How to Help Baby Gagging on Solids
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While you should expect gagging when introducing solid foods (gagging helps babies learn to eat), there are ways to help a child move through this stage of development. Our pediatric pros explain how it’s done.
If you are just getting started, check out Gagging vs. Choking for how to safely respond.
Why is baby gagging?
Our bodies have a gag reflex to protect us from choking. Gagging is a normal part of learning how to eat, and at this age, the gag reflex is sensitive for a reason: it helps teach baby how food works in the mouth. It can feel scary to see baby gagging, especially when it happens for the first time, but it is not an emergency. In fact, babies are often not bothered by gagging. When babies gag, they typically move through it and keep going.
Watch Reza, 7 months old, work through a gag with support from Kary Rappaport, Pediatric Feeding/Swallowing Specialist.
How do I help baby stop gagging?
Offer food teethers and stick-shaped foods that are soft enough to be mashed by the gums but firm enough to hold their shape as baby munches– such as cooked green beans or sweet potato wedges. All babies gag as they are introduced to solid foods, whether they are exploring purees, mashes, or finger foods. However, food teethers and stick-shaped foods are better at helping baby move beyond gagging.
Baby can hold food teethers with their hands. This control helps keep food at the front of the mouth because baby can easily put it in and pull it out with their hands.
Baby practices chewing in a low-risk way. Food teethers are resistive enough to not break as baby munches. This texture activates the chewing reflexes so baby can practice chewing without the added pressure to prepare food to swallow.
Baby builds a “mental map” of the mouth. As a food teether touches the inside of the mouth, the brain collects information as baby chews. This awareness of how the mouth works leads to better control of food in the future.
Babies gag less and less as the mental map of the mouth becomes clear, and baby's jaw and tongue coordination grow. Now baby can move food around to be chewed, know when it is thoroughly chewed, move food toward the back of the throat to be swallowed, and spit out food when needed. Check out our article, How Babies Learn to Chew for more about the mental map of the mouth.
Kaia, 5 ½ months old, munches on a mango pit. Mango pits build chewing skills in a low-risk way because babies cannot bite through them and they are very flavorful, which wakes up the senses and activates the chewing reflexes.
Riley, 6 months old, builds a mental map of the mouth by munching on a spare rib with most of the meat removed from the bone.
Cooper, 9 months old, works on a chicken drumstick—another great food teether for helping baby create a mental map of the mouth.
What to do if baby is gagging and throwing up on food?
Elliot, 7 months old, gags on honeydew melon and vomits his milk feed.
As they begin exploring solid foods, baby gagging with vomit can be normal, but it is so hard to observe, especially when it happens the first time. To minimize this reaction, try one or all of these strategies:
Add time between meals. A gag turns to vomit easily when the belly is full, so add in a little more time between a baby’s last nursing session or bottle and their next solid food meal. Go for at least an hour so the stomach has time to digest breast milk or formula.
Take a break from foods that easily cause gagging. Avoid foods that easily scatter in the mouth, such as rice or grains, and mushy foods like ripe avocado and soft banana that easily stick to the tongue or roof of the mouth. These foods are more challenging to manage in the mouth, which can cause strong gagging that may lead to vomit.
Practice with food teethers. Offer lots of opportunities for baby to practice chewing with unbreakable food teethers. While these foods don’t result in much (or any) food in the belly, they are terrific at building chewing skills and the mental map of the mouth, which eventually lead to less gagging. Letting baby mouth fingers, large toys, and baby spoons away from the table can also help soften the gag reflex.
If, after trying these tips for a few weeks to a month, baby continues to forcefully gag and vomit at most meals, it is time to seek help from your pediatrician, who may refer you to a feeding and swallowing specialist.
Kim Grenawitzke, Pediatric Feeding/Swallowing Specialist talks about gagging to the point of vomiting.
Why is baby gagging on pureed food?
Purees are a little thicker and taste different than breast milk and formula, and when they enter the mouth the first few times, baby is likely to gag because this is a new experience in the mouth. With breast milk or formula, babies have learned to move the tongue around a nipple to begin sucking. When a spoonful of puree is dropped on the tongue, baby does not yet know how to move the food toward the back of the mouth, and they have nothing to suck on or push against like the nipple. Eventually gagging on purees slows or stops because babies figure out with just a little practice that the food can be sucked to swallow just like breast milk and formula.
Not all babies who are spoonfed will gag, but many do. Not surprisingly, when a baby is exclusively spoonfed for a prolonged period of time (past 8 months of age, for example), the child may gag more when they start finger foods.
If baby is gagging on purees, try letting baby feed themselves. You can load a spoon and hand it over, or even let baby eat purees off their fingers. Self feeding can better prepare the brain for the texture, and helps to stimulate the tongue to move more to manage the puree.
Max, 4 months, gags on rice cereal.
Levi, 6 months, gags on a vegetable puree.
Jai, 6 months old, gags on a squash purée and mom (rightfully) asks her partner not to intervene.
What if baby gets upset from gagging?
Some babies are more affected by gagging than others. If your baby gets very upset when they gag, know this is normal and you can provide support to help them through this phase.
Remain calm. It may be hard, but try to remain calm–your baby will look to you to see how to interpret this experience. If you look panicked, baby may feel this, too.
Provide support. After baby gags, bring them to your lap and offer cuddles and calm, supportive words like “that was hard for you,” “you’re safe.”
Avoid sticky foods for a while. Avocado, banana, pancakes, soft breads, and other sticky foods tend to cling to the roof of the mouth and/or tongue, which can cause intense gagging.
Practice with food teethers. Unbreakable sticks of food help baby develop the “mental map” of the mouth while desensitizing the gag and building chewing skills.
You can also make sure baby is well supported and properly positioned in their high chair or on your lap at mealtime. Poor trunk control can impact how a baby moves food around in the mouth. If baby continues to gag and frequently gets upset, consider talking to your healthcare provider about a referral to a feeding and swallowing specialist for an evaluation.
Written By
J. Longbottom, MS, CCC-SLP, CLC, Pediatric Feeding/Swallowing Specialist
K. Grenawitzke, OTD, OTR/L, SCFES, IBCLC, CNT, Pediatric Feeding/Swallowing Specialist
K. Rappaport, OTR/L, MS, SCFES, IBCLC, Pediatric Feeding/Swallowing Specialist
R. Ruiz, MD, FAAP, CLC. Pediatric Gastroenterologist
M. Suarez, MS, OTR/L, SWC, CLEC, Pediatric Feeding/Swallowing Specialist
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