Newborns occasionally gag or choke on milk. Understanding the distinctions between gagging and true choking can help parents respond appropriately and calmly. Most instances are not severe, as babies often clear their airways independently.
Understanding Gagging and Choking
A newborn’s gag reflex is a protective mechanism, triggered when milk flows too quickly or touches the back of their tongue. When a baby gags, they make noise, such as coughing, sputtering, or gurgling, and their face might turn red. This noisy response indicates air is still moving through their airway. Conversely, true choking is a silent danger, occurring when the airway is partially or completely blocked, preventing the baby from breathing, coughing, or crying. A choking baby might struggle to make sounds, show difficulty breathing, or their skin may turn pale or bluish.
Emergency Steps for Severe Choking
If a newborn is truly choking and unable to make noise or breathe, immediate action is necessary. Position the infant face-down along your forearm, resting it on your thigh, ensuring their head is lower than their chest. Deliver up to five firm but gentle back blows between the shoulder blades using the heel of your free hand. This creates pressure in the airway to dislodge the obstruction.
If the object remains, turn the baby face-up on your other forearm or a firm surface, keeping their head lower than their chest. Place two fingers in the center of their chest, just below the nipple line, and deliver up to five quick chest thrusts, compressing the chest about 1.5 inches deep. These thrusts work by squeezing air out of the baby’s lungs, expelling the blockage. Continue alternating five back blows with five chest thrusts until the obstruction clears or emergency medical help arrives.
Common Reasons Newborns Choke
Several factors can contribute to a newborn choking on milk. An overactive let-down reflex in breastfeeding mothers can cause milk to flow too rapidly, overwhelming the baby’s ability to swallow, often spraying forcefully from the breast. A baby’s immature suck-swallow-breathe coordination can make it challenging for them to manage milk flow effectively. Incorrect feeding positions, where the baby lies too flat, can also increase the risk of milk entering the airway instead of the esophagus.
Preventing Choking During Feeding
Adjusting feeding practices can significantly reduce the likelihood of a newborn choking. For breastfeeding mothers with an overactive let-down, nursing in a laid-back or reclined position allows gravity to slow the milk flow, giving the baby more control. Expressing a small amount of milk before latching the baby can also help manage a forceful let-down. For bottle-fed infants, paced bottle-feeding is beneficial, where the bottle is held more horizontally to allow the baby to actively draw milk rather than having it flow continuously by gravity. This technique encourages the baby to take breaks as needed, mimicking the natural rhythm of breastfeeding.
When to Seek Professional Medical Care
Seek immediate medical attention if a baby loses consciousness, turns blue, or stops breathing during a choking incident. Even if the obstruction is successfully cleared, a medical evaluation is recommended after any significant choking episode. Lingering breathing difficulties, such as wheezing or rattling sounds, or persistent coughing after a choking event, also warrant professional assessment. Prompt medical attention ensures complications, like aspiration of milk into the lungs, are addressed.