Q: My 12 month old son is still having trouble with thick foods such as cottage cheese and thick oatmeal. He gags with almost everything. He even chokes on stage 3 baby food sometimes. He's fine with some puffs. He's okay with yogurt & string cheese if I break the string cheese up in tiny pieces. He loves bread, again if I break it into tiny pieces. It scares me to death when he chokes. He also won't feed himself with a spoon, I've tried to let him do that.
A: It’s very scary for parents when their children gag or nearly choke on food, and you’re wise to be concerned about your son’s tendency to gag while he’s eating. The first course of action is to take your son to his pediatrician for a checkup and a search for possible causes of his tendency to gag while eating foods with a thicker consistency.
The automatic gag reflex helps prevent choking, and it can be a lifesaver. It’s triggered when food or another substance unexpectedly touches the soft palate or the soft tissue on the roof of the mouth. The gag reflex is a series of involuntary muscular contractions at the back of the throat, designed to prevent food, water, and other substances from entering the windpipe. Some individuals—even adults—have a very sensitive gag reflex. They have to be careful chewing their food, swallowing pills, and even brushing their teeth. Adults with a hyperactive gag reflex can benefit from relaxation techniques to make swallowing easier, but of course babies can’t do this yet.
Your pediatrician will search for physical conditions that might be responsible for your son’s gagging. If there doesn’t seem to be a problem physically, you can try a few techniques at home, such as offering tiny spoonfuls of thicker foods to your son at mealtime, and placing the spoon only at the tip of your baby’s tongue rather than into his mouth. This way, your son can slurp the food off of the spoon and into his mouth slowly, so that the gag reflex isn’t triggered.
If your son continues to gag while he’s eating, your pediatrician will likely refer him to professional who is trained to help children with feeding and swallowing issues, such as an occupational therapist, a physical therapist, or a speech-language pathologist.