Parenthood is filled with all sorts of weird and unexpected sounds, but one sound you never want to hear is that of your child choking or gagging, especially when there is something in their mouth like a pacifier.
Why does my baby gag when I give them a pacifier? There are several reasons your baby may be gagging on their pacifier. Many of these factors are associated with the gag reflex in the back of the baby’s throat, which is sensitive and easier to trigger than in adults. Additionally, they may not like the pacifier’s taste, smell, size, or texture.
Keep reading to learn more about pacifiers, how they’re used, why your baby is gagging on them, and what you can do to help.
Why Baby Gags on Pacifier
Rest assured that babies gagging on pacifiers is common and doesn’t make you a bad parent for offering them one.
There are many possible reasons that your baby is gagging on their pacifier. So, we’ve formulated a few of the most likely culprits.
1. Nipple Too Long
Pacifiers come with different nipple sizes that are conducive to the depth of the baby’s mouth at different ages.
While the way nipple lengths are measured and labeled varies from company to company, there are three main nipple sizes:
- Size 1 is meant for 0+ months
- Size 2 is meant for 6+ months
- Size 3 is meant for 18+ months
- One Size is meant for all ages
If the nipple is too long for the depth of your baby’s mouth, it will end up triggering their gag reflex. This typically occurs with newborns and infants. If you notice this happening often, try a smaller-size pacifier.
2. Doesn’t Like Pacifier Shape or Texture
Pacifiers come in many shapes to fit different mouth anatomies and sucking styles. What sits comfortably in one baby’s mouth may not do the same in another. The main nipple shapes are:
- Bulb: The tip is bulbous while the base is cylindrical.
- Round: The whole thing is cylindrical from the base to the tip.
- Flat: The nipple is flat and sits between the roof of the mouth and the tongue.
- Slanted: The tip of the nipple is bulbous with a slanted tongue side.
If the shape of your baby’s pacifier is bothering them, they may try to push the pacifier out of their mouth. Doing so can trigger their gag reflex and cause them to gag on the pacifier.
After trying a different size, it’s best to try a different shape.
3. Doesn’t Care for Pacifier Taste or Smell
When we taste or smell something unpleasant, we often gag, and a baby does the same. Our natural instincts tell us that if something tastes or smells foul, it’s probably not the best to eat.
Babies are much more sensitive to and reliant on this instinct.
4. Naturally Strong Gag Reflex
The first year or two of life is about experiencing the world through touch and taste, so babies have a naturally strong gag reflex to protect them from themselves.
The gag reflex is triggered further up in the mouth, and because it’s more sensitive, it’s easy to trigger.
As the baby grows, so will the mouth. The gag reflex will push further back into the mouth and become less sensitive.
5. Pacifier Put in Mouth Too Abruptly
Our gag reflexes are designed to block anything that enters and is not meant to be eaten.
Your baby’s gag reflex will react to foreign objects, like a pacifier or food, being put in too abruptly. Sometimes, they even gag themselves by doing this with their fingers.
6. Doesn’t Want Pacifier
If your baby doesn’t want the pacifier, they will try to push it out of their mouth with their tongue. Sometimes this action backfires, and the pacifier dips deeper into their mouth. This triggers their gag reflex.
They will continue to try and remove it from their mouths until they are successful or until they get frustrated and the parent removes the pacifier.
7. Tongue-Tie or Other Oral Issue
If the baby is unable to suckle correctly due to a tongue-tie or an oral issue, they may also struggle to push the pacifier out of their mouth. This can lead to the pacifier dipping too far back into the throat, thereby triggering the gag reflex.
If you believe your child may have a tongue-tie or other oral health issue, it’s best to contact their pediatrician for an evaluation. Most tongue-ties can be resolved via minor surgery or snipping.
When To Be Concerned
If your child is making any sort of gagging or choking sounds, remember to remove the object from their mouth immediately.
But remember choking is a silent killer, it is not at all like what is seen in the movies, and the same is certainly true for babies.
Watch for signs of choking, specifically the coloration of the baby’s face and the presence of visible and audible breathing.
Depending on the kind of pacifier that’s being used, the nipple may have dislodged from the base, or your child may be having an allergic reaction.
Are Pacifiers Good for Newborns?
Pacifiers pose positive health benefits specifically for newborns. Not only do they help babies learn to self-soothe when upset, but they can also aid in pain relief when teething.
In infants under one year of age, they reduce the risk of SIDS when used during sleep periods.
Are Pacifiers Necessary?
While it’s a common occurrence, it is not necessary to use a pacifier for your baby. Some babies will shy away from pacifiers altogether, and some parents prefer that their child not have them in the first place.
However, it’s a great tool for soothing and does have benefits for infants.
Pacifier Pros and Cons
Deciding what’s best for your family and your little one is no easy task. Here are the pros and cons of using a pacifier:
- Pacifiers reduce the risk of SIDS.
- Pacifiers help babies learn to self-soothe.
- Pacifiers can provide pain relief.
- Pacifiers can cause nipple confusion in breastfed babies.
- Pacifiers used for too long can cause dental issues.
- Pacifiers are linked to more frequent ear infections.
- Children may form an attachment to or reliance on the pacifier.
When To Stop Pacifier Use
The American Academy of Pediatrics recommends waiting until after 12 months of age to begin weaning your baby from the pacifier. It’s advised to wait until this point because using a pacifier during sleep periods reduces the risk of SIDS in infants.
Additionally, the American Dental Association recommends that children stop using pacifiers prior to the age of 2.
Habitual pacifier use after this age can have negative impacts on dental health. However, most parents wean their children from the pacifier between the ages of 2-4.
Should I Remove Pacifiers When Baby Is Sleeping?
No, it is perfectly safe for an infant to sleep with their pacifier. In fact, the American Academy of Pediatrics recommends using them at sleep times to reduce the risk of Sudden Infant Death Syndrome (SIDS).
Why Do Some Babies Not Like Pacifiers?
Some babies, especially breastfed babies, do not like pacifiers. Most of the time this has to do with the mouth-feel of the pacifier, i.e., its shape, size, material, or texture.
Many parents choose to give their babies pacifiers for the health benefits and for their own sanity, but pacifiers can cause some babies to gag if they do not like the taste, texture, size, or smell.
When a baby gags, the best thing to do is calmly remove the item from their mouth, comfort them, try again, and listen to their cues. Some babies don’t like pacifiers at all, and that’s okay as well.
Charley is a mother of three with a passion for raising good humans. With her children in tow, she studies English and has made a career creating content about motherhood. In her free time, she enjoys traveling within the states to kayak, camp, and hike.