Gag Reflex and Swallowing Problems

by T. Berry Brazelton, M.D., author of Feeding: The Brazelton Way

All babies gag when solid foods are first introduced at 4 to 6 months of age. Most will first push away the spoon with their tongues because of a reflex (the extrusion reflex) that is still active at this age. If they do this for several days in a row, they may be trying to tell you they're not ready for solids yet. Try again in a week or so to see if this reflex has become less reactive.

Some babies, though, gag and spit up even earlier, such as when a bottle is introduced. The gag reflex itself may be hypersensitive. Or the swallowing muscles may be poorly coordinated. Typically there are three components of sucking:

1. The lapping of the tongue in the front of the mouth
2. The massaging and pull from the back of the tongue
3. The pull from the throat

But in some babies these different actions are not working together. Each one is set off alone, and the separate movements don't come together to pull in your finger. In fact, your finger may set off an opposite reaction—vomiting or spitting up. If you find this happening, consult your child's doctor about ways to help the baby feed successfully.

Some babies' mouths and tongues may be especially hypersensitive—to touch, texture, or taste. When this is the case, it may help for you to press firmly on the baby's lips before you offer the finger or the feeding. You may even need to press with your finger on the insides of her cheeks and on her palate. Then the baby may begin to suck normally. But keep your finger away from the back of her throat, where you can set off the gag reflex and make her become more uncomfortable and spit up.

Excerpted from:

Excerpted from Feeding: The Brazelton Way © 2004 by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Perseus.

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