Baby-led weaning - gagging and choking question

[atpeace]

I need some advice from other baby-led weaning parents.

DS is six months old, and while I know solids aren't necessary yet, I'm interested in starting to introduce them, slowly and gently, for fun.  And I know that on-demand nursing is priority, which we will be continuing for a long time still.   

I'm convinced that I want to avoid the whole "pureed mush fed to baby with a really cute spoon" route, and the "baby must eat x amount of y by xyz age" shenanigans, and the whole "laborious 'baby food' preparation according to expert, specialty cookbooks, using expert kitchen gadgets" fiasco.  

The problem is the gagging/choking issue.  DH is not entirely convinced that BLW is the way to go because he's very concerned with safety in general, and is a bit mind-boggled that people give 6-7 month old babies whole pieces of real food to gnaw on.  He's worried about DS breaking a piece of the food off, and it getting lodged in his throat.    

How have you dealt with the gagging and choking issue with others in your life (family, friends, self)?  What does it really mean when babies gag (I know it's not necessarily choking)?  

Are there any anti-BLW sites or groups or people here, just so we can get a general sense of the other side of the debate?  

[Knitting Mama]

Well, I can give you my experience. We started BLW when Cecilia showed the readiness signs-- sitting independently, loss of infant tongue thrust, interest in food, ability to pick things up and self-feed. I wouldn't start earlier than all of those signs, personally.

I purposely chose softer foods for her first foods. They were, in order, avocado, steamed butternut squash, soft pear, and steamed sweet potato. Others do banana as well; I am allergic to the and the smell makes me vomit, so we haven't done banana. Because the food is soft, it was very easy for her to gum on (she didn't get her first tooth until after we started).

As for the worry about gagging and choking, it's totally understandable. I know that you know this already, but there is a difference between gagging and choking. Gagging is completely natural, and it is what happens when the food goes towards the back of the mouth before the baby is ready for it to. They gag, and it moves forward again, to be gummed or chewed. It's also usually pretty noisy (Cecilia makes awesome noises when she gags). Choking is generally a very silent thing; because the airway is blocked by food, they can't make much sound. I would highly suggest taking an infant CPR class before starting. That might help your husband feel more confident too.

You can also talk to him about the benefits of going BLW. I would also highly suggest getting the Rapely book. Here are some good sites as well:

http://www.wholesomebabyfood.com/babyledweaning.htm (this page has some more links towards the bottom)

http://babyledweaning.blogware.com/blog/GettingStartedFingerFoodBasics

http://www.rapleyweaning.com/assets/blwleaflet.pdf

[sapphire_chan]

Any website on infant feeding that isn't a baby-led weaning site will go off about how you have to make stuff super-duper smooth to avoid gagging and choking.

The best way to get your dh to chill? Let him see your LO with a chunk of real food. When he sees the eensy teensy little bitty bites they take when they can control their own bites, it should make him relax.

Plus, if the baby is handling picking up the food and eating, you can keep a closer eye on things and have your hands free to handle any difficulty ASAP.

My dd didn't like soft foods for awhile. She preferred firmer things like lightly steamed broccoli.

[newsolarmomma2]

I'm no expert, but for me the point of baby led weaning is that you give them food when THEY want it, what you start with is not as important as following their cues. I dont find the food itself important, but thats only my view, others think differently, which is great- its about YOUR baby.

I started my now 5 mo son on solids when he started grabbing at my food and staring at it while I ate. It was wild, he took the spoon right out of my hand and put it in his mouth! He started at 3 months, much to my pedis dismay, but he was ready, and 17# at the time (21 now). Also, he is much happier when he gets food, not just milk. I dont know why this is.

We started with bits of whatever we were eating, as long as it wasnt spicy or raw, and smooshed it up. he has no teeth, and Im no heimlich master, so Im not giving him hard things or big pieces yet, though it can be done. I dont know why people are against rice cereal, or the other grains, or baby food (other than price, ouch!) he likes it and its easy for him to eat. AND easy to make! Some of his favorites are mini plantains (banannas) squished up, mangoes, pears, squash, refried beans and apples and carrots mixed up. Right now he eats from a spoon or with fingers. hes good at getting spoon to mouth, but not spoon to food, so I do help him. Im sure some people would not consider this BLW, but I do, as it is following his cues, to each his own.

Good luck!

[Knitting Mama]

Originally Posted by newsolarmomma2 

I dont know why people are against rice cereal, or the other grains, or baby food (other than price, ouch!) he likes it and its easy for him to eat. AND easy to make! 

Rice cereal is nutritionally useless, empty calories. And, there is new research showing that early introduction of it may lead to obesity. http://www.drgreene.com/whiteout

I have nothing against whole grains or baby food, we just choose to wait on grains and do not choose to use commercial baby food. To each their own.

[newsolarmomma2]

Thanks Cecelia, I was wondering about this. I make it with formula, so its not totally void of nutrients, but Im not going to worry about it, he doesnt get enough to make much difference. We feed what we eat because baby food is a rip off, amd we eat pretty healthy anyhow.

[P.J.]

Originally Posted by sapphire_chan 

The best way to get your dh to chill? Let him see your LO with a chunk of real food. When he sees the eensy teensy little bitty bites they take when they can control their own bites, it should make him relax.

Agreed! DH was never opposed to BLW, but now that we've been doing it for 6 weeks or so, he is totally convinced. Several times (including breakfast today) he has happily raved to me about how impressed and convinced he is that this is the way to go. He said he was not convinced when I told him about it, but now that he sees it in action (and benefits from how much easier it is!), he is totally into it.

And get the Baby Led Weaning book (that's the actual title). Ask DH to read it before he makes any further arguments (it's a quick, easy read). There is a section in there on gagging and choking, he could at least look at that.

GL!
 

[atpeace]

Thanks, everyone.  I did get that book from the library, and DH has skimmed it, and read the gagging section.  It didn't convince him because all it basically says is that gagging is different than choking, but it doesn't address how to prevent both of them (other than not offering obvious choking hazards).  He's worried that the gagging could lead to choking, and he has a hard time watching DS gag.  

We're sort of on the fence about it, him more so than me (I've been ok with it, but truthfully the gagging and potential for choking freaks me out a bit too).  I've been hesitantly offering chunks of food to DS (cucumber slice yesterday, a stick of red pepper and broccoli today).  He gums it really hard and pieces break off.  I gave him a rotini pasta yesterday, and he mushed it up in his mouth, and proceeded to gag on it, which to be honest freaked me out a bit too.  How do I get over this fear?  Especially since someone above suggested we take an infant CPR course, which implies that we'll need it...even though I'm trained in infant CPR, I'd rather not have to use it!

Ugh, I didn't think this whole feeding thing would turn out so complicated and concerning!    

[lifeguard]

We started with the really soft stuff (cooked sweet potatoe, avocado, banana) that he could really gum & mush about. From there I found it pretty easy to follow his lead as to what he could & could not handle. We never had a choking incident, but yeah, occasionally he did gag a bit.

But gagging is NOT choking - I just wish I could convince my mom & mil of that! Gagging doesn't even necessarily mean that there is even really something in danger of causing choking as it can take a VERY small something touching the right spot to cause a gag reflex. And of course babies tend to have pretty sensitive gag reflexes (for good reason).

Have you both reviewed what to do in the case of choking? Taken a cpr course recently? 'Cause I think that is part of what made me feel less panicky about it - I feel pretty confident I can deal with things.

And of course, ds NEVER ate without someone right beside him.

[ScottyG]

I'm curious about this too.  We've been trying out some baby-led weaning, but I worry about the choking thing myself.  I know the difference between gagging and choking, but what I don't know is whether the risk of choking is greater with BLW versus puree-feeding.  I was hopeful about the "eensy teensy little bitty bites they take when they can control their own bites" that sapphire_chan mentions, but my little girl wants to take gigantic bites (like, golf-ball sized pieces) and mush them around in her mouth, then let most of it dribble out while swallowing the rest.  I like the idea, but it also makes me nervous.  

Any ideas about how to proceed when the little one wants gigantic bites that she can't really handle?

Edited by ScottyG - 1/7/11 at 1:41pm

[dmpmercury]

I did BLW with my older kids. The reason babies gag so easily is because in young babies the gag reflex is at a much higher place than in an older baby or an adult. It is a safety mechanism so they learn how to manage the food. It can be a little scary when they gag a little but they aren't choking. My kids didn't take teeensy tiny bites but they never bit off stuff that would of been a size that is a choking hazard. I always make the food softer when I am first starting and don't do chokable food. I don't prepare it so soft that it turns to mush though. In the long run my kids were less likely to choke because they knew how to handle food from a very early age. The gagging didn't last long before they knew what they could chew. I never had to cut things up in tiny pieces. I knew toddlers who still needed their food cut up into little pieces and would likely choke if you didn't do that because they didn't know how to handle their food and would stuff whatever you hand them in their mouth without chewing.

[goinggreengirl]

Even babies that are puree fed until they are toddlers gag on solid food when they start eating it. We are allowing DS to feed himself soft foods and he does pretty well. DH is SUPER paranoid though, so much so that HE makes me nervous even though I know DS can handle the food. Just remember that when they are gagging it means they aren't choking. Gagging is good, gagging is natural. It means they are learning how to work the food around in their mouth. It will lessen as they figure it out and won't gag as much (if at all) when they are toddlers.

[sapphire_chan]

Something to point out to your dh, when a little baby gags, they're doing it forward in their mouth and it's easy for the food to fall out. When an older baby gags the food is farther back in the mouth and they're more likely to choke.

One way or another, there's going to be gagging. The question is whether you'll let the baby gag when it is teaching them how to manage their food, or whether you'll give super smooth purees until they're old enough to end up gagging on choking hazards?

[sapphire_chan]

Originally Posted by ScottyG 

I'm curious about this too.  We've been trying out some baby-led weaning, but I worry about the choking thing myself.  I know the difference between gagging and choking, but what I don't know is whether the risk of choking is greater with BLW versus puree-feeding.  I was hopeful about the "eensy teensy little bitty bites they take when they can control their own bites" that sapphire_chan mentions, but my little girl wants to take gigantic bites (like, golf-ball sized pieces) and mush them around in her mouth, then let most of it dribble out while swallowing the rest.  I like the idea, but it also makes me nervous.  

Any ideas about how to proceed when the little one wants gigantic bites that she can't really handle?

Give firmer food. The one time I was actually worried about dd choking as a baby was when she had some canned pear. It was really soft and cut in wedges so she was able to gum off a huge (for her) bite. This was the same day she had had no problem tackling lasagna.

Fixed it by tipping her forward so the food fell out.

She also took far too large of a bagel the first time she encountered one, she turned to me with a look of "this isn't working!" and I reached in with a finger and popped it out. On that one, she wasn't distressed (the pear really made her panic), she just didn't know what to do with a bite that filled her mouth.

[Kobaby]

Bump!

[SKMarker]

What age?

[rinap]

One thing to think about is whether they can get off a big bite. For babies without teeth, if they get something very large (say, a whole apple), they may be able to gnaw at it and get little bits off, but not get the whole thing into their mouths far enough to choke themselves. This doesn't help if they're gagging on the apple scrapings, but it does keep bigger bits from choking them. (you then have to keep an eye on them to make sure they aren't capable of biting off bigger pieces than you expect, or don't grate down the food to choking dimensions)

[behaviourmama]

I know this thread is a bit old but I just wanted to say that I'm doing BLW for the second time, not because I really prefer it, but because my babies dislike purees, or objects being brought towards their faces, or really like control (or all of those options!). This time I've been giving DD pureed foods in ice cube form.. which is working out really nicely, because she can grab it, it melts quickly, and the texture is still really fine so she isn't gagging. She LOVES it. The 3YO is eating them too, which is a nice side effect! I also am preferring this over soft whole foods bc I don't have to worry about prep and waste.. I can do it when it's convenient, give her small portions, and obviously the rest will keep for awhile. The only thing to watch for is one time the foodsicle stuck to the roof of her mouth; it might have been too cold, so I've been letting it thaw for a few minutes before I give it to her. It's also SUPER messy but I think that's a given when you're choosing the BLW route?

[wendizbaby]

Originally Posted by behaviourmama 

I know this thread is a bit old but I just wanted to say that I'm doing BLW for the second time, not because I really prefer it, but because my babies dislike purees, or objects being brought towards their faces, or really like control (or all of those options!). This time I've been giving DD pureed foods in ice cube form.. which is working out really nicely, because she can grab it, it melts quickly, and the texture is still really fine so she isn't gagging. She LOVES it. The 3YO is eating them too, which is a nice side effect! I also am preferring this over soft whole foods bc I don't have to worry about prep and waste.. I can do it when it's convenient, give her small portions, and obviously the rest will keep for awhile. The only thing to watch for is one time the foodsicle stuck to the roof of her mouth; it might have been too cold, so I've been letting it thaw for a few minutes before I give it to her. It's also SUPER messy but I think that's a given when you're choosing the BLW route?

My neighbor does this with purees that she makes and she loves it too.

I'm not trying to be rude, but what is wrong with pureed food?  It sounds like a great way to get different tastes and nutrition in your babe.  I'm just wondering why anyone would not want to try that route if they are afraid of choking.  I am VERY afraid of choking...I've had to pull food out of my 5 year old ds more times then I am comfortable with (ONCE is actually enough), so will be very careful with this baby.  Also, I didn't see this mentioned, but what about one of those baby mesh feeder things?  I have a few....you put the food in there so they can just suck on it.  
 

[Katie8681]

wendizbaby, I feel the same way. My ds (7.5 mos) will put anything and everything in his mouth, and I let him go at it with soft solids a few times, only to have him take chunks that he would gag on to the point where I'd have to finger sweep it out. I am just not comfortable with that. So I'm going a middle ground and pureeing steamed fruits and veggies, but I'm not spoon feeding. I plop it in front of him with a spoon and let him go at it, because he is so fascinated with us eating. He has fun, has total control over how much he eats (not a whole lot at this point), enjoys being part of family meal time, _and_ dh and I aren't on the edge of our seats watching for him to turn blue. Win-win-win! That is working best for us, but I have friends who did baby-led weaning and it worked perfectly for them. I was so nervous about how/when to intro solids and for me, this has taken pressure off. We're just having fun here. He has done just fine EBF up until now. I plan to ask my pediatrician to test for anemia at his 9 month visit, but he definitely shows no signs of it.