Helping an overactive gag reflex
The gagging reflex
Gagging is a reflex that is present from birth and remains with us for our whole lives. Its purpose is to protect our airway and stop foreign objects and foods from ‘going down the wrong way’, reducing the risk of us choking.
In babies the gag reflex is further forward in the mouth than it is in adults. By the age of 4-6 months your baby will begin to have more control of this reflex, which coincides with being ready for weaning at around 6 months. The gag reflex moves further back in the mouth with age and by around 9 months should be sitting around the back 1/3 of the tongue.
When weaning starts you should expect your baby to gag. The main reasons they do this are;
They are still learning to control the reflex.
The reflex is further forward in the mouth than an adult.
They are learning to eat and do not have fully oral motor control so will be more likely to gag.
It is important to recognise that this is part of the normal developmental feeding experience for all babies. Gagging is different from choking and it is good idea to educate yourself about these differences.
The majority of babies will naturally gag less as they become more proficient at eating, however for some infants this doesn’t happen as quickly or even at all. In my experience, some groups of infants are more likely to gag than others.
Infants who are not ready for solids and who are weaned too early.
Babies who were born prematurely.
Those with neurological conditions or developmental delay.
Babies who cannot sit well without support.
Babies who have a tongue tie.
Infants with reflux or who have had reflux in the past.
Infants who have had feeding difficulties in infancy.
There are things you can do to help your little one with gagging if it is very prevalent or persists with frequency as eating skills develop.
Firstly, try to stay relaxed and calm when your baby is gagging. If your baby sees you become worried or panic they may too. Just calmly say “oh dear, that was tricky” or something else reassuring. You can lean them forward gently if they continue to gag, to help move the food to the front of the mouth or offer them a sip of water once they have finished.
You can desensitise the gag reflex by encouraging mouth play with teethers and other toys. I really like this teether* as it can go quite far back in the mouth. It is also good for practicing chewing and biting.
Raw sticks of finger foods such as carrot or celery can also be a great way to allow your baby to explore food whilst training the gag reflex to move further back in the mouth. A small baby won’t be able to bite off a bit so they can safely explore. Please ensure your baby is able to sit up unsupported before giving these foods.
If your baby’s gag reflex is related to a sensory issue, then touching and playing with foods and being encouraged to self feed with their hands can help to desensitise. This includes purees too!!
Offering a range of textures as you move through weaning and avoiding getting stuck on purees is also important. Your baby needs to learn to get used to lots of different foods. It is common that when moving from one texture to the next that your baby may gag more, but try to persevere. It is through experience that the gagging will become less sensitive.
If you are struggling with a baby who has a hypersensitive gag reflex and you need help, then you can ask your GP to refer you to a feeding and swallowing specialist speech therapist. Alternatively, you can contact me for support and advice.
*affiliate links used
