Choking Prevention and Treatment

Choking kills more children under six years of age than any other home accident. Parents need to keep an eye open for potential loose items on toys or loose items on the floor which can be picked up and swallowed.

Choking Guidelines from the American Academy of Pediatrics.

What can I do to keep my child from choking?

Do not feed children younger than 4 years round, firm food unless it is chopped completely. Round, firm foods are common choking dangers. When infants and young children do not grind or chew their food well, they may try to swallow it whole. The following foods can be choking hazards:

  • Hot dogs
  • Nuts and seeds
  • Chunks of meat or cheese
  • Whole grapes
  • Hard, gooey, or sticky candy
  • Popcorn
  • Chunks of peanut butter
  • Raw vegetables
  • Fruit chunks, such as apple chunks
  • Chewing gum

Dangerous household items

Keep the following household items away from infants and children:

  • Balloons
  • Coins
  • Marbles
  • Toys with small parts
  • Toys that can be squeezed to fit entirely into a child’s mouth
  • Small balls
  • Pen or marker caps
  • Small button-type batteries
  • Medicine syringes

What you can do to prevent choking

  • Learn CPR (cardiopulmonary resuscitation) (basic life support).
  • Be aware that balloons pose a choking risk to children up to 8 years of age.
  • Keep the above foods from children until 4 years of age.
  • Insist that children eat at the table, or at least while sitting down. They should never run, walk, play, or lie down with food in their mouths.
  • Cut food for infants and young children into pieces no larger than one-half inch, and teach them to chew their food well.
  • Supervise mealtime for infants and young children.
  • Be aware of older children’s actions. Many choking incidents occur when older brothers or sisters give dangerous foods, toys, or small objects to a younger child.
  • Avoid toys with small parts, and keep other small household items out of the reach of infants and young children.
  • Follow the age recommendations on toy packages. Age guidelines reflect the safety of a toy based on any possible choking hazard as well as the child’s physical and mental abilities at various ages.
  • Check under furniture and between cushions for small items that children could find and put in their mouths.
  • Do not let infants and young children play with coins.

The following suggestions are given to help prevent a tragic choking accident:

  • Remove loose parts from toys before your child does: eyes and buttons from dolls and teddy bears, wheels from cars and trucks, and noise makers from party horns.
  • Throw away fragments of broken toys, guns or crayons.
  • Close safety pins – keep them off the diaper changing table.
  • Routinely pick up all loose items: coins, buttons, pins, tacks, beads, paperclips, bottle tops, plastic wrappers and popped balloons.
  • Check pacifiers. The nipple should resist pulling. The guard should not pass through the baby’s lips.
  • Have baby teethe on a ring, not a piece of biscuit, bone, or carrot.
  • Don’t give baby a Styrofoam cup.
  • Cut food into small pieces, including hot dogs. Teach your child to chew well.
  • Remove small bones from fish, meat and fowl. Take out seeds from oranges,grapes, melons and other fruits.
  • Don’t put snack foods like peanuts on low tables.
  • The following foods are most likely to cause choking. They should be withheld from the diet until the child can effectively grind up his or her food. This occurs somewhere between ages two and five. Make sure children are seated when they receive these foods: raw carrots, corn kernels, hot dogs, popcorn, raisins, sunflower seeds, small bits of hard candy, and peanuts (including candy bars with nuts).

What Do You Do If Your Child is Choking?

If your child can breathe but is coughing or wheezing, an air tube may be partially blocked. Don’t slap the child on the back, don’t give a drink, don’t hold the child upside down. If the child coughs, the foreign body may get in a worse place. Call the Rescue Squad (911).

If a child can’t breathe but is conscious:

1. If the infant is less than one year, straddle the baby over your forearm with his head lower than his body. Deliver four blows between his shoulder blades with the heel of your hand.

If the baby still does not breathe, deliver four chest thrusts on the breast bone about two seconds apart. If the baby still does not breathe, open the mouth by grabbing the tongue and lower jaw. If you can see the obstruction object, remove it with a finger sweep. Avoid blind sweeps in infants because you may push the object farther down. If the baby still does not breathe, administer four breaths mouth to mouth and start the sequence over.

2. If the child is over one, the Heimlich Maneuver or subdiaphragmatic abdominal thrusts is now recommended as the exclusive method of dislodging a foreign body. If the child is coughing forcefully, the rescuer should encourage him to persist and attempt the Heimlich Maneuver only if the cough becomes ineffective and respiratory difficulty increases. The Heimlich Maneuver involves 6-10 thrusts repeated in rapid sequence until the foreign body is expelled.