Weaning advice on baby’s gag reflex, with Feed Eat Speak

Stacey Zimmels, Feeding and Swallowing Specialist and Speech and Language Therapist, is the founder of Feed Eat Speak, a feeding and speech therapy service for infants and children.

The weaning process:

Feed Eat Speak explain introducing solid foods to your baby is an exciting time. It means your baby is ready for the next stage on their feeding journey. We all know that weaning is a process that starts with exclusive milk feeding and ends with proficient eating of adult foods with milk as a compliment, however, less consideration is given to how a baby becomes a capable eater. An infant’s oral motor skills and reflexes change and develop with age and maturity as well as with experience and practice too. The gag is one of the reflexes that is associated with feeding.

Gagging:

At around 6 months your baby will start to eat solid foods. Whether you use a baby led weaning (BLW) approach or the more traditional spoon-feeding method, you will likely notice that your baby will sometimes gag in the first days and weeks of weaning. For some of the parents I work with, this can be very worrying. Below is some useful information to help you feel more confident about gagging when weaning your baby to solid foods.

• Gagging is a normal protective reflex that is highly sensitive when weaning starts. This is because it’s designed to stop your baby from choking.
• When solid foods are first introduced, your baby uses immature oral motor movements. They mature with time and practice. One of the reasons that gagging occurs is that infants haven’t yet developed the oral motor control they need to prepare the food for swallowing – and so they gag to stop it going down the wrong way.
• In addition, to help protect an infant from choking, the gag reflex is triggered relatively forward in the mouth at this age. As your baby learns to eat, the gag reflex will move further back in the mouth and gagging will reduce.
• Gagging looks like your baby may be about to be sick, they will open their mouth and push the tongue forward as part of the gagging mechanism. It may be silent or there may be a retching noise that goes with it. Before and after a gag your child will be able to vocalise normally.
• Babies are rarely distressed when they gag, they often just pick up the next piece of food and carry on eating.
• If you see your baby gagging try not to panic or your little one could sense your alarm. Stay calm, count silently to 10 and remember it’s a sign that your baby’s body is doing what it is meant to do.

Choking

• Gagging is often confused with choking. Choking is usually silent or very quiet. This is because during a true choking episode a piece of food (or other object) will become lodged in the airway and stop the air from the lungs from travelling up and out of the mouth, making it difficult to make sound or breathe.
• Signs of choking may also include, changing colour of the face and lips to grey/blue, a look of panic, and an older child may flap or wave their hands in the air.
• A baby who is unable to sit upright without support is at risk of choking as the gag reflex may not be as effective if they are leaning backwards. This is why it is important to wait until your baby is sitting upright before you start baby led weaning or finger foods.
• If you are concerned about your baby choking then it would be advisable to do a parent first aid session. This would give you the confidence that you would know what to do in the rare event that it may happen and enable you to calmly move forward with your weaning journey

There are certain groups of infants whose gag reflex may be more sensitive, they include those who have reflux and/or vomiting, infants who have been sick and hospitalised particularly if they have needed tubes in their mouths and throats and those with certain medical or developmental conditions.

If you have an infant who is presenting with gagging beyond what you may expect e.g. if it doesn’t improve during the weaning process, if it is causing distress or if is stopping your infant from progressing with weaning, then please do seek support and advice from a qualified feeding and swallowing specialist speech and language therapist.