Episode 161: Introducing Solids: 9 Differences Between Choking vs. Gagging

Quick disclaimer. All information, content and material of this podcast are the opinions of the speakers and is for the informational purpose only and not intended to serve as a substitute for the consultation, diagnosis and or medical treatment of a qualified healthcare provider.

Hi, and welcome to episode 161 of the Untethered Podcast. This is your host, Hallie Balkan, and it's me and you today. Yay. So what are we going to talk about? This is a big topic. We're going to talk about choking versus gagging. Before we jump in, I do want to mention that we have our next pediatric screening feeding screening training. Like learn how to screen your first pee feeding patient coming up, May 16th through 20th. And you're going to want to go to feedthepedes.com backslash training. And that will get you on the list so you get all the updates, you know where we're hosting the training and all those fun details. I'll tell you everything you need, okay? So make sure you do that. Door to feed the peas. Our next round of the course will open between May 23rd and 27th, five days only. And the course starts on May 26th. So mark your calendar, get on the waitlist. You can also go to FeedThePedes.com to get on that wait list. Wanted to let everybody know because everyone keeps asking, when is the next course starting? So it's starting soon. But I wanted to go through the differences and this is going to be a quick episode today because this is just really a great informational episode on the differences between gagging and choking. And the reason why I want to cover this is because I, I so often see parents worry about their children's skills and say, oh, my baby chokes a lot. We had this choking episode the other day. They choked and then they vomited. Well, that is possible. That can happen. But whenever I've seen videos following these explanations, it's actually usually a gagging episode. And sometimes they're more severe than others. Right. So let's cover the nine differences between. We're going to go right through them and then I'll review them at the end. But with gagging, it's going to be loud. Okay. Versus choking. That will be quiet or silent gagging. You're going to have a baby's mouth usually open and their tongue is going to thrust forward. They're trying to expel that food. Whereas with choking, a baby's mouth will open, but their tongue is not going to come forward. They're going to be a little bit helpless in that regard. With gagging, a baby might like cough or sputter or gurgle or make some type of noise trying to explain, expel that, you know, that food. And with choking the baby or liquid, food or liquid. With choking, a baby will struggle to cough. They may not be able to cough at all, depending on the level of obstruction. With gagging, oftentimes baby may fuss or cry, whereas with choking, the baby won't cry. If they try to make any noise at all, they're probably going to sound like they're struggling to make a noise. With gagging, there's no trouble breathing. Okay? But with choking, baby will have trouble breathing. They might make a high pitched sound even because of the airway obstruction, depending on how obstructed they are. With gagging, the face often turns red, whereas with choking, the face or lips, you know, in the skin might become blue or bluish. With gagging, the gag reflex is protecting the baby from choking, whereas with choking, the baby's airway is blocked. Okay? With gagging, you know, we want to let the baby work this out on their own, which I know is the scariest thing for so many of our parents. But intervening can actually lead to choking. Okay? They need to develop the skill. Now with choking, baby needs you to intervene, right? We need to intervene immediately and try to dislodge that, you know, the food from. Generally it's going to be a solid piece of food, right? Or item from the airway. And I'm not going to sit here and teach you how to do that. That's not the point of this episode. But with infants, I highly recommend taking a C CPR class because the way that you do CPR in a baby is going to be different than an adult. And they also teach you what happens when a baby's choking because you have to turn the baby over to their belly and there's a certain way that you lay them across your knee and use the back part, you know, use your, the palm of your hand to, you know, bring it to their back and help to dislodge that, that item from their airway. So really important skill that I recommend all parents make sure they learn how to do if you're, if you're a parent or parent to be for a young infant. But providers, especially all of you medical professionals that work with these infants and even toddlers definitely should be trained in this as well. And then gagging is a normal part of these transition periods and weaning, right? We might be transitioning from just solely being on breast or bottle to introducing solids. It could be, you know, they're using their hands to feed themselves or using a spoon or a fork, a utensil. Maybe they're drinking from a straw cup or an open cup now, right? There's different things going on that may lead to gagging. And part of that's normal, but it shouldn't continue indefinitely as the child gets used to this new, you know, introduction of food, this new transition to all these different utensils and cups and different ways of getting nutrition in their body. Right? Whereas with choking, it's not. It's not normal and it might be life threatening. So it's a lot. It's a lot more serious. Right? So. So let's review. Told you this is going to be a super fast one today. We're going to do some short ones like this just to give you some really great tidbits over the next couple of weeks. But the biggest things to know, and I didn't mention this, but with gagging, we might see the eyes get a little watery as well. So with gagging, you know, the airways clear, they may. You'll hear that noise, right? It might be this loud noise or like a cough or a sputter or a gurgle, but they're breathing. They're likely going to be red in the face and trying to push that food out. Their tongue may come forward, right? And it's a normal reflex. It's not something we want to get rid of. It's a protective mechanism. So in some babies and even in some adults that that gag reflex may see sit too far forward in the mouth for any number of reasons. We often see this with tethered oral tissues, like a tongue tie, for example, where the reflux didn't move further, far back enough. Maybe it's like on, like halfway back.

On the tongue where we want it.

Like all the way to the back third of the tongue. But with babies, you know, in all these transitional periods in their first year of life, they should be moving that gag reflex back, especially as they're starting to mouth objects and items. And, um, you know, whether they're eating from their fingers or spoons or a little baby fork or something, you know, or they're chewing on chewy tubes or toys or other hard objects. Really great for their job. But you know that those things are the things that move the gag reflex back again. You never want to get rid of it. You just want to move it back. Okay, but we don't want to panic. We want to stay calm and let them work through it, maybe silently count to, like, 10 in your head and just observe them and just remain very calm while they work their way through it. Okay. This is compared to choking, where, you know, the baby may have, like, a panic look or a blank stare. They're going to have a blocked airway. Airway. So they'll be silent, right. They're not breathing. They'll turn bluish in the face and the skin and the lips, maybe because of the lack of oxygen. It's. This is not normal. Right. Then this is an emergency. So we need to intervene immediately and seek help. Okay. The one thing I will say, and I don't have, like, the names of them in front of me, you can go and Google this and see what you can find. But there are little things I know because some parents are very anxious about this, and rightly so. There are little, like, tools and things that some people will keep, like in a diaper bag or in the car or somewhere that basically has, like, a mask that goes over the nose and mouth and a little thing that you pull and it will help dislodge something straight out of the airway. And it can work on children and adults. So, um, you know, if that's. If this is something that makes you really, really anxious, definitely have something like that on hand and it will definitely make you feel a lot better. I, you know, I, I haven't seen it work in, like, person in real life, but I've seen it on videos of, like, real people having to use things like this with infants specifically, and they do appear to work really well. So definitely something good to have on hand and probably one of those, you know, googleable type of devices that you can. You can buy relatively cheap usually, too. So I hope this is helpful again. If you're an SLP or ot, join us. If you haven't done this in the past with us or come hang again, you're always welcome to rejoin us@feedthepedes.com backslash training. We are going to do the free training on how to screen your first pediatric feeding patient using my children as your models. And we're going to. You're going to see one child who has really great feeding skills. And I'm going to do that screening. You're going to see that whole thing and you see me fill it out and everything. And then we are going to screen my other child together who has not so typical feeding skills. The challenge will run from May 16th to the 20th, and the cart or doors, if you will, to feed the Peas@feedthepedes.com will open between May 23rd to May 27th, five days only and we start that course on May 26th. So make sure you go to feedthepedes.com backslash training to get on the list for all the details for the free training and and then go to justfeedthepedes.com to get on the waitlist for the full course. I have enjoyed sharing this information with you. This is not so light topic but one that I definitely wanted to make sure we cover on the podcast because like I said this question comes up so much and it's really important critical information that we should have out there and accessible to practitioners and parents. So everybody have a wonderful day and we will chat with another short episode next week. Thanks for listening to this podcast.

If you want to hear more of these Myotots, Airway and Feeding related episodes, be sure to leave a review on Apple Podcasts or pledge a small amount on patreon.com forward/the untethered podcast if you found value.

Others you know in this space will too. So be sure to share this episode.

On your social media platforms and join us over on Facebook on my Facebook page at Halle Balkan Biz on Instagram @hallebulcken and you can head over to theuntetheredpodcast.com to grab a copy of the Show Notes where you can also subscribe to be kept up to date on the latest podcast episodes.