By Jeanette Bradley 

 Medically reviewed by Jonathan B. Jassey, DO

Some toddlers seem to gag on anything that isn't baby food. Even older preschoolers can sometimes prefer liquid over solid food and may gag on anything with chunks. These kids may even throw up after eating solid foods. As a parent, it can be hard to know if a child with these problems is simply a picky eater or has a hidden medical problem.

This article looks at some of the reasons why a child might gag when eating, and what can be done to treat this problem. It also offers advice on when you should take your child to see a pediatrician.

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Some children have trouble learning how to eat solid foods. These children may simply take longer than their peers to get the hang of it. While they're learning, they may resist solid foods or gag on them.

Other children have a physical difference in the mouth, tongue, or throat. This difference might keep them from swallowing normally. These children struggle with the muscle coordination that's needed to chew and swallow without choking or gagging.

When to See Your Pediatrician

Not all babies are ready for solid food at the same time. First, a baby needs to be able to:

• Hold up their head

• Open their mouth for the spoon

• Physically move the food from the front of the mouth to the back1

The age that babies can do these things varies. This is why pediatricians urge parents to move slowly on solid food. Look for cues, such as:

• Your baby reaches for food

• Your baby is big enough to sit upright

Once your baby seems ready, you can start solids on the right schedule.

Gagging is a normal part of learning how to eat. It's the body's natural way of protecting the airway and preventing choking. Most if not all kids will gag when they first try solid foods. Different textures are especially likely to trigger this. If you think your child may have a feeding problem or if your child suddenly starts gagging when eating solid foods, talk to your pediatrician. Your pediatrician can determine if there is an underlying problem.

Recap

Make sure your baby is ready before offering solid foods. Remember that gagging is normal at first. If it continues, your pediatrician can look for an underlying problem.

Possible Causes of Gagging

Swallowing is a fairly complicated process. Gagging can point to a problem somewhere in this process, or in overall development. Some possible causes of gagging on solid foods include:

• Swollen tonsils or adenoids: Children who have chronic swelling in their throats may find it difficult or painful to swallow.2

• Gastroesophageal reflux disease (GERD): Some children with GERD may swallow food only to have it come right back up. This is one potential cause of swollen tonsils or an inflamed throat.3

• Sensory processing disorder (SPD): Gagging can indicate food rejection. Some children with SPD will gag on food if they don't like the texture.

• Low muscle tone: This is a symptom of some developmental disorders. Children with low muscle tone may not have the strength and coordination to move food around in their mouth and swallow.4

Feeding Problem Treatments

If your child has been diagnosed with a feeding problem, a number of steps can help. For example, children with GERD may need reflux medication. Children with SPD or low muscle tone may be referred to a physical or occupational therapist. These specialists can help your child improve oral muscle coordination and feeding skills.5

Recap

Gagging can point to a few possible problems with development or an underlying medical condition. Depending on the cause, the problem can usually be treated with medication or physical or occupational therapy.

Summary

Gagging can be a sign of a picky eater or a child who is slow to learn how to eat solid foods. In some kids, though, gagging on food can be a sign of an underlying medical problem.

Talk to your pediatrician if you think your child may have a feeding problem. Problems like GERD, sensory processing disorder, and low muscle tone can be corrected with medication or help from a specialist.

5 Sources

UCSF Benioff Children's Hospitals. FAQ: Introducing your baby to solid foods.

Boston Children's Hospital. Enlarged tonsils and adenoids.

Stanford Children's Health. Swallowing problems (dysphagia).

Howe TH. Oromotor therapy. In: Pediatric Dysphagia. Springer, Cham; 2018:119-134. 

UNC Pediatric Feeding Team. What to expect in feeding therapy?

Additional Reading

American Academy of Pediatrics. Starting solid foods.

American Speech-Language-Hearing Association. Feeding and swallowing disorders in children.

By Jeanette Bradley
Jeanette Bradley is a noted food allergy advocate and author of the cookbook, "Food Allergy Kitchen Wizardry: 125 Recipes for People with Allergies"