gag reflex

ag reflex, also known as pharyngeal reflex is the process of involuntary contraction of the muscles of the pharynx so as to prevent non-food objects from entering the food pipe. Pharynx is a conduit with funnel like shape which conducts food to the esophagus and air to the larynx and lungs.

What causes gag reflex?

Simply gag reflex is contraction of the back of the throat caused by objects which touch the roof of the mouth or the area around the tonsils or the back of the tongue. Gagging is a natural phenomenon which prevents anything other than normal food entering the system.

When objects including food reaches the back of the throat, a number of physiological steps do occur in order to produce quick and spontaneous reflex preventing the objects from entering the pharynx.

When abnormal sized objects touch the back of the throat gag reflex occurs. In majority of the people, this is a normal physiological activity.

But there are a number of people who are not that sensitive and such gag reflex do not occur in them normally without inducement. Likewise there are people who are hypersensitive and gag reflex occur to them more quickly. Both the extremes are due to various underlying medical conditions that are to be examined and appropriately treated. Gagging is also induced artificially in certain cases in order to vomit or throw out undesired food or other objects either before entering the food pipe or after reaching the stomach.

Should you be bothered?

While gag reflex is not an altogether undesired physiological function in as much as it prevents choking in addition to facilitating smooth passage of all types of liquid or solid foods, there are certain adverse complications that arise out of or the cause of gag reflex. More particularly in the case of babies it is a bothering and sometimes a serious issue.

All are bound to have gag reflex but only when it becomes hypersensitive preventing swallowing food it becomes worrisome. In newborns, say up to six months gag reflex occur even on normal mother’s feed or substitute milk feeding. This happens when the brain receives warnings about the digestive capacity of the stomach of the infant.

It may be a false alarm but ensure that the baby does not get choked as it is not prepared to swallow semi solid or solid foods. Gag reflex in infants is mainly on account of the fact that their digestive tract is yet to mature unlike a grown up child.

When do the symptoms of gag reflex decrease?

Once the child becomes six months old such gag reflex automatically decreases enabling the child to consume different forms of food. However, in the case of hypersensitive gag reflex, even consumption of certain sticky foods like banana or smashed potatoes etc. can cause reflex preventing normal and adequate consumption of food leading to malnutrition sometimes. Hypersensitive gag reflex is due to stimulation of soft palate.

When the baby chokes every time it is fed, it is an indication that it is hypersensitive and need to be addressed. The urge to gag in infants is essentially due to aversion towards certain types of foods.

Newborns and infants who are on breast feed or other milk food experience frequent gag reflex. This is due to excessive flow of milk from the breast to the baby’s mouth. This milk could be beyond the capacity of the child to swallow. So also when bottle feed is given, if the hole in the nipple is too big larger quantity of milk flows and induce gagging. When such excess flow happen it produces cough and gag reflex in the child.

In the case of adults acid reflex takes place from the stomach. Likewise in infants also such reflex is possible and consequently gagging takes place. In addition to breast or bottle feeding, infants may also experience gag reflex upon introduction of solid foods. Inadvertent entry of the food particles into the air pipe might also cause gagging.

Myths about gag reflex

It must be understood that gag reflex in infants need not necessarily be due to excess feeding. It may also not be because the child is fed when not feeling hungry. This is a sensitivity issue and needs to be addressed when it becomes hypersensitive.

While gag reflex in adults can be removed by desensitizing techniques of the soft palate. It is altogether a different process in babies.

Before treating the baby for gag reflex, distinguish it from choking. In the case of choking, the airways are blocked which results in producing unusual noise.  In this case, the baby is unable to cough or even cry.

Remedies for gag reflex

Remedies for gag reflex in babies are:

  • Give frequent pauses while breast or bottle feeding
  • Ensure the hole of the nipple of the bottle is right sized. This is in order to restrict the flow of milk to the desired level.
  • Introduce solid foods after at least six months of age. Ensure that the baby is ready to swallow solid foods.
  • Introduce spoon feeding in small quantities and make the child suck the food.
  • The child has to learn to push the food into the throat using the tongue which may take some time.
  • Introduce different forms of food slowly giving sufficient time to the baby to regularize the habit.

When normal measures to tackle gag reflex are not effective, it is necessary to consult a pediatrician.

Kripa Sivasubramanian, MBA, earned her Master’s degree in Business. After a long stint in the Technology sector, she took up courses in natural medicine and yoga. Ms. Kripa is certified in Ayurvedic yoga for Dosha. She is also certified by Stanford University School of Medicine in Introduction to Food and Health.