MS, RDN, CDN
Allison is a registered dietitian who holds a Master’s in Nutrition and Physical Fitness. She also loves helping families get creative with their wellness choices.
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As your baby learns to eat solids foods, it can be normal to feel nervous about your little one choking. But knowing which foods to watch out for can help you prevent choking.
Choking occurs when a foreign object (think food or another small object) becomes lodged in the throat or windpipe, blocking off airflow.1 In general, choking hazards include foods that are round, hard, and about the same size as a child’s airway.
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 they are eating.
Read more: Introducing Solids: First Foods & Textures
Every baby learns to handle solid foods at their own pace. With practice and time, your baby’s mouth and tongue muscles will begin to develop the correct movements and coordination for chewing and swallowing.4, 5
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, nor your baby’s ability to eat soft solid foods. In fact, your baby can “gum” most soft foods into a mash before swallowing them.5
Make sure any food you feed your baby can be easily smushed between your fingers, or is able to be dissolved by saliva, to help ensure it is safe for baby to eat.6, 7
Wait to advance textures (purees to lumpy purees/ mashes to soft solids) until your baby is showing appropriate signs of developmental readiness.
Learn more here: Introducing Solids: First Foods & Textures
It is very common for babies to gag as they are first learning to eat and manipulate solid foods.7 Being able to distinguish between gagging and choking will make mealtimes safer for your baby and more relaxed and enjoyable for you.
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. Gagging also helps babies learn how to safely manage food in their mouth.8 We all have this reflex with us our whole lives.11
Interestingly, at six months of age, the gag reflex is much closer to the front end of the tongue, making baby gag much more often while learning to eat.8 This reflex moves farther back as baby gets older.8
Gagging is a very normal part of learning to eat solid foods!
What does gagging look and sound like?
Choking is when the airway becomes blocked and baby can no longer breathe.1 Often baby may start coughing to try to clear the airway. Soft foods are many times easily coughed out, but harder foods or objects may get stuck. If your little one is able to speak, cry, or breathe – they are not choking and may be able to cough the object out.9
What does choking look and sound like?
If you suspect your child is choking, call 911.
Knowing first aid, such as the Heimlich maneuver and CPR, may be important should your child ever begin to choke. For more information, please chat with your child’s health care provider. You can also find resources at American Red Cross and American Academy of Pediatrics.
Keeping an eye on your little one will allow you to be ready to help if needed. This is especially important since choking may be silent.
Eating should only happen at a table or in a highchair while sitting up (and with good support for infants). Eating while walking or running may cause choking, as may eating while lying down.5
While tempting, the American Academy of Pediatrics does not recommend allowing children to eat in the car. Should your little one choke, it will be very difficult to help them as quickly as they may need it.5
Keep your baby’s meal and snack times relaxed and unrushed. Role model and teach chewing thoroughly and eating slowly.2, 3
Speaking and laughing with food in your mouth increases the risk of choking. Teach your little one the importance of chewing with your mouth closed and waiting to speak until after swallowing.10
Discourage your little one from putting too much in their mouth at a time.
Advance from purees to mashes to soft solids only as your little one shows they are ready. Make sure any food you prepare for your infant is soft enough for them to mash with their gums.7
For soft solids, cut into small pieces for baby to grasp and self-feed.
Avoid round shaped foods: Cut round foods length-wise and then into smaller pieces.6
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 know parenting often means sleepless nights, stressful days, and countless questions and confusion, and we want to support you in your feeding journey and beyond.
Our Happy Baby Experts are a team of lactation consultants and registered dietitians certified in infant and maternal nutrition – and they’re all moms, too, which means they’ve been there and seen that. They’re here to help on our free, live chat platform Monday – Friday 8am-8pm (EST), and Saturday – Sunday 8am-4pm (EST). Chat Now!
Read more about the experts that help write our content!
Introducing solids: Different approaches and strategies
Introducing solids: First foods and textures
Introducing solids: Signs of readiness
Introducing Major Food Allergens
Learning to Love Healthy Foods
1. NIH US National Library of Medicine. MedlinePlus. Choking. Accessed 6 September 2021. https://medlineplus.gov/choking.html
2. Centers for Disease Control and Prevention. Choking Hazards. Accessed 6 September 2021. https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/choking-hazards.html
3. American Academy of Pediatrics. Choking Prevention. Accessed 6 September 2021. https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/Choking-Prevention.aspx
4. Arvedson JC, Lefton-Greif MA. Anatomy, physiology, and development of feeding. Semin Speech Lang. 1996 Nov;17(4):261-8 https://pubmed.ncbi.nlm.nih.gov/8979310/
5. Holt K., Woolridge N. Bright Futures: Nutrition Supervision, third edition. American Academy of Pediatrics. 2011 https://brightfutures.aap.org/Bright%20Futures%20Documents/BFNutrition3rdEditionSupervision.pdf
6. American Academy of Pediatrics. Starting Solid Foods. Accessed 7 September 2021. https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Starting-Solid-Foods.aspx
7. Centers for Disease Control and Prevention. What, When, and How to Introduce Solid Foods. Accessed 7 September 2021. https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/when-to-introduce-solid-foods.html
8. American Academy of Pediatrics. Supplemental Information: Recognizing the Difference Between Choking and Gagging. Pediatrics 2016 Oct;138(4) https://pediatrics.aappublications.org/content/pediatrics/suppl/2016/09/15/peds.2016-0772.DCSupplemental/PEDS_20160772SupplementaryData.pdf
9. American College of Emergency Physicians. CPR for Infants and Children. Accessed 7 September 2021. https://www.emergencyphysicians.org/article/pediatrics/cpr-for-children
10. American Speech-Language-Heating Association. Unsafe Chewing: Choking and Other Risks. Accessed 7 September 2021. https://leader.pubs.asha.org/doi/10.1044/leader.FTR1.24112019.42
11. Sivakumar S, Prabhu A. Physiology, Gag Reflex. [Updated 2021 Feb 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan https://www.ncbi.nlm.nih.gov/books/NBK554502/