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 newborn is gagging, and it all 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. Contractions compress the chest, which leads to the fluid being squeezed out from the lungs. In addition, immediately following birth, a doctor suctions out 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.
Wet Lung Disease
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; 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.” It’s also possible that 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 mouth between breaths.
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 it 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 throat. 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 it 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).
Helping 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.Use a bulb syringe to remove fluid from the back of the throat and/or nose.
When to Call the Doctor
Persistent gagging that does not distress your baby can be evaluated by your pediatrician. However, if your baby seems is acting abnormally or something seems otherwise wrong, go to the nearest emergency room. Choking and trouble breathing are different from gagging and need to be addressed quickly. If your baby stops breathing, begin infant CPR while you wait for medical attention. If you haven’t been taught how to do this, find a CPR class near you so you are prepared in case of an emergency.
Bluish skin color (cyanosis)Difficulty breathing/cessation in breathingInability to cry or make much soundLoss of consciousnessRibs and chest pulling inward when inhalingSoft or high-pitched sounds while inhalingWeak, ineffective coughing
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.
