Babies and young children are at high risk of choking because they are learning how to chew and swallow, and they do not have molar teeth to grind foods into a smooth paste. They have less control over swallowing than older children and adults, and they have small airways. Toddlers are at highest risk of choking because they like to explore their surroundings by putting anything that fits into their hands into their mouths.
What happens when a child chokes?
Choking is most serious when something blocks a child’s windpipe or airway. If the windpipe is partly blocked, a reflex causes coughing, which is the body’s way of trying to clear the airway. If the windpipe is completely blocked, the child could die unless the Heimlich maneuver is successfully performed.
Choking can also happen when the airway is not blocked. Instead, foods or objects can lodge in the voice box, vocal chords, lungs or esophagus.
What do I do when a child chokes?
If the child is turning blue and is not able to speak or cough, give the Heimlich maneuver.
Do not give the Heimlich maneuver if the child is coughing and able to talk. Stay calm and encourage the child to cough the object or food out.
If the child continues to cough or has other symptoms such as retching, vomiting or wheezing, take the child to emergency right away or call 9-1-1. Foods or objects that do not completely block the airway can lodge in different parts of the child’s airway, esophagus or stomach.
If you think you know what the child choked on, let the emergency staff know. If the child choked on dried peas or beans or batteries, the child needs immediate medical attention. Dried peas and beans absorb water and can swell, causing a more complete airway blockage. Batteries contain strong chemicals that can burn the child if they are swallowed.
What are the most common causes of choking in young children?
Objects:
Coins are the most common cause of choking in young children. Choking on coins is not usually fatal. The child may need to have surgery to remove the coin.
Plastic toy parts, metal hardware, and fishing tackle.
Balloons are particularly dangerous because they can completely block the child’s airway.
Batteries can burn the child with the strong chemicals they contain.
Foods:
Round and rubbery foods such as hotdogs and grapes can completely block the child’s airway.
Crisp and crunchy foods, such as peanuts, other nuts, raw carrots, apples, celery, popcorn, sunflower seeds, and dried peas and beans
Hard candies, fish bones and small chicken bones
Fruit poppers, also called gel candies, have caused children to die from choking. These are sold in mini-cups with a small piece of fruit surrounded by a gel-like substance called konjac.
How can I help make playing and eating safer for children?
Regularly inspect the play area for choking hazards and quickly remove them.
Keep the play area free of coins and make sure toys are appropriate for the children’s age and in good condition.
Be extra watchful at parties and holidays, when balloons or small toys may be around.
Teach children not to put pins, needles, nails, screws or thumb-tacks between their lips or in their mouths.
Take care when choosing and preparing foods for children:
Serve only small amounts of food at a time to prevent children from putting too much food in their mouths.
Introduce new foods or textures to babies and young children slowly and carefully. Offer cooked foods before trying them raw. For example, try applesauce or well-cooked carrots first. Then offer grated raw apples or carrots.
Cut grapes, cherry tomatoes and hot dogs lengthwise and into small pieces until children are at least 5 years old. You can serve these foods whole when children area at least 5 years old, and they can chew and swallow food with the texture of steak without coughing.
Do not give hard, crunchy foods to children until they are at least 3 years old and they can consistently chew and swallow crusty bread without coughing.
Hard, crunchy foods include peanuts, other nuts, raw carrots, apples, celery, popcorn and sunflower seeds.. Un-popped corn kernels are especially dangerous.
Hard candies should not be given to children until they are at least 5 years old, and they can understand that these foods can make them choke.
Spread peanut butter thinly on crackers or bread. A chunk of peanut butter can form a “plug” that molds to the shape of the child’s airway.
Remove bones from chicken and fish.
Cut foods such as meat and cheese into small pieces.
Do not offer other foods that are choking hazards, such as marshmallows, gum and gel candies.
Always supervise young babies and children when they are eating
Make sure children are awake and alert before offering them food.
Do not prop or leave a baby alone with a bottle.
Do not feed babies while sitting in their car seats or reclining baby seats.
Children should sit down to eat in a calm, quiet environment.
Make sure children sit up while eating and drinking, and keep their chairs upright while they eat
Children should not eat or drink while they are walking, playing, or sitting in a moving car, bus, or stroller.
Settle laughing or crying children before offering them food.
Teach children to chew their food well. Sit down and eat with them. Be a good role model – take small bites, chew food well, and eat slowly.
Teach older children not to give food or small toys to younger children.
Teach children not to catch foods in their mouths.
How can I be prepared to help a child who is choking?
Anyone who cares for young children should be trained in Infant Cardio Pulmonary Respiration, also known as CPR. This includes what to do if a child is choking, including training on the Heimlich maneuver. Contact your local public health nurse or first aid training institute for information on infant CPR training.
Each child cared for in a licensed care facility in B.C. must have immediate access to an employee with a valid first aid and CPR certificate. This employee must be able to communicate with emergency workers.
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