Is My Child Choking or Gagging

We’ve all been there. That terrifying moment. Your kiddo is sitting and eating and suddenly they’re making a horrible sound. Your heart races, you scoop them out of the chair and be sure there is no food in their airway. You’re on high alert and your kiddo has no idea what just happened but they know whatever it was scary.  

My question is when you stop and think about that moment and what led to it was it choking or could it have been gagging? What is the difference?  

Choking: The American Heritage Dictionary defines the verb choke as “to interfere with the respiration by compression or obstruction of the larynx or throat.” In other words, food gets stuck in the back of your throat in the opening of the airway, and you cannot breathe. This is a life-threatening occurrence and needs immediate intervention. You need to call 911 and clear the person’s airway immediately. This is an important factor to consider when feeding children and why you need to avoid common food choking hazards. These include but are not limited to whole grapes, hot dogs cut into circles, hard candies, gum, popcorn, larger chunks of meat and cheese, small pieces of raw vegetables, etc. When looking at typical meals, actual choking is quite uncommon. When someone is choking they cannot move air, the cannot speak and you cannot hear a cry. Instinctively many reach for their throat. 

Gagging:  Gag, on the other hand, is defined as “to experience a regurgitative spasm in the throat, as from revulsion to a food or smell or in reflexive response to an introduced object.” We’ve all done it. It could be from a throat culture for strep or the smell of rotten food you found in the back of the fridge. For some it’s the texture of a food or even the thought of something they don’t like. Some of us are easy gaggers and others not so much. Some of us will throw up with the slightest of gags and others just power through. For kids who are picky eaters we often find they have a very sensitive gag response. Remember we use all our senses to eat and for some it’s simply the sight or smell of a non-preferred food that will trigger the gag. This can be scary when it happens, but this is why it is important to know the difference between choking and gagging.  With gagging there is noise and there is breathing. When gagging happens the best thing to do is try not to overreact. I know, easier said than done but if 25 years of speech and feeding therapy has taught me anything it’s that when kids learn they an get out of something they don’t like by gagging they will try it for a strategy to get out of other things they don’t want to do.  Here are some suggestions for the “gagger” in your life. 

• Use all the senses when eating. Allow your child to look at the food, smell the food, feel the food before you put it in their mouth 

• If and when your child gags, use reassuring words like “different, hard, new” and avoid words like “gross, sticky, smelly, etc.” For example, “oh boy, that was new. It was wet and you’ve not had that before.” 
• Don’t end the meal with a gag. If your kiddo gags don’t end the meal in that moment. Talk and work them through it staying at the table and then offer something from that meal that was easier/preferred. We often remember the last moments of an event so with meals you want to leave them wanting more 
• In the moment of the gag/retch, try providing firm pressure input through their shoulders, arms, hands. This deep pressure is very calming and will often “break the gag.”  

If your kiddo is one who gags a lot, and it is affecting their success at meals or life in general it may be worth an evaluation by a Speech Language Pathologist or Occupational Therapist who has experience in this area. Lucky for you both are available at Family Chatterbox so do not hesitate to call or email with any questions or concerns! We love this stuff! 

 -Tricia