Why Your Newborn May Be Gagging

Newborn baby laying on blanket

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Newborns tend to be quite noisy, making a variety of sounds besides crying, like sneezing and hiccuping. Most of these noises are reactions to new sound disturbances around them and are healthy signs that their nervous system is functioning and maturing.

But, you may have also heard your newborn make a gagging or gurgling noise, and this can be understandably alarming. Besides just a normal clearing of their throat, there may be other reasons why your precious newborn is gagging, and it starts with some excess fluid left in their lungs after birth.

Why Newborns Gag and Gurgle

While a newborn baby is still inside their mother's uterus, their lungs are filled with fluid. Late in the pregnancy and before birth, fluid-secreting channels begin removing fluid from the baby's lungs, preparing them to take their first breath.

The passing of the baby through the mother's birth canal further helps to clear this fluid from the lungs. This is because as babies move through the birth canal with contractions, their chest is compressed, which leads to the fluid being squeezed out from the lungs. In addition, immediately following birth, a doctor suctions out the excess fluid to further clear the throat.

However, for some babies, the fluid remains in the lungs, sticking around for a few days after birth. This can cause babies to cough, as they try to clear the fluid themselves. Then, when the baby coughs or gags, the fluid and mucus come up, collecting at the back of the throat. This may then lead to a gagging or gurgling sound. 

Fluid in the Lungs

For some newborns, not enough fluid is cleared from the lungs during labor. These newborns may have trouble breathing, as evidenced by rapid breaths (more than 60 breaths per minute). The condition, which is normally diagnosed in the hospital soon after birth, is known as transient tachypnea of the newborn (TTN) or wet lung disease.

TTN requires monitoring in the neonatal intensive care unit (NICU) in the hospital. Most newborns respond well to treatment, with breathing difficulties usually resolving within 24 to 72 hours.

Gagging During Feeding

If your baby is gagging during feedings, there may be an issue with the force of the flow of milk or formula. If breastfeeding, your baby may need help dealing with forceful letdown or an abundance of milk. Try pumping for a minute or two before breastfeeding your child as the flow will slow down after the initial letdown. If bottle feeding, be sure to choose a slow-flow bottle and nipple.

Pace the feeding and break the suction periodically to give your baby a "breather." In addition, your newborn may gurgle simply because of air passing through the saliva or from refluxed milk as they gulp in air while feeding. This will go away as your newborn learns to swallow more frequently instead of letting the saliva build up in their mouths between breaths. 

Help Your Baby Clear Excess Fluid

If your baby is making gagging and gurgling sounds, you can help them clear excess fluid by turning your baby on their side and patting their back, as you would when burping them. Alternatively, you can use a bulb syringe to remove fluid from the back of the throat and/or nose.

Gagging After Feedings

Some newborns, particularly preemies, suffer from acid reflux, which can cause gagging after feedings. In reflux, some of the milk that gets swallowed comes back up into the esophagus, causing the baby to gag and/or spit-up. This is a common issue many babies experience, to varying degrees, and is especially common in the first few months of life. By 12 months, about 95% of babies have grown out of spitting up.

Burping your baby can help them clear regurgitated milk from their throats. Keep cloths or tissues handy to catch spit-up. You'll know your baby's gagging and spitting up is normal if it doesn't appear to bother your baby. If gagging, feeding, and/or spitting up makes your child irritable and/or seems to be painful, this could be a sign of an underlying issue, such as gastroesophageal reflux disease (GERD).

When to Call the Doctor

If the gagging persists and/or your baby seems to be in distress, call your doctor or go to the nearest emergency room. It is understandable to feel anxiety and even fear that your baby is choking. Note that choking and have trouble breathing is different from gagging and needs to be addressed quickly. Try to remain calm and assess the symptoms without jumping to conclusions.

However, if you think that your baby is acting abnormally or something is seriously wrong, don't wait. Seek medical care immediately. If your baby stops breathing, call 911 and begin infant CPR. If you haven't been taught how to do this, find a CPR class near you.

When to Call 911

If your baby experiences any of the following symptoms, call 911 or rush to your nearest emergency room.

  • Difficulty breathing
  • Ribs and chest pulling inward when inhaling
  • Soft or high-pitched sounds while inhaling
  • Inability to cry or make much sound
  • Weak, ineffective coughing
  • Bluish skin color (cyanosis)
  • Loss of consciousness

A Word From Verywell

While seeing your newborn gagging can be alarming, try to stay calm and allow your baby's natural reflexes to help clear their airways. Remember that we may think of babies as being quiet, but the truth is that they tend to be noisy—and most gagging sounds are not cause for alarm.

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Article Sources
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  1. U.S. National Library of Medicine. Transient tachypnea - newborn. Updated July 10, 2019.

  2. Czinn SJ, Blanchard S. Gastroesophageal Reflux Disease in Neonates and InfantsPediatric Drugs. 2013;15(1):19-27. doi:10.1007/s40272-012-0004-2

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