Gagging Newborns: What's Normal And What's Not?

is it normal for a newborn to gag

Gagging in newborns is a common occurrence and is usually not a cause for concern. It is a natural protective reflex that helps prevent choking. When something touches the back of a newborn's throat, it stimulates the gag reflex, causing a contraction at the back of the throat and pushing the object out of the mouth. This reflex is strongest in babies up to 6 months old, and it is normal for them to gag when they start solids. Gagging is also common when breast or bottle-feeding, especially if the flow of milk is too fast or the nipple doesn't fit well. As babies get older, the gag reflex moves further back in the mouth, and gagging becomes less common. However, if gagging is frequent and occurs without an apparent reason, it could indicate gastroesophageal reflux or another issue, so it's important to monitor your baby's reactions and consult a doctor if you're concerned.

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The difference between gagging and choking

Gagging and choking are two different reflexes that can occur when a baby is eating. Gagging is a natural protective reflex that results in the contraction of the back of the throat to protect from choking. It is a common reflex that occurs when babies start weaning and are learning to eat solid foods. Gagging is loud, and the child's skin may appear red. The baby's eyes may water, and they might push their tongue forward or out of their mouth, making a retching movement or even vomiting. Gagging is an important part of the learning process and helps the baby learn how to chew.

On the other hand, choking is when the airway is partially or completely blocked, and the child is unable to breathe, talk, or make any noise. Choking is quiet, and the child may gasp or wheeze, make odd noises, or no sound at all. Their skin may turn blue as they are not getting enough oxygen. If you suspect a baby is choking, you should administer infant choking first aid and call emergency services immediately.

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Why gagging is good for newborns

Gagging is a natural protective reflex that results in the contraction of the back of the throat. It is a safety mechanism that prevents choking and is, therefore, a good thing for newborns.

When the gag reflex is triggered, it forces the back of the throat to close, preventing swallowing. If food has caused a baby to gag, the reflex forces the food (or object) forward towards the front of the tongue. Young infants naturally open their lips when they gag, which means the food or object that caused the gag will move out of the mouth.

Gagging is good for newborns because it helps them learn to eat. It is a natural function that protects them from choking. Gagging helps them learn how to chew and teaches them how much food is too much to swallow. Over time, they will learn to take smaller bites and become more adept at moving food around their mouths.

If your baby is gagging, it's important to stay calm and observe quietly. Let your baby learn for themselves and keep an eye on them to make sure they're not choking. You can also try to keep your baby relaxed when they're eating and not push them to eat more than they want.

If your baby is constantly gagging for no apparent reason and is in discomfort, you should watch them more carefully. Frequent gagging is common but when it is not during mealtimes, it could indicate gastroesophageal reflux. This could lead to bad eating habits as your baby might avoid foods that cause them discomfort. Consult a paediatrician if you are concerned.

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When to worry about gagging

Gagging is a natural reflex in newborns and is completely normal. However, there are certain situations where gagging could be a cause for concern. Here are some instances where you should worry about gagging in newborns and take necessary actions:

  • Frequent Gagging: If your baby is gagging frequently, it could indicate a loss of control of liquid in the mouth. Signs of distress or trouble breathing could include colour change around the lips or eyes and sudden changes in breathing patterns.
  • Difficulty in Swallowing: If your baby is having difficulty swallowing food even after a week of trying solid foods, they may not be ready for solids yet. Consult with a paediatrician or a healthcare provider if this persists.
  • Gagging After Feeding: Gagging after feeding could be a sign of acid reflux, where swallowed milk moves back up the oesophagus, causing gagging or vomiting. This is especially common in premature babies.
  • Gastroesophageal Reflux Disease (GERD): If your baby is constantly gagging for no apparent reason, it could be a sign of GERD. This is when stomach contents move back up to the throat, causing discomfort and potentially impeding normal oral development.
  • Choking: Gagging is not the same as choking. If your baby is unable to cough, gasp, or cry, and their face or lips turn blue or purple, they might be choking. This is a medical emergency, and you should perform baby CPR and call for emergency services immediately.
  • Other Symptoms: Look out for other symptoms such as difficulty breathing, chest and ribs pulling inward while inhaling, high-pitched or soft sounds when inhaling, inability to cry or produce much sound, and weak or ineffective coughing. These could indicate an underlying issue and require immediate medical attention.

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How to help a gagging newborn

It is normal for newborns to gag, especially when they are first getting used to feeding. Gagging is a natural protective reflex that prevents choking. However, there are some steps you can take to help your newborn if they are gagging too much.

During Feeding

  • If your baby is breastfed, try nursing them in a more upright position, or on their side, to slow down the flow of milk.
  • If your baby is bottle-fed, ensure the nipple is the right size. Nipples with faster flow have more holes and can cause the baby to gag as too much milk comes out at once.
  • Don't prod your baby to eat more than they want, and let them eat at their own pace.

After Feeding

If your baby suffers from acid reflux, gagging after feeding may occur.

When Introducing Solid Foods

  • Make sure your baby is ready for solid food. They should be able to sit upright, have good head control, grasp, turn away when full, and show an interest in food.
  • Start by putting a small amount of food on a spoon and tipping it to get some food on the front of their tongue, rather than putting the whole spoonful in their mouth, which may trigger the gag reflex.
  • Feed them slowly and let them get used to the new way of eating.
  • Ensure solid foods are soft, easy-to-swallow, and cut into bite-size pieces.
  • Avoid giving them choking hazards such as whole grapes, hot dogs, nuts, raw vegetables, large chunks of meat or cheese, and popcorn.

General Tips

  • Stay calm and observe quietly if your baby is gagging.
  • If your baby is having trouble drinking water from a cup, switch to a straw or a sippy cup.
  • If your baby is gagging while being fed through a bottle, either switch to a nipple with a smaller outlet or feed them smaller amounts.
  • If your baby is gagging a lot during mealtimes or for no apparent reason, consult a paediatrician as it could be a sign of gastroesophageal reflux (GERD).

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Signs of gastroesophageal reflux disease (GERD)

Gagging is a natural reflex for newborns and infants as they learn to eat solid foods. However, gagging can also be a sign of gastroesophageal reflux (GER), which can develop into gastroesophageal reflux disease (GERD). GERD is a chronic condition that requires intervention to prevent damage to the oesophagus. Here are some signs of gastroesophageal reflux disease (GERD):

  • Arching of the neck and abnormal movements of the neck and chin
  • Choking, gagging, or problems swallowing
  • Irritability, particularly when regurgitating
  • Refusing to eat or loss of appetite
  • Poor weight gain, coughing, and wheezing
  • A sour taste in the mouth
  • Regurgitation (when stomach contents back up into the mouth)
  • Dry cough or repeated throat clearing
  • Sore throat, hoarseness, or laryngitis
  • Wearing away of tooth enamel
  • Trouble swallowing or feeling like there's a lump in the throat
  • Chest pain

Frequently asked questions

Yes, gagging is a natural reflex in newborns and infants that helps them learn to eat and protects them from choking. It is often triggered when something unfamiliar touches the back of their tongue.

Gagging is a protective reflex that pushes objects out of the mouth. Your baby may be gagging if they are making noises, coughing, gargling, or thrusting their tongue forward. Choking, on the other hand, is a quiet emergency where the baby's airway is blocked and they are unable to breathe. If your baby is choking, they may turn blue and be unable to cough or cry.

It is important to stay calm and let your baby's body get rid of the object on its own. Do not put your fingers or any other objects in their mouth as this may push the object further down their throat. If your baby gags frequently and seems distressed or uncomfortable, consult a healthcare professional.

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