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Choking vs gagging

Gagging is a noisy, normal reflex that keeps food out of a baby's airway; choking is a blocked airway, often silent, that needs 911 and first aid.

What It Means

Gagging and choking look alike at the table but are different things. A gag is a normal reflex that keeps food away from the airway while a baby learns to chew and swallow, and it's usually noisy, with coughing and sputtering. Choking means the airway is blocked, so the baby can't cough, cry or breathe well, and it's often quiet. It's an emergency: call 911 and start infant first aid.

Try It: Gagging or Choking? Sort the Sign

Pick what you see. The answers come from Nationwide Children's, Cleveland Clinic and the American Red Cross.

Sounds like gagging

A normal reflex. Stay close, let your baby work it out, and offer smoother food or smaller amounts next time.

Rule of thumb from Cleveland Clinic: gagging is noisy, choking is mostly quiet.

How Parents Say It

  • "He gagged and then just kept eating."
  • "She went quiet and red, and I panicked."
  • "Is it normal for a baby to gag this much on solids?"

The Breakdown

Side by side

GaggingChoking
SoundNoisy: coughing, sputteringMostly quiet
BreathingKeeps breathing and making noiseCan't breathe, cry or cough, or only weakly
ColorNo turn toward blueMay look flushed at first, then pale, blue or purple
What it isA reflex that keeps food out of the airwayA blocked airway
What to doStay close; slow down with smoother food or smaller bitesCall 911 and start infant first aid

Pick this response if it's gagging. Stay calm and within reach while your baby works the food forward. Nationwide Children's suggests slowing down with smoother foods or smaller amounts.

Pick this response if it's choking (baby under 1), per the American Red Cross

  1. Call 911, or have someone call while you start.
  2. Lay the baby face down along your forearm, supported on your thigh, with the head lower than the body.
  3. Give 5 firm back blows with the heel of your hand between the shoulder blades.
  4. Turn the baby face up, head still lower than the body, and give 5 quick chest thrusts about 1½ inches deep.
  5. Keep repeating 5 back blows and 5 chest thrusts until the baby can cough forcefully, cry or breathe, or becomes unconscious. If the baby becomes unconscious, make sure 911 has been called.

The Red Cross says abdominal thrusts aren't used for infants.

Good to Know

Practicing these steps once is worth more than reading them: the American Red Cross offers infant first aid and CPR classes. CDC lists foods that are common choking hazards for children under 4, including popcorn, whole grapes, spoonfuls of nut butter, cheese cubes, whole corn kernels, uncut cherry tomatoes, pieces of hard raw fruit or vegetables like carrots and apples, and raisins, and it says to prepare food in the right shape, size and texture for your child's stage. Always seat your baby upright and stay with them while they eat.

FAQ

Is gagging normal when a baby starts solids?

Yes. Nationwide Children's calls gagging a normal reflex that keeps food out of the airway while a baby learns to chew and swallow. It's usually noisy and passes on its own.

How do I know if my baby is choking?

A choking baby usually can't cough, cry or breathe well, may go silent, and may turn blue or purple. Call 911 and start infant first aid right away.

What do you do if a baby under 1 is choking?

The American Red Cross says to give 5 back blows and then 5 chest thrusts, repeating until the baby can cough forcefully, cry or breathe, and to call 911. An infant first aid class lets you practice the steps.

Do It in Buhata

Handoff Card

Put the infant choking steps and your home address for a 911 call on a Handoff Card (Premium) in Buhata so every sitter has them at mealtimes.

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Related Terms and Categories

  • Baby-led weaning

    A way to start solids where a baby feeds themselves soft pieces of food from about 6 months instead of being spoon-fed purees.

  • Purees

    Smooth, blended foods that many babies eat when they start solids at about 6 months, before moving on to lumpier and chopped textures.

  • Finger foods

    Small, soft pieces of food a baby picks up and feeds to themselves, usually begun once they sit up and can bring food to their mouth.

  • High chair

    A tall, freestanding seat with a tray for feeding a baby or toddler. CPSC's federal standard requires a three-point restraint and a passive crotch restraint.

  • Allergen introduction

    Giving a baby common allergy-causing foods, such as peanut and egg, early in the first year to lower the chance of a food allergy.

Baby and toddler

Sources

American Red Cross, "Infant Choking: How To Help"; American Red Cross Guidelines Database, "Management of Foreign Body Airway Obstruction"; Nationwide Children's Hospital, "First Aid for a Choking Baby"; Nationwide Children's Hospital, "Feeding Your Baby Solid Food"; Cleveland Clinic, "Choking First Aid and Prevention in Children"; Cleveland Clinic, "What Should I Do if Someone Is Choking?"; CDC, "Choking Hazards"

Last updated .