When your baby is ready to start solid foods, there can be a lot of nervousness amongst parents, especially if this is your first round with starting solids. Lalo’s co-founder Michael Wieder talks to Kim Grenawitzke, feeding expert at Solid Starts, about calming those nerves and understanding what is safe, and perhaps when to worry. As Kim quotes aloud, coughing is not choking. Gagging is not choking. Important mantras for any parent to a baby to understand. Food safety is important, which is why we ask Kim to explain more to you here.
Kim: I know there’s major anxiety around feeding when it comes to starting solids, which is choking. There's a lot of gagging that goes on, but choking is super rare.
I know that especially in partnered parenting, there's usually one parent that's super anxious about it, and one that doesn't even think it's an issue.
Michael: I was more the anxious parent, my wife was like this is not anything to worry about. I bring everybody through my journey of being the anxious parent to now becoming the non-anxious parent about choking.
Kim: Yes, it completely makes sense why you would be an anxious parent about choking, because the media makes you think that choking is a leading cause of issues and death in babies and young children. When you actually look at the data, it's truly not. It's actually a very, very, very small percentage of babies and children who are affected by true choking events in the United States.
With that said, we want to make sure that we are preparing our environment and preparing ourselves and our babies to be as safe as possible, because let's control what we can control.
Choking Rescue Preparation:
Kim: Everyone who's taking care of your child, whether it is grandma, grandpa, a child care provider, a babysitter, etc, should all be trained in choking rescue from the first day that they start taking care of your baby.
I can’t underscore that enough, because it is more common for babies to choke on non-food items than food items.
Choking on Non-Food Items:
Kim: Anyone that has a 7, 8 or 9-month-old, you've probably seen them crawling around all over the floor and picking up everything that they can see, because the pincer grasp does not discriminate. Your baby will pick up anything on the ground and put it in their mouth to explore it.
My friends have a text competition of what's the weirdest thing you've taken out of your kid's mouth? And it's anything from a cockroach to a cigarette (when no one in the home smokes, so who knows where that came from) to the little plastic thing on the back of a door stopper.
Your babies will pick stuff up from off the floor, put it in their mouth, and continue to crawl around. That is what scares me way more than food, because your baby is mobile, it's not something they're attempting to chew, and it's in their mouth.
So knowing choking rescue, knowing what to do in the event of an emergency is your number one most important thing you can do.
Feeding Themselves:
Kim: The research tells us that when a baby is in a well-supported seated position (so that means their hips are nice and secure, they're able to keep their bodies nice and upright, they're not reclined backwards) which is one of those important things about a high chair, feeding themselves reduces the risk of choking. The risk becomes extremely, extremely low.
This research actually started in nursing homes with geriatric population that they found that when nursing home residents fed themselves as opposed to nurses feeding them, the risk of choking decreased. This research has been repeated in a variety of different populations, including babies. So what we know is that when babies feed themselves, they are more likely to protect their airway and stay safe from choking. So a baby that is supervised in a well-supported high chair and feeding themselves, the risk of choking is very, very, very low.
Coughing is not Choking:
Kim: One other thing to keep in mind is that we all have tons of safety mechanisms to keep us safe from choking. Just because something scary is in your baby, your toddler, or grandpa's mouth does not mean they're going to choke on it. Our bodies are made to protect us. Babies, especially, have super strong protective mechanisms that keep things away from their breathing tube.
Gagging is not Choking:
Kim: We talk a lot about gagging, and everyone has questions about gagging, but gagging is actually a protective mechanism. We like to push stuff out of the mouth, so anybody with a young baby has probably seen how they put their hands in their mouths and their tongues immediately start sticking stuff out. That starts as a reflex, and then it is a motor pattern they know really, really well. And after that, we all cough. So if something gets too far back in our throat we start coughing because our body wants to keep our airway clear.
Coughing is not choking. I'm going to say it again. Coughing is not choking.
Kim: Coughing means air is flowing. It's pushing air out of the breathing tube, we want that. That's keeping stuff away. And then to top all of that off, the breathing tube closes on multiple levels when we swallow. So the inside of the breathing tube closes. There's a cap that goes on top of it. Everything's pushing stuff down, down the food tube and out of the mouth if it's in the wrong spot.
It's very, very unlikely that all of these protective mechanisms fail all at the same time. Can it happen? Yes, and that is when high quality, good choking rescue is super important to be able to jump in and do that right away.
Gagging is going to happen because of new textures- everything is brand new. So, you know, anything new can cause a gagging reaction, which is also not choking. Gagging is the brain's way of being like, wait, something's either not moving the way I expect it to in my mouth, which happens a lot with solids, or I'm not so sure about this, and I don't know if I should swallow it. So you know what I'm going to do? I'm not going to swallow it, I'm going to push it out. And because I don't want it to go in my breathing tube, I'm also going to close my breathing tube at the same time I'm pushing that out.
I've seen it with bottles and during breastfeeding that's not going well. I've seen it with toys, on fingers, on hands, on purees, on spoons, on food, you name it. It's just the brain's way of being like, nope, nope, nope, let's get that out. The therapist in me loves when I see a kid that was gagging food and spitting it out, start moving it forward in their mouth to practice chewing it. It's like, oh, their brain has kicked in and figured it out.
This is not medical advice, speak to your pediatrician with any questions or concerns regarding starting solids.
