What to Know

• High-risk foods associated with choking
• Strategies to prevent choking
• Understanding the important difference between choking and gagging

Feeling nervous or concerned about your baby choking on solid foods? You’re not alone. Educating yourself will help alleviate some of your (completely natural) anxieties. Choking occurs when a foreign object (think food or another small object) becomes lodged in the throat or windpipe, blocking off airflow. In general, choking hazards include foods that are round, hard, and the same size as a child’s airway.

Here are examples of high-risk foods associated with choking:

• Hot dogs and sausages
• Hard, gooey, or sticky candy like marshmallows and caramels
• Nuts and seeds
• Raw apples
• Whole grapes
• Small foods with pits like cherries and olives
• Raw carrots and celery
• Popcorn
• Chunks or thick layers of nut butters, including peanut, almond and cashew
• Chunks of cheese
• Chewing gum
• Raisins
• Large pieces of bread

Use this list as a guide, but ultimately your own judgment will come into play. Avoid foods that have similar consistency, texture, shape, or size to those listed above or are seemingly difficult for your baby to handle. Remember, choking can occur with any type of food so always supervise your baby while she is eating.

Since every baby is different, expect yours will learn to handle various foods at her own pace. Your baby’s mouth and tongue muscles will become more accustomed to chewing and swallowing with age. But don’t worry if your child does not have many (or any!) teeth. The number of pearly whites does not affect the risk of choking. In fact, your baby doesn’t actually need teeth to bite into food and can “”gum”” most foods effectively because her baby teeth are just underneath her gums. And always wait to introduce solid foods until your baby is displaying the appropriate signs of developmental readiness (described in further detail in Introducing Solids: Signs of readiness).

Also be aware that it is fairly common for babies to gag as they are first learning to handle and manipulate solid food. Being able to distinguish between gagging and choking will make mealtimes safer for your baby and more relaxed and enjoyable for you. So what is gagging? The gag reflex causes the throat to close, while pushing the tongue to the front of the mouth. It’s an important safety mechanism that actually helps prevent choking and assists babies in learning how to manage food safely. We all have this reflex with us our whole lives. Interestingly, at six months of age, the gag reflex is much closer to the front end of the tongue and moves farther back as the baby gets older, which is to say, it advances right along with your baby’s eating experience and competencies.

What to Do

Refrain from introducing solid foods until your baby is displaying the appropriate signs of developmental readiness

Take cues from your baby and avoid foods she has trouble handling.

Always supervise your baby while she’s eating

And help her position herself so that she is sitting up straight when eating.

Familiarize yourself with the list of high-risk choking foods

Remember that any food can be a choking hazard, especially if it shares similar consistency, texture, shape, or size with the high-risk foods listed earlier.

Take it slow to promote safety and good eating habits

Keep your baby’s meal and snack times relaxed and unrushed. Avoid letting her eat while moving around or riding in a car or stroller and teach her, by example, to chew her food slowly and thoroughly.

Offer sips of liquids between bites of food rather than together

Swallowing both food and liquids at the same time increases the risk of choking.

Learn the distinction between gagging and choking

Generally, when babies and toddlers gag they’ll make a throaty noise because the food is at the back of the throat but not yet lodged, and when they choke, they are silent and their faces turn red and then even blue because their airways are blocked.

Educate any caregivers on the strategies for avoiding choking

Make sure caregivers are familiar with the choking hazards and risks along with the appropriate plan of action in the event of an emergency.

We encourage you to enroll in an infant first aid class for choking and CPR

Possessing even more skills and knowledge on preventing choking will give you greater peace of mind.