For most parents, choking is a massive worry when they start their baby on solids. Even a laid-back BLW advocate like me was still nervous during the first few meals! But, while there hasn’t been loads of research into BLW yet, a recent study in New Zealand made news by finding that there is no increased risk of choking with BLW.
The truth is, babies can choke on pretty much anything so it’s important to reduce the risk (regardless of whether you BLW or traditionally wean). There are a few ways to do this.
Firstly, babies should always be completely upright, which allows food to fall safely out of the mouth if they need to cough it up. So no feeding in a bouncer chair or car seat. I don’t like feeding in a jumperoo or walker either – it doesn’t feel safe to me that they might potentially move (plus it doesn’t fit in with my personal commitment to family meals round the table). The safest option is to use a highchair that sits fully upright or to allow them to sit on an adult’s lap or on the floor/ground (only once they are able to sit upright unsupported).
Secondly, with BLW, babies should always be in control and put the food in the mouth themselves. That way, if it’s too big or they’re not able to eat it, it will naturally fall out. If it’s been put in their mouth for them, there’s a chance it will go further back than they can handle.
Probably the most important safety tip is to avoid leaving your baby on their own when they eat. It’s best to eat with them; if you do feel you need to get up (maybe to start clearing up) before they’re finished, make sure you are keeping a constant eye on them. Real choking will be silent so you might not realise if you leave the room.
Avoid giving your baby obvious choking hazards:
- Whole nuts are the big one here; avoid until age 5. You can offer nuts as nut butter, ground into flour or very finely chopped in things like baked goods.
- The risks of whole grapes have been well-publicised – the size and shape makes them a perfect plug for the airway and the skin helps stick them there. Always at least half grapes lengthwise – I quarter them lengthwise to be on the safe side.
- Some very hard raw fruit and veg, like carrot and apple, may be difficult for your child to manage safely until their chewing abilities are well established and possibly not before they have teeth. I either grate carrot and apple so Eli can pick them up in handfuls or steam them in the microwave to soften first. Some people find taking a bite out of an apple and offering to their baby works well, as they just scrape their gums on it and suck the juices.
- Other round, windpipe-sized things like cherry tomatoes can be quartered lengthwise like grapes.
- Sausages should be cut lengthwise and possibly have the skin removed.
Gagging V choking and what to do
When I’m talking about choking, let’s be clear – I mean the total or partial obstruction of the windpipe, which is very dangerous. There’s a difference between this and gagging, which is an integral part of how babies learn to handle food. Gagging is normal and not dangerous – you can usually tell the difference as the child tends to cough, splutter or make some kind of noise. They also often go red in the face. Choking on the other hand is silent and the child will go blue as they aren’t getting enough oxygen. (As a side note, my son’s gagging is generally quite silent but over in an instant; I’ve been lucky enough that we haven’t experienced choking or even extreme gagging yet).
Gagging can be alarming, but it’s best to let the child handle it themselves. A baby’s gag reflex is so far forward in their mouth that the food is unlikely to be anywhere near their windpipe – this is an in-built safety mechanism to help prevent choking. As they learn from these experiences and become more competent eaters, they will gag less and less.
Make sure you know what to do if your child does choke. Attend a paediatric first aid course or watch videos on Youtube to show you what to do. Here’s a good one from St John’s Ambulance.