Help! Why is My Baby Choking on Milk While Bottle Feeding?

Nothing feels quite as scary as seeing your baby choking. It’s not uncommon for babies to choke on milk while bottle feeding, but that doesn’t make it less terrifying. The real risk isn’t choking; aspiration into their lungs is the real risk, but it’s a rarity. Parents need to understand why this happens and how to approach the problem.

An underlying health problem could be the source of the problem, but babies choking on milk are due to improper feedings in most cases. Simple errors make it harder for babies to drink their formula or breastmilk comfortably without choking.

Here’s what to know if your baby is choking while bottle feeding. 

Why Does My Baby Choke When Bottle Feeding?

While it’s easy to worry when a newborn chokes on a bottle, it’s typically not an emergency. The first thing you need to do is figure out why this is taking place. It usually is a simple fix, and the problem goes away.

Here are the common reasons for a baby choking on formula.

Bad Positioning

Mom breastfeeds newborn baby girl in hospital bed

One of the most common reasons for choking on milk is that you have your baby in the wrong position for feeding. Lying your baby on their back or too far backward while bottle-feeding causes the milk to flow faster than your baby can control. 

Imagine if you tried to drink while lying backward. Chances are you would choke as well or, at least, spit it everywhere. The same goes for your baby. This isn’t the optimal position for feeding.

Too Large of a Bottle Nipple Size 

Another common problem is using too large of a nipple size for your baby’s age. If your baby coughs while drinking his bottle, it might be because you moved up a bottle’s nipple size too quickly.

As nipple sizes move up, the holes get larger, which allows for an increased rate of milk flow. If your baby cannot keep up with this flow, he will choke, cough, gag, or sputter while drinking his bottle. 


The age recommendations are guidelines; it’s not a requirement to change your child reaches a particular age. Follow his lead; if he is content, don’t mess with anything. If you notice your baby is frustrated while drinking his bottle, that could be a sign that changing to a larger size is needed.

Infant Reflux 

excessive crying baby

The first two reasons are the likely culprit, but if you aren’t lying your baby backward or using the wrong sized bottle nipple, infant reflux might be the problem. 

Chances are you’ve experienced acid reflux a time or two in your life. It feels as if acid is coming up your throat, and if this happens while your baby is feeding, it could cause a choking or coughing sound. 

Most babies grow out of reflux within a few months, but some need medication to make feeding time more comfortable, so don’t be afraid to speak to your pediatrician about your concerns. 

What Do I Do If My Baby Chokes on Formula?

My baby keeps choking while bottle feeding – so what do I do if he’s choking? 

First, stay calm. Babies rarely truly choke, which requires an obstruction of their throat, on milk. Coughing, gagging, and sputtering sounds aren’t choking, but they still feel scary. All parents should know the signs of an infant choking, which are:

  • Bluish skin color
  • Difficulty breathing
  • Loss of consciousness
  • Unable to cry or make any sounds
  • Weak coughing
  • Soft or high pitched sounds when trying to breathe in

If your infant meets these signs, call 911 and stay on the phone as they talk you through how to administer infant Heimlich maneuvers.

Thankfully, the chances of your baby indeed choking on milk is slim, but babies cough and gag, so what do you do if your baby gags on the bottle?

  • Sit your baby upright immediately, either in your lap or over your shoulder.
  • Rub his back and pat it gently.

How Do I Stop My Baby From Choking While Bottle Feeding?

This problem is easy to fix in most situations. Here are a few suggestions to try out. 

Sit Your Baby More Upright While Feeding

Make sure your baby isn’t lying down or backward while feeding. Try to sit your baby in a position similar to a sitting position with his head higher than his stomach. It helps the milk flow down into his belly rather than choking on his formula. Plus, this helps with reflux; try to keep your baby upright for 10-15 minutes after feeding as well. 

Use Paced Bottle-Feeding

Another essential trick that works for formula and breast milk (but it’s crucial for breastfeeding infants who occasionally take bottles) is to use paced feeding

Keep the bottle parallel with the ground rather than tilted with the end pointed towards the sky. Doing this allows your baby to control the milk flow, similar to controlling the breast’s flow. 

Paced bottle-feeding lets your baby pull the milk out of the bottle by actively sucking and swallowing while taking breaks. Your baby won’t feel as if he is drowning or has to keep up with the milk flow. When you tilt a bottle, gravity controls the flow rather than your baby. 

Reduce the Nipple Size 

If you recently switched nipple sizes and noticed that your baby is choking on the milk, go back to the previous size. There is no need to switch the nipple size just because your baby is now three months old; no age is a magical time to change. Watch for cues that your baby is ready to transition to the next size up. 

Avoid Bottle Propping 

One of the biggest culprits for babies choking on milk is bottle propping. This practice is dangerous – plain and simple. Babies should never drink from a propped-up bottle without supervision, and it should be avoided even with supervision.

Bottle propping prohibits your baby from controlling the flow of milk. If your baby isn’t ready to swallow, it doesn’t matter; the bottle is propped up, and milk is flowing out. This is particularly dangerous and has caused many infants to choke. 

Bottle propping is the root cause for most infant deaths due to choking on milk. Choking on milk is typically harmless, but this practice can cause your baby to turn blue, go limp, or pass out. 

Can a Baby Choke on Milk and Die?

Yes, babies can choke on milk and die, but it’s not common. The risk of truly choking depends on how much milk has entered your baby’s throat. The gagging and choking will dislodge a small amount; that’s their purpose.

However, babies have a narrow windpipe that becomes obstructed easier. Some babies are more likely to choke than others due to certain health conditions, such as:

  • Cleft lips or palate
  • Developmental delay
  • Down Syndrome
  • Cerebral Palsy
  • Gastrointestinal Reflux Disease (GERD) 

If your baby is frequently choking on milk while bottle feeding, be sure to speak to your pediatrician to rule out any underlying problems that might increase the likelihood that something is wrong. 

Final Thoughts

When you hear your baby choking on milk while bottle-feeding, it’s scary, but try not to panic. Most babies will cough, move the milk, and go back to normal. If this happens frequently, use the above tips to stop your baby from choking while bottle feeding. If that doesn’t work, be sure to speak to your doctor. 

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