Baby Led Weaning (BLW) is a popular method of introducing solid foods to infants that allows them to feed themselves, promoting independence and encouraging healthy eating habits. The theory behind BLW emphasizes the importance of developing motor skills, sensory experiences, and self-regulation of appetite, as infants learn to choose, chew, and swallow foods at their own pace. Some say that this can help prevent picky eating and promote a positive relationship with food as children grow. It can, however, expose parents and carers to children gagging and possibly choking, so when it comes to children and their safety during mealtime, understanding the difference between choking and gagging is crucial.
While both are related to airway obstruction, they have different mechanisms and require different responses.
Paramedic Tony Coffey highlights the mechanisms behind each identifying signs and explaining how to respond.
Choking v Gagging
Gagging is a natural reflex that prevents food or foreign objects from entering the airway. It usually occurs when the back of the throat is stimulated, causing distress but allowing the child to breathe and cry. Gagging can often happen during eating, particularly when children are trying new foods or haven’t learned to chew properly. It usually occurs when food or objects go too far back in the throat, triggering the body’s protection mechanisms.
When a child gags, they may have a strong cough or be retching but can still breathe.
Choking, on the other hand, is much more severe and happens when an object blocks the airway, preventing airflow. This is known as a Foreign Body Airway Obstruction (FBAO) and can lead to a dangerous situation where the child is unable to breathe, speak, or cough effectively. Common causes of choking include small food pieces, toys, or other objects that children might put in their mouths. Choking can quickly escalate into a life-threatening emergency.
How to Tell the Difference
Recognising the signs of each condition is crucial for effective response.
- Gagging may present with coughing, choking sounds, or signs of discomfort, while the child is still able to breathe and make noise.
- Signs of choking are more alarming: the child may be unable to speak, may show signs of distress, even panic, and may appear blue in the face or struggle to take a breath. They may clutch their throat or look in wide-eyed panic if the airway is completely blocked.
If a child is gagging, they may:
- Cough loudly
- Be able to make sounds or cry
- Appear concerned but not panicked
- Have a short struggle but usually be able clear the obstruction on their own
If a child is choking however, they may:
What to do about each.
- Be unable to cough or speak
- Have a strained or distressed expression
- Show signs of panic or distress
- Turn blue in the face or have pale skin
If you suspect a child is choking, immediate action is vital.
1.If the child cannot cough, speak, or breathe, call 115 for emergency medical help.
2. Position the child, preferably head down, and deliver up to 5, firm back blows between the shoulder blades.
3. If back blows do not work, deliver up to 5 chest or abdominal thrusts.
4. Alternate between back blows and chest / abdominal thrusts until the object is expelled or emergency services arrive.
(FOR INFANTS UNDER 12 MONTHS CHEST THRUSTS AND BACK BLOWS ONLY)
In cases of gagging, it is often best to remain calm and encourage the child to cough to dislodge any obstruction.
- Give them time to dislodge the object themselves.
- If the gagging persists or if the child shows distress, seek medical advice to ensure no further complications arise.
- Keep calm and stay nearby to monitor their progress.
“Finally,” Tony adds, “While these incidents can be distressing for parents and carers to witness, remember the child is relying on you for an effective response. If you panic, it can add to the child’s distress and often lead to poor decisions being made by the carer. I would strongly recommend attending a training course so you can practice the skill on a manikin and be prepared.”
Author: Tony Coffey Paramedic, Co-Founder Survival Skills Vietnam.
