Baby Gags So Bad He Throws Up Every Time I Try to Feed Him
Gagging is a natural protective reflex that results in the contraction of the back of the throat to protect us from choking. Just like the reflexive kick that occurs when the physician taps your knee in just the right spot, the gag happens automatically, initiating a rhythmic bottom-up contraction of your pharynx (the tube that leads to your tum) to assist in bringing nutrient up and to terminate the swallowing reflex from making our bodies attempt to swallow.
Just starting solids? Take a look at our virtual grade on starting solids every bit well as our guides and recipes on for the best first foods for infant. And if y'all are struggling with the transition from spoon feeding / purees to self-feeding with table food, sentinel our Spoons to Fingers video.
Notation: This page has been created with typically developing infants and children in mind. The information here is generalized for a broad audience and is for informational purposes only. If your child has underlying medical or developmental differences, including simply not limited to prematurity, developmental filibuster, hypotonia, airway differences, chromosomal abnormalities, craniofacial anomalies, gastrointestinal differences, cardiopulmonary disease, or neurological differences, we strongly recommend you discuss your child's feeding program with the kid'due south doctor, health intendance provider or therapy squad. The opinions, advice, suggestions and data presented in this article on gagging are for advisory purposes only and are not a substitute for professional advice from or consultation with your pediatric medical or health professional.If your kid is having a health emergency, please call 911 or your emergency medical resource provider immediately.
How is choking dissimilar from gagging?
Commencement, information technology is important to distinguish the divergence betwixt gagging and choking.
True choking is when the airway is obstructed, and the infant is having trouble breathing. Signs of a baby choking can include:
- inability to cry
- difficulty breathing
- skin tugging into the breast
- expect of terror
- high-pitched sounds
- skin color changes (ranging from blueish to regal to ashen-like)
If you suspect babe is choking, immediately administer infant choking first aid with alternating dorsum blows and breast thrusts and call 9-1-1 or local emergency services on speakerphone and so your hands are gratuitous. If another person is present, one person should immediately perform choking first aid while the other calls for help. Bear historic period-appropriate CPR if you believe baby'due south airway is open up, but the child is not breathing.
On the other paw, gagging is a common protective reflex that results in the wrinkle of the back of the throat. It is a natural function and protects u.s.a. from choking. When this happens, information technology's of import to let baby work the nutrient forrard on their ain. Refrain from sticking your finger in babe's oral fissure, which can push button the object further down the pharynx, making the state of affairs worse.
We strongly recommend you have a CPR form online or at your local wellness facility and review prophylactic procedures. Our choking, gagging & infant rescue video tin also help yous visualize the divergence. Further resources:
- American Red Cross: Child & Baby CPR
- American Heart Clan: Infant CPR Training Kits
- Harvard Health: Heimlich Maneuver on an Baby
Babies gagging on food is normal
Gagging is a completely normal reflex in infants, children and adults akin. Gagging is very mutual and will happen a lot in babe'southward solid nutrient journeying. All babies gag in their eating journey—it's one way they learn how to eat. The adept news is that babies typically outgrow gagging subsequently a couple of months of practice with various textured foods.
Babies ofttimes gag well before they start solids, when chest or bottle feeding. This typically occurs when baby either isn't properly latched, and the nipple triggers the reflex, or if the baby isn't ready to swallow milk for whatever reason. Some babies gag when mom'southward letdown is too fast. Others gag when they need to catch their jiff instead of swallowing. Many babies volition gag on a pacifier or certain bottle nipples if they aren't familiar with them. All of these gags occur because the brain is trying to protect the infant from swallowing an "intruder," or something the baby isn't ready to swallow. This gag reflex typically lessens over the first few months of baby'southward life when baby gets "desensitized" and learns to accept it (pacifier, nipple, or food texture) without gagging. This occasional gagging at a young historic period does not seem to bother most infants.
Interestingly, the gag reflex of a 6- to ten-month-old baby is much more sensitive and can be triggered more frontward on the tongue than an adult. one 2 This is why babies gag easily: the more forward the gag trigger is on the tongue, the easier information technology is to trigger. three It is not uncommon for babies to gag (and occasionally vomit) for the first few weeks of solids. If baby repeatedly gags and vomits past the first calendar month of starting solids, consult your pediatrician, who may refer you lot to a swallowing specialist.
Watch our video on gagging and all of the other normal, sometimes nervus-wracking things babies do while starting solids.
Gagging helps prevent choking
When the gag reflex is triggered, it forces the back of the throat to close, substantially preventing swallowing. If food acquired infant to gag, the reflex forces the food (or object) forward towards the front of the natural language. Young infants naturally open their lips when they gag, which ways that typically, the food or object that caused the gag keeps moving out of the rima oris.
Gagging is completely normal and incredibly important for baby'south safety, both at the tabular array and away from it.
Gagging helps babies learn to swallow
For babies to build the skills for chewing and managing all foods (non just easy-to-chew foods), we need to give them opportunities to brand mistakes, like taking a too-big bite of food. When a baby bites off also much nutrient and cannot properly movement information technology effectually to chew, the gag reflex volition boot in and aid thrust the food forward. The experience teaches infant that the nutrient was too big to swallow. These experiences are essential for learning and building confidence in bitter and vehement. Over time, baby will learn to take smaller bites and get more adept at moving food around to chew properly.
Once baby is a few weeks into their solid food journey, you can use the gag reflex to your advantage. Offering foods that are not equally easy to chew to help accelerate baby'southward oral development more speedily. When poorly chewed food touches the tongue, the gag reflex volition do its chore, and infant will learn they demand to chew the food more.
It's important to challenge babybefore they get too accustomed to mashes and soft foods. Babies quickly acquire that chewing and swallowing mashes and other like shooting fish in a barrel-to-chew foods easily satisfies their hunger with minimal work. Many babies won't bother trying to better their skills with tough consistencies that require more than biting and tearing, and may refuse the challenging foods and wait for the easier foods.
Why is my baby gagging? Gagging is easily triggered
When it comes to immature babies, the gag reflex is pretty easy to trigger. Touch on the heart of the tongue, and many babies will gag. If you lot watch a 3- to 4-month-quondam babe mouthing their easily and fingers, you will see them gagging themselves frequently. This is common and normal. Babies are typically not bothered by it and will frequently keep doing it.
Our mouths are one of the most sensitive parts of our bodies. The human being oral cavity has many sensory receptors to find touch, taste, temperature, pressure, and other input types. Babies are driven to explore with their mouths to learn about their world simply considering the mouth is sensitive. Mouthing exploration could be very unsafe if babies didn't have gagging as a natural safety net.
Importantly, young infants take immature hand and finger coordination, which ways they can't easily remove something they put in their oral cavity. They also accept immature oral motor (tongue and mouth) coordination. They can't easily use their tongue to observe an object in their mouth and spit information technology out. This is another reason the gag reflex is a safety reflex, every bit it allows a baby to put an object in their oral fissure and then push it back out once more without letting it become close to the throat. Every bit babies put things in their mouth, the gag reflex tells them when things are not supposed to be there and prevents it from moving also far back towards the throat.
The gag reflex moves further back in the mouth as babies age
From nascency to effectually 7-nine months, the gag reflex is triggered close to the front of the oral fissure (around the heart of the tongue). At this age, the gag reflex is equally sensitive equally information technology volition ever exist. 4 This is important for safe because objects (nutrient or annihilation else) volition quickly trigger the gag reflex and be pushed out of the oral fissure before they get past the heart of the tongue.
Sometime around seven-12 months of historic period, the gag reflex slowly desensitizes. The gag trigger moves from the centre of the tongue to the dorsum of the natural language towards the throat. 5 At this betoken, nutrient or objects tin get much closer to the throat before the body recognizes something is too large to swallow and tries to push it back out. This might sound scary, but remember, our bodies are amazing! The gag reflex remains active and strong, and so if something (food, barbie shoe, bug, etc.) hits the back of the tongue, the back of the palate (roof of the mouth), or even the dorsum of the throat, the gag still kicks in.
Babies gag on puréed nutrient and jarred infant nutrient, too
The threshold for what triggers a gag and the gag'southward intensity is different in every baby, just about infants will go through a period where anything in their mouth thicker than breast milk or formula will cause a gag. The brain says: "Wait, this isn't right! I shouldn't swallow this! GAG!" Many volition gag with spoon-feeding experiences even with runny, watery bland purées.
Until the special day you decide to start solids, babe hasn't had to manage anything simply a watery-thin, fast-moving liquid. Enter something slightly thicker, slippery, and a different flavor — babe's brain will kicking in with protective mechanisms to gag and prevent swallowing this invading purée. This is unremarkably curt-lived because thin purées are quite like to liquids and the texture won't trigger a gag for very long.
Babies know to push the tongue against a breast or bottle nipple to initiate suction and motion the liquid backward to their throat. Spoon-feeding tin can nowadays unique oral-motor challenges. With a spoonful of purée dropped on the eye of the natural language, baby has nothing to suck or push against and doesn't nonetheless know the skills to assist move that nutrient backward. Because they can't movement the purée backward rapidly, information technology either continues to sit on the heart of the tongue or volition start spreading around the oral fissure, which can atomic number 82 to gagging. Many wise babies will suck on the spoon to help them quickly movement the purée back to swallow, just like they practice from a bottle or chest. Those babies, who now have a way to control the purée, will often easily consume with minimal or no gagging.
While not all babies who are spoon-fed gag, many practice. Non surprisingly, when a baby is exclusively spoon-fed for a prolonged catamenia of time (past 8 months of historic period, for instance), that child may gag more when they start finger foods due to the lack of texture exposure.
Spoon-fed babies gag less at first but gag more after
When a baby is started on solids with sparse, watery purées and pouches, the baby's tongue receives less sensory input. While babies gag on purées likewise, they acclimatize to the smooth texture or figure out how to use the spoon to suck dorsum and swallow, which reduces gagging. However,allbabies will frequently go through gagging periods when introduced to finger foods — whether 6-month-olds or older spoon-fed babies. When baby is first offered finger foods, the brain engages the safety phone call: "This doesn't seem right! I don't know how to motility this! We shouldn't eat this food!" Ofttimes, this period of gagging will last longer with babies who started with spoon-feeding. half dozen
In 2016, the "BLISS" report institute that babies who follow a spoon-feeding approach to solids (spoon feeding smooth purées > lumpy purées > finger foods) tend to gag less at vi months but more at 8 months and afterwards. 7 Remember: around eight months, a baby's gag reflex becomes less sensitive and moves further in the dorsum of the mouth. This ways that nutrient is closer to the throat before the body reacts and tries to push button it out. 8 In other words, waiting to innovate finger foods until afterward baby is viii or 9 months old mayincrement the choking risk as the gag reflex is less sensitive, further back in the oral fissure, and baby is not accepted to textures other than soft foods from a spoon.
By 8-9 months quondam, a spoon-fed infant has been practicing a very specific skill to eat. "Purées come into my rima oris. I suck or elevator my natural language to move that puréed food backward, and I swallow it." Babies will always start with the skill they know and try to use that same blueprint on solid foods. They try to move that solid food straight back without the necessary pace of moving the foodlaterally to their gums to chew. This motor blueprint oftentimes leads to even more than gagging.
The older the baby, the more aware they are of gagging and its unpleasantness. A nine-calendar month-old babe is more aware of gagging than a 6-calendar month-onetime baby. "Hebbian plasticity"—a fancy term that encephalon specialists utilise—tells united states that neurons that fire together wire together. This means that when 1 office of the brain lights up simultaneously as another part of the encephalon, the brain starts to build a connectedness betwixt those 2 areas. So, frequently gagging as the babe gets older and more than enlightened of their body may be problematic for some babies who seem to draw a connection between existent food and gagging. These babies seem to larn rapidly that real nutrient will make them gag and can lead to refusal of whatever food that is not a purée or mash. By contrast, younger infants don't seem affected as much every bit older babies and toddlers.
Baby-led weaning and gagging
At half dozen months old, the gag reflex is necessary to exploring food. It's what allows a immature baby with almost aught chewing skills to put a slice of food in their oral cavity and, if it is too big to swallow, go that food safely back out.
Infants learn how to do amazing things—sitting, crawling, walking, and running—past using reflexes, fumbling around, and making lots of mistakes while slowly building strength and adding 1 movement on summit of another. The same applies when learning to chew—babies use reflexes coupled with fumbling as they acquire.
Amazingly, babies have two other key reflexes—the biting reflex and the tongue lateralization reflex— which help them acquire to chew right away at 6 months. For foods to exist properly chewed, baby needs to:
- Take a seize with teeth.
- Motion that food to the side (tongue lateralization).
- Munch up and down to break downward the food downwardly.
- Move the food back to the tongue for swallowing.
When babies first start finger food, they will struggle to apply their biting and lateralization reflexes in any coordinated way. Only put, they fumble around! Equally babies learn to eat, they won't interruption downwards food enough to safely swallow, which requires the gag reflex to push the unchewed food back out. But every fourth dimension baby does that, they are learning where the food is in their mouth. Slowly and incrementally, babies acquire how to move nutrient to dissimilar parts of their mouth. They learn their tongue can help push button food around the mouth in lots of directions. They learn their palate, tongue, gums, and saliva will break the food downwards as it moves around their mouth. All of these actions turn a solid food into something like a brew!
Some experts advise that purees teach babies to swallow correctly, and gives practice swallowing solids before you lot introduce the thought of chewing. Most babies do not need to exist taught how to consume. Swallowing is a deep brainstem reflex present by 15 weeks gestationtwo and well established by total term nativity. Babies already know how to swallow; there is no need to do! Interestingly enough, thicker textures are really easier for babies to swallow (call up purees), and our feeding therapists explain that babies who have swallowing difficulty are actually prescribed thickened milk to drink! Just purees do teach baby a motor design: bring food in, move it back, consume. This is a unsafe pattern because most solid foods require chewing before you move them back and can safely eat. Nosotros believe that exclusive purees are fourth dimension wasted because baby isn't practicing chewing and is practicing a dangerous motor pattern that must be unlearned.
Interestingly, the Bliss study also demonstrated that infants who started solids with finger foods experienced more gagging at half dozen months, butlessgagging at 8-9 months every bit they developed more than control and coordination in moving food effectually their mouth. nine This demonstrates that babies who are given the opportunity to piece of work with finger foods early on in their solids journey—well earlier 8 months of age—develop the oral-motor skills required for mature eating more than quickly than spoon-fed babies.
Later a couple of months, about babies who start with finger foods at 6 months of historic period develop the skill and coordination to chew and move well-chewed nutrient backward to swallow safely. The baby feels comfy with their skills and is accustomed to food moving in this mode. The body won't initiate a gag and then readily.
Past dissimilarity, babies who get-go solids with purées have had fiddling chewing practice from 6-eight months. Information technology'due south probable they are less coordinated with moving nutrient around their mouth, less able to break down the nutrient, and less safety in the example that the food gets pushed back further in the mouth than they can handle.
How to help baby move past gagging by building skill
Successful eating is not but most chewing but about feeling where the food is in the rima oris and knowing if it'south chewed "enough" to swallow safely. As adults, nigh of us tin can identify and discretely spit out a tiny piece of bone or eggshell from a bite of food. Because this is happening within the mouth, we aren't using our eyes; our brains visualize what's going on within our oral cavity, fifty-fifty though we don't frequently see what'south going on in there. We have a mental image of our mouth and where everything is in relation to other parts. Babies don't have this "mental map" of their mouth at first.
To help y'all understand the necessity of a mental map, recollect about babies learning to stand. Before they tin can practise this, they need to develop "torso awareness" or, substantially, a mental "map" of where all their body parts are in relation to each other. Infant lays on the floor and slowly learns to roll around before they ever sit down up. Rolling and touching their whole body—from head to toe—while their muscles push and pull helps form the mental "map" of their torso. They need deep input all over their body to add all the details to that map. A small touch to 1 part of their torso or a light brush of your manus over their body helps a little but isn't really enough. It's the floor's house input to the whole body while moving the muscles that really seems to grade a clear map.
The aforementioned goes for the inside the mouth. When things touch the within of our mouth, a map slowly "draws" in our brain. As babies develops the map inside their mouth, they gain more command, figuring out how to move nutrient effectually appropriately. They also become more confident in their skill to motion food around. This command seems to help quiet the gag response and motility it further back in the mouth over time. The baby does not need the gag reflex to eat one time they have a clear map and strong coordination. They now have active control to chew the food, know if it'south chewed enough, move it back to swallow, or spit it out and endeavour again.
We know that many types of sensory input in the mouth help babies course the "mental map," simply that bigger inputs are more effective than light sensory inputs. (Think well-nigh the difference between a tight hug versus a tickle on the shoulder.)
There are two types of input that feeding therapists know are well-nigh constructive for sensory-motor learning:
- Touch on or tactile input – when nutrient touches a part or many parts of the mouth
- Messages from the muscles and joints or proprioceptive input – when the mouth gnaws on firm or resistive foods that don't interruption when chewing.
The simultaneous combination of tactile and proprioceptive input is most effective for forming the map. This is why feeding therapists oftentimes recommend giving resistive, flavorful foods similar a rib os for baby to chew.
Foods like a rib bone attain the trifecta:
- Babe tin can concord the food, easily put it in their rima oris, and pull it back out with their hands, which gives them control to go along the food at the front end of their mouth even if they don't have oral motor control.
- Babe gets big input to their oral cavity (touch input and muscle feedback as they bite on the os), which maps the mouth and leads to better control in the time to come.
- Baby triggers two fundamental reflexes (bitter reflex and the natural language lateralization reflex), which mimic chewing and help baby build strength and coordination for future eating.
Are these experiences for eating? No. These are "exercises" to help build a stronger connection betwixt the oral cavity and the brain. Drawing a detailed map of the mouth contributes to decreasing the sensitivity of the gag. As this map develops, the babe also develops more confidence in their skill, farther decreasing the gag's sensitivity.
When to seek help
We recommend y'all speak with your child's pediatrician regarding a referral to a feeding therapist if:
- Baby continues to gag at most meals afterward an initial learning period (one to two months of finger foods).
- Baby is frequently becoming upset after gagging (crying, tantrums, vomiting).
- Baby is airsickness at well-nigh meals, even on an empty tummy.
Let's normalize the gag
While it tin can be disturbing—and nerve-wracking to watch—gagging is a completely normal reflex in infants, children, and adults. Bottom line:
- Babies volition probable gag when they get-go start solids, regardless of starting on purées or finger food.
- Babies who are spoon-fed sparse purées are likely to gagless initially only gagmore afterwards when they start finger foods.
- Babies who beginning with finger foods tend to gagmore in the outset andlesssubsequently on as their oral-motor skills develop more than rapidly.
- All babies gag in their eating journeying—information technology'south one fashion they acquire how to swallow. The adept news is that babies typically outgrow gagging after a couple of months of practice with various textured finger foods.
Infant CPR & First Aid Resource
1 of the near of import things you can practise to protect infant is take a CPR class online or at your local health facility and review safety procedures. Some resource:
- American Red Cross: Child & Baby CPR
- American Heart Association: Infant CPR Grooming Kits
- MedlinePlus: Choking Beginning Aid for Infants Nether 1
Remember, you are responsible for supervising your child's health care and for evaluating the appropriateness of the information in this commodity for your kid. Only you lot know your kid and how your kid will react to foods and feeding procedures. Although the information presented in this commodity is based on well-documented inquiry by medical and nutritional professionals, it is upward to yous to review and consider the information and how information technology will work with your child.
E'er seek the advice of your pediatric md, nutritionist or health care provider with whatsoever questions yous may have regarding a medical condition or feeding issue. You should refer to our Terms of Utilise for further information.
Reviewed past:
K. Rappaport, OTR/L, MS, SCFES, IBCLC
1000. Grenawitzke, OTD, OTR/L, SCFES, IBCLC, CNT
- Rapley, One thousand., & Murkett, T. (2010).Infant-Led Weaning. The Essential Guide to Introducing Solid Foods.
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- Isaac, N., & Choi, E. (2018). Infant anatomy and physiology for feeding. In S. H. Campbell, J. Lauwers, R., Mannel, & B. Spencer (Eds.), Core curriculum for interdisciplinary lactation care (pp. 37-55). Burlington, MA: Jones & Bartlett Learning.
- Naylor, A. J., & Marrow, A. L. (2001). Infant Oral Motor Development in Relation to the Duration of Exclusive Breastfeeding.Developmental Readiness of Normal Full Term Infants to Progress from Sectional Breastfeeding to the Introduction of Complementary Foods, 21–25.
- Naylor, A. J., & Marrow, A. L. (2001). Infant Oral Motor Development in Relation to the Duration of Exclusive Breastfeeding.Developmental Readiness of Normal Full Term Infants to Progress from Exclusive Breastfeeding to the Introduction of Complementary Foods, 21–25.
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- Naylor, A. J., & Marrow, A. Fifty. (2001). Infant Oral Motor Evolution in Relation to the Elapsing of Exclusive Breastfeeding.Developmental Readiness of Normal Full Term Infants to Progress from Exclusive Breastfeeding to the Introduction of Complementary Foods, 21–25.
- Fangupo, L. J., Heath, A.-L. M., Williams, Due south. M., Erickson Williams, Fifty. Due west., Morison, B. J., Fleming, E. A., Taylor, B. J., Wheeler, B. J., & Taylor, R. W. (2016). A Infant-Led Approach to Eating Solids and Adventure of Choking.PEDIATRICS,138(4).
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