Colin Snow
Gagging in babies is a common occurrence, and it is usually a natural reflex to prevent choking. However, it can be distressing for parents, especially when it happens during sleep. There are several reasons why a 2-month-old baby might gag in their sleep, including gastroesophageal reflux (GER) or acid reflux, sleep apnea, colds, allergies, asthma, or even fluid in their lungs. GER can progress to gastroesophageal reflux disease (GERD) if left untreated, causing continued symptoms or complications. If your baby is gagging frequently or showing other signs of discomfort, it is important to consult a doctor for a proper diagnosis and treatment.
| Characteristics | Values |
|---|---|
| Gagging | A natural reflex that helps prevent choking |
| Gagging and choking | Two different things |
| Choking | A medical emergency |
| Causes of gagging | Introduction of solid foods, enlarged adenoids and tonsils, sleep apnea, colds, allergies, asthma, reflux, fluid in the lungs, GERD, or acid reflux |
| GERD | Gastroesophageal reflux disease |
| GERD symptoms | Frequent gagging, abdominal discomfort, frequent coughing, spitting up, or vomiting |
| GERD diagnosis | Seek medical care for an exact diagnosis |
| GERD treatment | Outpatient surgery to remove enlarged adenoids and tonsils |
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What You'll Learn
The gag reflex is a natural response to prevent choking
It can be distressing for parents to see their baby gagging and coughing. There are many reasons why a baby gags, and it is important to understand the differences between gagging, choking, spitting up, and vomiting.
The gag reflex is an automatic, involuntary, natural response that helps prevent choking. It is a defence mechanism that prevents something from being swallowed and ingested. It is a neuromuscular action controlled by muscles and nerves. The gag reflex brings food forward in the baby's mouth so that they can more easily chew it and safely swallow smaller pieces. This reflex may be evoked by stimulation of the posterior pharyngeal wall, tonsillar area, or tongue base.
In the first few months of life, the gag reflex is triggered by any food that the baby's body deems too large or solid for them to digest. This reflex causes the baby to thrust their tongue forward when something touches the back of their throat. This is called the tongue-thrust reflex, and it can make early feedings challenging for both babies and parents. The tongue-thrust reflex is normal in four- to six-month-old babies when solid foods are introduced. As the baby develops, the gag reflex moves further back on the tongue, and gagging becomes less frequent as the baby learns to regulate the quantity of food they swallow.
Gagging is not the same as choking. Choking occurs when the baby's airway is partially or completely blocked, and air cannot get through. If a baby is choking, they may struggle to breathe and will likely be in pain. Their face, mouth, or lips may turn blue. Gagging, on the other hand, is the body's way of preventing choking by spitting out or swallowing the object blocking the airway.
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Babies may gag due to gastroesophageal reflux disease (GERD)
Gagging is a common occurrence in babies and is usually not a cause for concern. The gag reflex is an automatic response that helps prevent choking. However, in some cases, gagging in babies may be a sign of gastroesophageal reflux disease (GERD).
GERD is a more serious and long-lasting form of gastroesophageal reflux (GER). GER is common in babies, especially those under 2 years old, as they have a liquid diet and spend a lot of time lying down. Most babies with GER will spit up a few times a day during their first three months and typically outgrow it by the time they are 12 to 14 months old.
GERD, on the other hand, can become a long-term physical problem if left untreated. It occurs when the lower esophageal sphincter (LES), a muscle at the bottom of the food pipe (oesophagus), relaxes too often or for too long, allowing stomach acid to flow back up into the oesophagus. This can cause nausea, vomiting, heartburn, and breathing problems.
Babies with GERD may exhibit symptoms such as frequent vomiting, coughing, noisy breathing, and failure to gain weight. If your baby is displaying any of these symptoms, it is important to consult your healthcare provider. They may recommend lifestyle changes, such as holding your baby in an upright position for 30 minutes after feedings, or medication to block and lower stomach acid.
It is important to note that gagging can be caused by various factors, including the introduction of solid foods, sensitivity to certain foods, or fluid in the lungs after birth. As such, it is always advisable to consult a healthcare professional for a proper diagnosis if you have concerns about your baby's health.
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Sleep apnea can cause gagging and coughing while sleeping
Furthermore, sleep apnea can be associated with gastroesophageal reflux (GER) or its more severe form, gastroesophageal reflux disease (GERD). GER is common in babies under 2 years old and involves occasional regurgitation or spitting up. However, GERD is a more serious condition with persistent symptoms. Both GER and GERD can cause gagging and coughing due to the stimulation of the gag reflex by stomach contents.
It is important to note that gagging and coughing in babies can also be attributed to other factors, such as the introduction of solid foods, sensitivity to certain foods, or the presence of fluid in the lungs after birth. While gagging is a protective mechanism against choking, it is crucial to monitor your baby's breathing patterns and overall health. If you observe frequent coughing, difficulty breathing, or other concerning symptoms, consult a healthcare professional for proper diagnosis and treatment.
To address sleep apnea and minimise gagging and coughing, certain measures can be implemented. Elevating the head of your baby's bed, providing extra fluids, and using a humidifier in their room may help alleviate respiratory symptoms. Additionally, a pacifier may reduce the risk of apnea, and in some cases, surgery to remove enlarged adenoids and tonsils may be recommended. It is always advisable to consult your baby's doctor for personalised advice and treatment options.
While it can be concerning to witness your 2-month-old gagging and coughing in their sleep, it is important to remember that sleep apnea and other factors can contribute to these symptoms. By understanding the potential causes and seeking appropriate medical guidance, you can help ensure your baby's comfort and well-being during sleep.
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Feeding techniques can help reduce gagging
Gagging is a natural part of a baby's development and is usually not a cause for concern. The gag reflex is an automatic response that helps prevent choking. However, frequent or prolonged gagging may indicate an underlying issue and parents should consult a healthcare professional if they are worried.
Feeding Techniques to Reduce Gagging
- Keep your baby upright for about 30 minutes after feeding to reduce reflux symptoms and make them less prone to gag during sleep.
- Burp your baby regularly to prevent gagging from air bubbles.
- If your baby is bottle-fed, control the flow of milk to prevent it from coming out too fast and triggering their gag reflex.
- The nipple size and shape can also contribute to gagging, so ensure you are using an appropriately-sized bottle nipple.
- If your baby is gagging while chewing food, try giving them purees with soft chunks of boiled vegetables or fruit.
- If your baby's gag reflex is related to a sensory issue, encourage them to touch and play with different foods to help desensitise them.
- Try to keep your baby relaxed when they are eating, and don't push them to eat more than they want to.
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Gagging can be a sign of an underlying condition
Gagging in babies is usually a normal occurrence, and is the body's way of protecting itself from choking. However, in some cases, gagging can be a sign of an underlying condition.
Gastroesophageal reflux disease (GERD) is a condition that can cause gagging in babies. GERD is a more serious and long-term form of gastroesophageal reflux (GER), which is common in babies under 2 years old. Babies with GERD may experience continued symptoms or complications, and it can become severe if left untreated. Acid reflux may also cause gagging in babies, and this can be identified by other symptoms such as abdominal discomfort or frequent coughing.
Babies with enlarged adenoids and tonsils may also gag due to sleep apnea. This occurs when the enlarged glands block the upper respiratory passages, making breathing difficult. Sleep apnea usually does not present symptoms until children are between the ages of 3 and 6.
If your baby is gagging frequently and you suspect an underlying condition, it is important to consult a doctor for a proper diagnosis and treatment.
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Frequently asked questions
Gagging in newborns is normal and can be caused by gastroesophageal reflux (GER) or acid reflux. Babies have a strong gag reflex that helps prevent choking. If your baby is repeatedly gagging in their sleep, visit the doctor to get an appropriate diagnosis and treatment.
Gagging is not the same as choking. During a gag, the airway is not blocked, and your baby is actively working on spitting out or swallowing whatever is blocking their airway. Choking, on the other hand, is a medical emergency where the airway is partially or fully blocked, and your baby may struggle to breathe.
If your baby is gagging, do not panic or put your fingers or any other object in their mouth to try to remove what they are gagging on. Let your baby gag and throw up what they are unable to swallow. Interrupting them may result in choking. You may help them lean forward to bring the food from the back of their mouth to their tongue and spit it out.
