Choking vs. gagging: What parents need to know when introducing solid foods to children Children's Wisconsin
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Tips Mar 18, 2024

Choking vs. gagging: What parents need to know when introducing solid foods to children

Patrick Lehman, MD, Pediatrician Mar 18, 2024 4 minute read

Navigating the world of parenting can be equally rewarding and challenging. A common struggle for parents of young children is transitioning from breast milk or formula to solid foods. This significant milestone for babies is also often met with a fair amount of parental anxiety. 

Pediatricians recommend that parents introduce solids to their babies around 6 months old. But before your child takes that first bite, there are a few things parents should know.

Starter foods

Since your baby's chewing and swallowing abilities are still developing, you'll want to start with soft foods, like:

  • Avocados

  • Bananas

  • Unsweetened apple sauce

  • Well-cooked sweet potatoes

  • Infant cereal

You can feed your baby with a spoon or give them larger chunks of food and let them explore and feed themselves through baby-led weaning. The one thing you want to remember is to avoid serving foods with added salt or sugar.

There is no need to stress how much solid fold your child eats at 6 months, as they should still receive all their required calories from breastfeeding or formula. Also, just because your baby didn’t appear to like a particular food the first few times, they tried it doesn’t mean they won’t like it in the future. In fact, some children need to try food 10 to 15 times before they start to enjoy it.

Allergy concerns

As you continue introducing new foods, allergies can become a cause for concern. For this reason, start one new food every few days. If your child is allergic to a particular food, trying multiple foods for the first time may make it difficult to know which food caused an allergy.

Some children, like those with a moderate to severe eczema or an egg allergy, may be at higher risk of peanut allergies. If your child falls in this category, they could benefit from starting peanuts at a younger age (4-6 months old). If you child is at higher-risk, be sure to talk to their pediatrician before trying foods with peanuts for the first time.

Children who don't have risk factors can begin more common "allergic foods" whenever parents feel comfortable. Newer evidence may point to starting eggs and peanut butter for all children before 11 months old

If an allergic reaction does occur, it will typically develop within 10-15 minutes. Some signs of an allergic reaction include:

  • A breakout of hives

  • Multiple episodes of vomiting

  • Mild swelling of the lips

If any of these occur, avoid introducing other foods and contact your child's pediatrician. If swelling occurs around your child’s lips or mouth, or if they start wheezing or have difficulty breathing, call 911 immediately.

Choking vs. gagging

The main reason so many parents are nervous about starting solids is the threat of choking that hangs over every bite. But the risk of choking is low if you practice safe eating — baby sitting upright in a highchair, pureed or well-cooked fruits and vegetables cut into appropriate sizes.

A common source of anxiety for parents is confusing gagging with choking. While it certainly can be alarming, rest assured your child's gag reflex is their body's natural defense against choking. When you start feeding solids around 6 months, your child's gag reflex is farther forward in the mouth — it'll move back in the throat as they age. Because of that, coughing, gagging and expelling food are expected during the first few months of solids.

If your baby starts to cough or gag, give them time to work through it independently. Don't try to remove the food with your fingers initially, as you risk pushing it farther back and causing it to get lodged in their throat. In extreme cases, your baby might vomit. Again, this is a perfectly normal and is an instinctual defense against choking.

Gagging involves a lot of coughing and gurgling, while choking is a whole other story. Choking occurs when a piece of food has wholly or partially blocked the windpipe, obstructing breathing. This can cause high-pitched sounds while breathing or may even be silent. If this occurs, you need to intervene immediately.

CPR and first aid

If you suspect your baby is choking, a series of back blows alternating with chest thrusts may help to dislodge the object from the throat. Only remove the object from the mouth if you can see it. "Blind sweeps" can push the food or object further back in the throat. If your child loses consciousness, do CPR and call 911.

Preparing for the worst-case scenario pays dividends during an unlikely crisis. Caregivers are encouraged to take CPR and first aid classes regardless of their child's age. It's one of those things you hope you'll never have to use, but if a situation ever arises, you'll be thankful you know the proper life-saving techniques.

And since the CPR techniques depend on your child's age or development, you'll want to refresh your training every few years. The American Heart Association and Red Cross offer CPR and first aid training courses throughout the state. While there is a cost, it's a small price for peace of mind.

Enjoy the journey, but stay educated

While it might take a little practice, remember that eating is natural. For this reason, try to remain calm and confident as your child learns the essential life skills. Above all, enjoy every messy and giggly moment with your little one as they embark on learning how to eat solids. 

Children's Wisconsin Resources

Children’s Wisconsin has more than 20 primary care offices conveniently located throughout the Milwaukee area and southeast Wisconsin. Find a pediatrician near you. View more articles from Patrick Lehman, MD

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