Colin Snow
It can be distressing for parents to see their newborn gag while sleeping. While it is a common occurrence, it is important to understand the underlying causes and know when to seek medical help. Gagging in newborns can be caused by various factors, including reflux, colds, allergies, asthma, or even fluid in their lungs after birth. In some cases, it could be a result of their body's natural response to protect the airway and prevent choking. Understanding the difference between gagging and choking is crucial, as choking implies a partial or complete blockage of the airway, requiring immediate medical attention.
| Characteristics | Values |
|---|---|
| Cause | - Fluid in the lungs |
| - Gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD) | |
| - Allergies | |
| - Asthma | |
| - Sleep apnea | |
| - Colds | |
| - Enlarged adenoids and tonsils | |
| - Learning to eat solids | |
| - New tastes, temperatures, or textures | |
| - Loss of control of liquid in the mouth | |
| - Being sick | |
| Treatment | - Keeping the baby upright for about 30 minutes after feeding |
| - Cut their food into small pieces (no bigger than half an inch) | |
| - Avoid giving them foods like nuts, popcorn, and whole grapes | |
| - Infant gaviscon | |
| - Surgery to remove enlarged adenoids and tonsils |
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What You'll Learn
The newborn gag reflex
The Gag Reflex in Newborns
The gag reflex is a natural protective mechanism in newborns that helps prevent choking. It is triggered when any object touches a sensitive area in the back of the throat, stimulating an automatic muscle contraction that pushes the object out of the mouth. This reflex is particularly strong in babies during their first six months, as it helps them adapt to new tastes, temperatures, and textures as they transition to solid foods.
Gagging in newborns can be caused by several factors, one of which is gastroesophageal reflux (GER), a common condition in babies under 2 years old. This occurs when stomach contents flow back up the oesophagus, leading to spitting up or gagging. Keeping your baby upright for about 30 minutes after feeding can help reduce reflux symptoms and minimise gagging during sleep.
Another cause of gagging in newborns could be fluid in their lungs. During labour, babies release fluids from their lungs, but sometimes, fluid remains for a few days, causing coughing and gagging as they try to clear it. Enlarged adenoids and tonsils can also cause gagging by blocking the upper respiratory passages and making breathing difficult, especially when the throat muscles relax during sleep.
While gagging is a normal protective reflex, excessive gagging may indicate an underlying condition. Frequent gagging during feeding could suggest a loss of control of liquids in the mouth, difficulty coordinating mouth movements, or sensitivity in the gag reflex. If you are concerned about your baby's gagging, consult a healthcare professional for advice and potential referral for a feeding evaluation.
It is important to distinguish between gagging and choking. Choking occurs when there is a partial or complete blockage in the airway, often indicated by bluish skin around the lips or eyes. Gagging, on the other hand, is a reflexive attempt to clear the airway and is typically accompanied by coughing or gargling sounds. Always stay observant when your child is eating, and if choking occurs, respond accordingly with baby CPR and emergency medical care.
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Gastroesophageal reflux (GER)
Reflux happens when a ring of muscle (the lower oesophageal sphincter) that separates the oesophagus from the stomach relaxes at the wrong time or does not close as it should. When babies have reflux, they spit up, usually after feeding. Reflux differs from vomiting because vomiting is more forceful. Sometimes, reflux happens when a baby burps after feeds and liquid comes out of the mouth or nose or both.
GER is common in infants because they have a liquid diet and spend a lot of time lying down. It is usually not a cause for concern, and most babies outgrow it. However, if GER is more severe and long-lasting, it is called gastroesophageal reflux disease (GERD). GERD can make it hard for babies to get proper nutrition, and they may not gain weight or even lose weight. Other symptoms of GERD include coughing, noisy breathing, vomiting, and pain from oesophageal irritation, which can cause difficulty in eating or a refusal to eat altogether.
If your baby has GER symptoms, it is recommended to keep track of their feedings. If you are breastfeeding your baby, keeping a journal of the foods you eat can also help the doctor understand what is going on. Some simple feeding changes can help most babies with reflux spit up less. For example, giving smaller feedings more often can help prevent reflux.
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Sleep apnea
It is important to note that sleep apnea is different from choking or gagging. Choking occurs when there is a partial or complete blockage in the airway, preventing breathing. Gagging, on the other hand, is a reflexive response triggered by the stimulation of sensitive areas in the back of the throat. This stimulation leads to automatic muscle contractions that push any object in the opposite direction, out of the mouth. Gagging is a protective mechanism that can help prevent choking, and it is normal for babies to gag while they are learning to eat solid foods.
If your newborn is gagging while sleeping, there could be several reasons. One possibility is infant reflux or gastroesophageal reflux (GER), which is common in babies under 2 years old. Keeping your baby upright for about 30 minutes after feeding can help reduce reflux symptoms and minimise gagging during sleep. Another reason for gagging could be fluid in the lungs, which can remain for a few days after birth. This fluid can collect at the back of the throat and cause gagging and coughing.
It is important to consult a doctor if you are concerned about your newborn's gagging or choking during sleep. While gagging is usually a normal reflex, frequent and excessive gagging may indicate a more serious issue. Additionally, choking is a medical emergency, and if your baby is choking, it is crucial to start baby CPR and call for emergency assistance immediately.
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Allergies and asthma
The gag reflex is a natural protective mechanism in babies that helps prevent choking. It is activated when any object touches a sensitive area at the back of the throat, causing an automatic muscle contraction that pushes the object out of the mouth. Babies usually have a strong gag reflex until they are about six months old, which is when they start eating solid foods. Gagging is a normal part of learning how to eat solid foods. However, excessive gagging may be a sign of gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD).
GER is common in babies under two years old, while GERD is a more long-term, serious condition with continued symptoms or complications. Babies with reflux may spit up more often, leading to gagging or coughing. Keeping your baby upright for about 30 minutes after feeding can help reduce reflux symptoms and make them less prone to spit up and gag during sleep.
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Choking hazards
Gagging is a natural reflex that protects your baby from choking. However, choking is a medical emergency that requires immediate action. It occurs when a baby's airway is partially or completely blocked, and they are unable to breathe or make any noise.
- Young babies can choke on liquids like breast milk, formula, or even their own spit-up or mucus. Their airways are small and can be easily obstructed.
- Small, sticky, or hard foods that are difficult to chew and swallow, such as popcorn, chips, hard candy, and gum.
- Food served uncooked, whole, or in certain shapes or sizes, such as blueberries and small tomatoes. Always cut up potential choking hazards into smaller pieces and mash foods if necessary.
- Toys with small parts, especially in a stroller or crib, where they may choke without an adult noticing.
- Other common choking hazards found around the home include batteries and coins. Keep these items out of your baby's reach or create a dedicated "safe space" that's gated off.
It is important to know the signs of choking and how to respond. If your baby is choking, start baby CPR and call emergency services immediately.
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Frequently asked questions
Gagging while sleeping is a natural reflex for newborns. It can be caused by fluid in their lungs, reflux, colds, allergies, asthma, or sleep apnea. If you are concerned, consult your baby's doctor.
Gagging is a reflexive attempt to push something away from the airway. Choking, on the other hand, occurs when the airway is partially or completely blocked, preventing breathing. Gagging is not a foolproof way to prevent choking, but it can serve as a warning sign.
Choking is a medical emergency. If your baby is choking, immediately start baby CPR and call emergency services.
To reduce gagging caused by reflux, keep your baby upright for about 20 to 30 minutes after feeding. You can also try elevating the head of their bed, but be sure to consult your healthcare provider first.
