Gagging Cough in Babies: What Should You Do?

    Updated 27 November 2021 |
    Published 14 August 2019
    Fact Checked
    Reviewed by Dr. Anna Klepchukova, Intensive care medicine specialist, chief medical officer, Flo Health Inc., UK
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    Lots of parents get worried when their baby gags. However, in most cases, gagging isn't a problem for babies. It's another developmental milestone can happen frequently in some babies. Read on to learn why babies gag and when a gagging cough becomes a reason to call the doctor.

    Why do babies gag?

    There are lots of reasons why a baby gags. The gag reflex is an automatic response that helps prevent choking. Until your newborn baby is four to six months old, they have a reflex that causes them to thrust their tongue forward the moment something stimulates the back of their throat. The tongue-thrust reflex can make early feedings challenging for some babies —and their parents!

    Gagging after eating

    Gagging after eating is normal in four- to six-month-old babies when you introduce solid foods. The gag reflex brings food forward in your baby's mouth so that they can more easily chew it and safely swallow smaller pieces. Gagging after eating becomes less frequent as your baby develops and learns to regulate the quantity of food they swallow.

    Try to keep your baby relaxed when they're eating, and don't push them to eat more than they want to. Also, introduce solids only when they're ready for them. Start by placing a small amount of food on a spoon. Tilt the spoon and place some of the food on the front of their tongue. This way, they can take the remaining food from the spoon slowly without setting off the automatic reflex at the back of their throat.

    Once your child is ready to eat food at a table, make sure their food doesn't pose any choking hazards. Cut their food into small pieces (no bigger than half an inch) and avoid giving them foods like nuts, popcorn, and whole grapes, which are easy to choke on.

    Coughing while sleeping

    Sometimes children cough while sleeping because of sleep apnea. Enlarged adenoids and tonsils that block their upper respiratory passages can make breathing difficult. When the muscles of the throat relax at night, these enlarged glands can temporarily prevent air from entering the lungs. Children with sleep apnea usually don't show signs until they are between three and six.

    If your baby is coughing while sleeping due to sleep apnea, a doctor can help. They may refer your child to an ear, nose, and throat specialist, who will evaluate their adenoids and tonsils. A simple outpatient surgery to remove the glands may solve the problem.

    Colds, allergies, and asthma can also result in coughing while sleeping. Call the doctor if your baby has difficulty breathing, a cough lasting for more than one week, a fever, or if the cough starts suddenly or they are choking while coughing. You can try elevating the head of your child's bed (but consult your healthcare professional first), giving them extra fluids, and running a humidifier in their room at night. You can also ask your doctor to prescribe medication to help with the cough.

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    Baby choking on saliva

    Your baby might also choke on their saliva sometimes. This might be because of swollen tonsils that block the flow of saliva. In infant reflux, the esophageal sphincter isn't fully developed and can't keep the stomach contents from coming up. To decrease infant reflux, try these tips:

    • Keep your child upright for at least 30 minutes after feeding.
    • If your baby is drinking formula, try a different brand.
    • Give your baby less milk, but feed them more frequently.

    If necessary, the doctor may recommend removing your child's tonsils.

    Additionally, a cold or an allergy can make it difficult for your child to swallow the thick mucus or saliva. Your doctor may advise treatments to thin the mucus, including a vaporizer or saline drops. Teething can also cause excess saliva, causing some babies to cough or gag.

    Newborn fluid in lungs

    Before babies are born, their lungs contain fluid. During labor, babies' bodies release chemicals that help their lungs remove this fluid. The pressure of delivery during a vaginal birth also removes the fluid from their lungs. However, sometimes fluid remains in some baby's lungs for a couple of days after birth. This can cause newborns to сough as they try to remove the fluid themselves. The fluid then collects at the back of their throat and may cause gagging and gurgling.

    Why do babies wake up coughing? 

    Your baby might wake up coughing because of sleep apnea (because of swollen adenoids or tonsils), infant reflux, colds, allergies, or asthma. If your baby repeatedly wakes up coughing, visit the doctor to get an appropriate diagnosis and treatment.

    How to distinguish gagging from choking

    Gagging isn't the same as choking. Choking implies that there is a partial or complete blockage in your child's airway, preventing breathing. Here's how to distinguish gagging from choking:

    Your baby may be gagging if they are pushing their tongue forward or out of their mouth, making a retching movement, and trying to bring food forward. Their eyes might water. Gagging can lead to coughing or vomiting. As difficult as it may be to watch, it's best to let your baby keep gagging and coughing. As long as they're still breathing, this is the best way for them to get saliva, mucus, or food from their throat.

    Your baby may be choking if they aren't able to cough, gasp, or cry. They may produce odd sounds or no sound while opening their mouth. To remove the blockage you may have to do chest thrusts or back blows on your baby.

    Reasons to call a doctor

    If your child develops any of these symptoms, seek immediate medical care:

    • They have difficulty breathing.
    • Their chest and ribs are pulling inward while inhaling.
    • They produce high-pitched or soft sounds when inhaling.
    • They can't cry or produce much sound.
    • Their coughing is weak and ineffective.
    • Their skin turns bluish.
    • They lose consciousness.

    Lots of parents worry when their baby is gagging or coughing. Gagging after trying solid foods is normal in four- to six-month-old babies. There are a number of things that can cause children to cough while sleeping, including sleep apnea, colds, allergies, and asthma. Your baby may also choke on their saliva due to infant reflux or swollen tonsils. Some newborn babies gag because of fluid in their lungs. It can be scary when your child is gagging, coughing, or choking, but now you've got the information you need to take action when necessary.

    History of updates

    Current version (27 November 2021)

    Reviewed by Dr. Anna Klepchukova, Intensive care medicine specialist, chief medical officer, Flo Health Inc., UK

    Published (14 August 2019)

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