How to cope when your baby gags

Until the point when solids are introduced, your baby has been used to feeding by sucking (a nipple or teat) at the very back of his mouth.

Now he needs to learn to use his tongue to move food from the front of his mouth to the back, so he can swallow it. As he masters this skill, and as you make food more lumpy in texture, it’s likely that he’ll gag from time to time.

What to do if your baby gags

Gagging, as opposed to choking, is actually a safety mechanism – the natural response to food travelling too far back in the mouth. So think of your baby gagging as him dealing with the problem.

It goes without saying that you should never leave your baby unattended while he’s eating, but 99 per cent of the time, he’ll sort the situation out without your help.

Babies pick up on your anxiety so, hard as it is, try to stay calm if he gags. Be on hand to offer a gentle pat on the back or sip of water, as well as a reassuring smile, rather than leaping into action at the slightest cough.

Occasionally, as well as spitting up the offending lump, babies may vomit a little of their food. This is normal, but if it happens often, see your GP to rule out a tummy bug or digestive problems such as reflux.

All babies are different and while some accept new flavours and textures readily, others will gag very easily on the smallest of lumps. Start with soft foods that you know your baby likes and mash them slightly less each time you offer them.

If your baby likes banana or avocado, say, make them a little every time, working towards giving small pieces for your baby to hold and gum. And remember to keep an open mind and be flexible: some babies will prefer getting to grips with large chunks of food, while others need a very slow transition from purées.

To minimise the chance of your baby choking on food, never give whole pieces of solid food such as grapes, olives, ice cubes, nuts or dried fruit, fruit that contains stones, or raw fruit or vegetables that could easily lodge in and obstruct the throat. Long, stringy pieces of food, such as unchopped spinach or fatty meat, can also pose a risk.

Foods that are softer, cooked, or that will break up as your baby gums, sucks and chews them, should be OK. But always supervise your baby at mealtimes or when offering finger food snacks, and make sure grandparents and carers know to do the same.

If your baby chokes

If the gag reflex doesn’t resolve the problem and your baby does start to choke:

1. Look inside his mouth and remove the obstruction if you can do so easily, without risking pushing it further in.

2. If this doesn’t work, and your baby is still breathing, lie him along your forearm or your thigh, with his face down and head low and supported.

3. With your free hand, give up to five firm slaps between the shoulder blades.

4. If this doesn’t work, turn him over and give five chest thrusts (using two fingers in the middle of the chest, a finger’s width below the nipple line), pressing down about a third of the depth of your baby’s chest, at a rate of about 20 per minute.

5. Repeat steps 2-4 above, three times.

6. If this doesn’t work, phone for an ambulance but continue with the slaps and thrusts.

A course in paediatric first aid can be very reassuring if you’re concerned about the prospect of your baby choking while weaning. St John Ambulance, local NHS Ambulance Services and the British Red Cross all offer basic first aid courses for parents.