stopping solids or switching only to smooth purees can actually delay the skills they need to eat. Stay calm, let baby push the food forward, and continue offering a variety of textures.
