Gagging Hints for Smoother Swallowing

Hints for Smoother Swallowing

Close your eyes and pretend you are a baby. For the first six months of your life, you have been getting all your nourishment by sucking on a nipple--and you do it rather well. Sucking is something that you practiced in the womb, could do at birth and have been doing ever since. You are a natural, and life has been a pleasant procession of liquids expertly extracted--until today.

Today, your father has put you in an infant seat and is waving a silver spoon with great enthusiasm. On the spoon is a heaping mound of white goo--tremendously exciting stuff by the look on Dad's face. The goo comes closer, closer, closer, then plop! He shoves it in your mouth. ''Acchh,'' you gag. How the heck are you supposed to suck down that stuff? You spit the goo on Dad's new tie, then clamp your jaws shut. For the moment, feeding time is definitely over.

Although Dad might be alarmed because you gagged on your first bite of solid food, a certain amount of gagging is par for the course when a baby starts to eat. ''Eating solid food is a learned process,'' says Robert Wyllie, M.D., head of the Section of Pediatric Gastroenterology at the Cleveland Clinic Foundation in Ohio.

'' With the sucking reflex, babies bring their tongues to the front of the mouth and then up toward the palate. They may take 10 to 20 sucks, and then take a big swallow. With solids, though, the tongue needs to swing the food to the back of the mouth--almost the opposite motion,'' notes Dr. Wyllie.

Learning to swallow solid foods is not easy for a baby. And during the learning process, he may gag if food starts heading toward his airway rather than toward his stomach. You can help make mealtimes a gag-free experience, though, by adopting some new feeding tactics. Here are some tips from the experts.

Wait until your child is sitting up. ''If your child is gagging a lot while eating, he may not have reached the stage in his development where he's ready for the experience,'' says Flavia Marino, M.D., a clinical instructor in pediatrics at New York University Medical Center, Tisch Hospital, and a pediatrician in New York City. '' Your child should be at least four or five months old before you start feeding solids,'' Dr. Marino says.

The cue? Introduce solids when your child can sit up fairly well by himself, suggests Dr. Wyllie. '' When your baby eats sitting up, gravity will help him get food from the mouth down the esophagus,'' he says.

Start the meal with liquids. '' When your child is really hungry, breastfeed or give a bottle first to take the edge off her appetite,'' suggests Eileen Behan, R.D., a registered dietitian and consultant at Sea Coast Family Practice in Exeter, New Hampshire, and author of Microwave Cooking for Your Baby and Child. ''If your baby is less ravenous, it will be easier for her to manage the complex task of eating solid foods,'' she says.

Reach for rice. Rice cereal is an ideal first food because kids are seldom allergic to it, and it can be made very diluted by mixing it with extra milk, says Dr. Wyllie. '' Your baby will have less trouble eating the cereal if the texture is more like the liquid he is used to swallowing,'' he notes. Once your baby can swallow rice cereal, you can gradually work your way up to foods that are thicker and have a coarser consistency.

Keep the first meals small. ''Early solid-food meals are for practice, not sustenance, '' notes Dr. Marino. ''A baby who is learning to eat needs just a few teaspoons of food per day to practice on. The main nutrition should come from breast milk or formula.

Try a tiny dollop. '' When your child opens her mouth, place a pea-size portion of food on the front of her tongue,'' says Behan. ''A large dollop of food is harder to deal with, and if you drop it in toward the back of her mouth, your child is much more likely to gag on it.''

Easy does it. Don't try to force the issue if your baby is having trouble with a new food. ''If your child is gagging on a particular food such as potatoes or strained beef, I recommend omitting that food from the diet for a few days, then trying it again in slightly finer texture,'' suggests Dr. Marino.

Don't overfeed. If your child vomits or gags at every feeding, you may be giving him more than he can handle,'' says Dr. Wyllie. ''In the first year of life, a baby can't control his food intake very well, so it is your job not to overfeed him.'' Look for cues that your baby is full, says Dr. Wyllie. He may start turning his head away or closing his lips when the spoon comes near his mouth.