Letter from a mom I received recently:
“I’m grateful I have found your article about BLW. My daughter is 6m and a week and she has been introduced to solid food. From the beginning, she was willing to hold the food and a spoon by herself and lick or bite a bit of food while I was holding it. Seeing she is ready for solids and interested in manipulating I started the BLW. She has two teeth and recently she got two more teeth on the front and two more are coming. Because of that, the BLW started to be more stressful for me as she is able to bite a lot of food and it makes her gag or choke.
I gave her some mashed food as well but she is less enthusiastic about it even though she opens her mouth when feeding with a spoon. I gave her the mashed food to explore with hands but she seems not to understand she can put it in her mouth and eat it.
I am concerned, as I know she is ready for BLW but she can bite so much and then not able to chew it yet before swallowing it. What can I do?”
First of all, congrats on your little new eater in the house! So exciting!
Most babies at this age prefer to suck on or gum the food. They cannot chew food and move the pieces towards the end of the mouth yet.
But if your little one easily bites food off larger pieces, it does not mean she is going to try to swallow them, necessarily. She may gag a little, trying to expel the pieces but her skill to actually move the food towards to the back of the mouth has not developed yet. So, providing she is sitting upright, it’s not likely that the pieces of food will end up close to her throat. In most cases, you will just find them on the floor or her clothes later.
In fact, research shows that BLW babies are not more likely to choke than puree-fed.
Here are two things you will help you feed your baby confidently:
- The difference between gagging and choking
- How to cut finger foods for a baby who can bite chunks of food off but does not know how to chew yet
Below I cover each of them in more detail. (Scroll down till the end to grab the infographic version of the explanation!)The difference between gagging and choking and safe finger foods for babies with teeth. via @nataliastasenkoClick To Tweet
The difference between gagging and choking
Here is an extract from my online class Stress-Free Solids, explaining the difference between gagging and choking and how to minimize gagging and avoid choking.
“What is gagging?
Many babies gag once solids are started, even with smooth purees. Nature’s safely mechanism preventing babies from choking, the gag reflex moves to the back of the tongue by 9-10 months. At this point, most babies eat with minimal gagging and enjoy a variety of textures.
When babies gag, they often make a retching sound. They may just bring up the food they had in their mouth or, occasionally, vomit everything they had in their tummies. While distressing to watch (and messy to clean up!) your baby’s gagging may be normal.
Gagging is a safety instinct protecting your baby’s airways from being blocked by the food he is not prepared to handle yet.
Babies may gag when just starting solids, or when they try textures they are just learning to handle, like thick puree or lumps of finger foods.
If your baby is a “happy gagger”, does not vomit or does it very occasionally, does not get upset by his gagging and continues to eat, he is probably doing fine. Make sure not to overreact when he gags and he will soon learn to handle all kinds of food.
If, on the other hand, your baby vomits regularly because of gagging, is upset and crying when he gags, it is probably a good idea to experiment with other textures. If it is pureed that make him gag all the time, try finger foods. If it is finger foods, revert to purees to see if gagging gets better. If lumpy foods challenge him too much, stick to finger foods and smooth purees for a little longer.
In other words, be guided by your baby’s abilities and skills. If gagging persists, talk to your doctor about evaluating your baby for sensory and oral motor challenges.
Because so many parents are worried about gagging, I included a few videos of babies gagging in my online program Stress Free Solids. It’s really helpful to see how babies manage to successfully and safely get rid of the challenging food.
What is choking?
Choking is very different from gagging. Choking occurs when a piece of food gets lodged in the throat. Here are the signs of choking:
Signs of choking:
- Blue skin color
- Waving or flapping hands
- Blank stare
- Inability to make sound or cry
- Weak coughing
- Difficulty breathing
- Lips turning blue
- Loss of consciousness
How to minimize the risk of choking:
- Avoid choking hazards. Small round shaped food like whole grapes, cherry tomatoes, big blueberries, popcorn or candy may be dangerous. Hard food that snaps off easily, like raw carrots and apples are also not appropriate for a baby.
- Make sure that the finger foods you serve to your baby are soft enough to be squashed between your fingers.
- Peel all fruit and vegetables you give to your baby as finger foods. Remove the membrane from segments of oranges and clementines.
- Do not give your baby solid foods before she is ready.
If your baby cannot sit straight with minimal support and can only sit in a recliner, she cannot eat solid foods safely yet.
- If your baby has a strong tongue thrust reflex and gags a lot even with thin purees, he may not be ready for solids just yet. Pushing your baby to start solids before he is ready may increase his risk of choking.
- Avoid feeding your baby when he is walking/crawling around.
He has a higher risk of choking if he is not sitting at the table. For the same reason, do not leave trays with food for him to graze on while he is playing.
- Be near and prepared. Stay with your baby at all times when she is eating. Take a CPR course to give you peace of mind and essential skills.”
2. How to cut finger foods for a baby who can bite chunks of food off but does not know how to chew yet
If you still feel nervous about choking because your baby got teeth, my advice for you would be to stick to two options:
Option 1: offer finger foods that are really difficult to bite off from. Essentially, they will serve as gag reflex desensitizers rather than sources of nourishment, but that’s fine. You can give your baby puree to provide nutrition, in the meanwhile. (That’s why the mixed approach to solids is my favorite!)
Choose finger foods that are at least two-finger thick and are tougher, chewier, and do not let smaller pieces be snapped off easily. Example: thick slabs of well-done steak, slightly steamed broccoli floret, a thick slice of chewy bagel or ciabatta.
Option 2: offer softer foods cut very thinly, sliced on the mandolin or grated. This way, even if she does bite off a piece it will not be a choking hazard. Example: soft roasted vegetables, thin slices of avocado or cooked apple, thin slivers of boiled egg, steamed zucchini, thin slices of very soft ripe fruit, grated steamed carrot, apple or cheese.
What happens next?
You will notice more chewing in a month or two. Then you can be more relaxed about the size and texture of her finger foods because she will be able to chew and swallow most finger foods safely, although you will still have to avoid common choking hazards.
I hope this article will help clear some confusion around gaging and choking and will give you more confidence to continue giving your baby finger foods even if you got an enthusiastic biter!
If you would like to get the whole framework and all the steps to start your baby on solids using the mixed approach, check my Stress Free Solids program – it’s completely online and has videos of babies eating both finger foods and purees, in addition to recipes, schedules and the latest scientific advice on introducing allergens. You will also learn how to progress between textures on time, so your baby learn to self feed and eat table foods fast!
Starting solids the easy, safe and stress-free way!
Let me show you how to feed your baby using the mixed approach, so you can be guided by your baby and not by a rigid philosophy.