The lifelong automatic response that helps prevent choking is called the gag reflex. Everyone has this reflex, however it may be more sensitive in some than others. When you gag, two different parts at the back of your mouth work to close off entry to your throat: Your pharynx contracts, and your larynx pushes up. This is a defense mechanism to prevent something from being swallowed and ingested. Gagging is often accompanied by abdominal muscle spasms and a feeling of nausea. Gagging is normal for babies as they learn to eat. Gagging brings food forward into your baby's mouth to help them learn how to chew.
It can be alarming when your baby gags on food, but it's part of the normal process of learning to eat. From birth to about 9 months, the gag reflex is actually triggered closer to the front of the mouth. Gagging might be more common when first starting solids and lessen once your baby gets older (around 9 to 12 months), when the gag reflex moves more to the back of the mouth. It is best to check with your pediatrician to be sure that your baby is ready for solid food before you introduce it. Some indicators that a child is ready include being about 6 months old, able to sit upright, has good head control, grasps, and shows an interest in food. Gagging is part of the learning process but if a child continues to gag or push food out of their mouth with their tongue after a week, they may not be ready. It is always best to consult with a pediatrician.
It is important to remember that gagging is different from choking. A child who is gagging may push their tongue forward or out of their mouth and do a retching movement to try to bring food forward. Their eyes may water. They may cough or even vomit. This means their airway isn't completely blocked. Coughing can usually effectively clear their airway. A child who is choking is unable to talk, cry, or cough because their airway is blocked. They may gasp, wheeze, or make no sound at all while opening their mouth. A choking child will require a first aid response.
When is gagging considered to no longer be typical and part of the process? Gagging at the sight, smell, touch, or taste of foods is no longer related to the mechanics of eating. It can be an indicator that there are sensory issues when it comes to food. Gagging can also be a learned behavior that may have started from either a sensitivity to sensory input or difficulty chewing or swallowing food at some point. Gagging may also be observed when food is not present, but instead may be triggered by sight, smell, and touch/texture that a child may find offensive. These behaviors are atypical and can be problematic.
Concerns about gagging are best to be discussed with a professional in order to determine the cause and identify strategies to help the child and improve the situation. Consult with your pediatrician or with a speech language pathologist if you have questions or concerns about your child’s feeding. A speech language pathologist can complete a comprehensive evaluation and create a program to support your child’s feeding needs or refer you to an appropriate specialist. Contact us for more information!