Baby-led weaning is the best approach to mealtimes, but accidents can happen no matter how you feed your baby.
Choking is every parent’s biggest concern during weaning, so it’s understandable when they panic at the sight of their little one gagging during mealtimes. Better safe than sorry, right? The problem is, looking horrified when your baby gags only makes them panic more. If you stay calm when they gag, they won’t learn to associate gagging with fear. At the same time, of course, knowing the signs of choking is paramount—so today I’ve summarised the differences between choking and gagging in babies so you can be present and alert, while only springing into action if you need to.
How to spot the difference between choking and gagging
Choking is when the airway becomes blocked by food or another object. It’s visibly different to gagging. For one thing, your baby won’t be able to cry, cough, or make any noise if they’re choking. For babies of a lighter skin tone, their face and lips may turn blue. For babies of a darker skin tone, their gums and fingernails and the inside of their lips may turn blue.
When your baby gags, on the other hand, they’ll still be able to cough and retch. If they have a lighter skin tone, they may go red in the face. They won’t generally be upset by the experience, and once it’s over (after 10 seconds), they’ll likely be happy to return to eating as normal.
|Airway is blocked
| Airway is clear
|Baby is silent
|Coughing, retching, or other sounds
|Baby is not breathing—their chest and ribs may be pulled in as they struggle to breathe
|Baby is breathing
|Face and lips may turn blue (if they have a lighter skin tone). Gums and fingernails and the inside of the lips may turn blue (if they have a darker skin tone).
|Face is normal colour or slightly red (if they have a lighter skin tone)
Choking is a medical emergency. Start first aid and seek medical help immediately.
What should I do if my baby is choking?
Seeing your baby choking is scary, but a basic understanding of baby first aid can galvanise you to act fast.
- If you can see the object blocking your baby’s airway, try to dislodge it by taking it between your finger and thumb. But don’t poke around with your finger: you might push the obstruction farther into their throat.
- If the airway is partly blocked and they’re coughing, encourage them to keep coughing, as this can bring the obstruction up.
If you can’t remove the obstruction, try back blows:
- Sit down and hold your baby lying facedown along your forearm, supported by your thigh, while supporting their head.
- Use the heel of your hand to give up to five blows in the middle of their back, between the shoulder blades. Effective back blows put an end to most choking incidents.
If back blows don’t work, try chest thrusts:
- Lay your baby face up on their back. Find the point at the breastbone where their lowest ribs join in the middle, just below the nipples. Place two fingers above this spot, one finger’s width apart.
- Push sharply in a downward direction to give up to five chest thrusts (or chest pushes) which compress your baby’s chest by about a third.
If none of these has worked and your baby is conscious, repeat the sequence while continuing to call out or send for help.
Finally, when the obstruction does come out, it’s important to still seek medical help. A part of it may have been left behind, or your baby may have been affected in some other way by the incident.
If your baby becomes unconscious from choking, put them on a firm, flat surface. Shout for help or call 999 on speakerphone so your hands are free. Open your baby’s mouth. If the object is visible, remove it, and start performing CPR.
What can I do to prevent my baby from choking?
Baby-led weaning doesn’t increase the odds of your baby choking compared to spoonfed weaning. That being said, it’s still vital to cut and serve foods appropriate for your child’s stage of development to reduce the risk of choking.
Medical emergencies can happen no matter how many precautions you take, so it’s a fantastic idea to take a baby first aid course. They’re available both online and in person. There are also apps that give you all the information and step-by-step guidance you need at a moment’s notice.
Why do babies gag?
Gagging is normal and nothing to worry about, and you’ll likely see it a lot during weaning, because your baby’s gag reflex is not only highly sensitive, but also triggered close to the front of their mouth. It moves back in the mouth as they get older, and they should start gagging less.
Gagging occurs because your baby’s chewing skills and oral muscles are undeveloped. They can’t control their chewing or move food to the back of their mouth before swallowing, so gagging is simply nature’s way of ensuring food doesn’t go down the wrong way. You can think of the gag reflex as the protective mechanism against choking.
What should I do if my baby is gagging?
Gagging may be alarming to new parents on their first weaning journey, but remember: your baby probably won’t actually be distressed by gagging themselves. They will simply reject the food from their mouth and make retching sounds like they’re going to be sick—but they probably won’t actually vomit. If this happens, stay calm, and let the process take its course. Be soothing and encouraging, but don’t let panic spread over your face. That way you help your baby learn to properly use their oral muscles while keeping mealtime a fun and happy experience. Gagging doesn’t mean dinner has to come to an end!