Prevent Choking in Babies and Young Children:
For Child Care Providers
It is important that individuals and groups who provide care to babies and young children be aware of the risks of choking.
Babies and young children are at high risk of choking because:
- they have less practice controlling food in their mouths;
- they do not have molar teeth to grind foods into a smooth paste;
- they have small airways; and
- they explore the world by putting small objects into their mouths.
If a child has difficulty chewing or swallowing, they are at greater risk for choking. Talk to the child’s parent or a health care provider to find out what foods are safe.
What is choking?
Choking is when something becomes stuck in the airway, and they are unable to breathe. If the airway is partly blocked, the body tries to clear the airway by coughing. If the airway is completely blocked, the stuck item must be removed or the child will not be able to breathe and could die.
Choking can also happen when a child’s airway is not blocked. Foods or objects can get stuck in the voice box, vocal chords, lungs or esophagus.
What do I do if a child chokes?
If a child is turning blue and cannot speak or cough, take appropriate action as outlined in your health and safety procedures. The child should then be seen by a health care professional.
If a child is coughing and able to talk, stay calm and encourage them to cough the object or food out.
Go to the emergency room right away or call 9-1-1 if the coughing continues, or if a child has symptoms such as retching, vomiting or wheezing. Tell the emergency staff what you think the child choked on.
Immediate medical attention is needed if a child chokes on dried peas, beans or batteries, even if they seem fine. Dried peas and beans swell when they absorb water, causing a more complete airway blockage. Batteries contain strong chemicals that can burn a child if they are swallowed.
What are common causes of choking in children?
- Coins are the most common cause of choking in young children. It is not usually fatal but the child may need 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.
- Disc batteries and other batteries. Disc batteries are used in watches, calculators and handheld games. The strong chemicals can burn a child.
- Round and rubbery foods such as hotdogs and grapes can completely block a 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 in the middle of a gel called konjac.
How can I make playing safer for my child?
- Teach the child not to put small objects between their lips or in their mouths. For example, pins, needles, nails, screws or tacks.
- Check the child’s play area often for choking hazards and quickly remove them.
- Make sure the child’s toys are in good condition and are appropriate for their age.
- Be extra watchful at parties and holidays, when balloons or small toys may be around.
How can I make eating safer for a child?
Always supervise young babies and children when they are eating.
- Serve food in small amounts to prevent the child from putting too much food in their mouths.
- Introduce foods in textures that are safe for babies and young children. Offer cooked foods before trying them raw. For example, try applesauce or well-cooked carrots first and then offer grated raw apples or carrots at a later time.
- Cut grapes, cherry tomatoes and hot dogs lengthwise and into small pieces until children are at least 4 years old and they can chew and swallow food that is the texture of steak without coughing.
- Do not give hard, crunchy foods to a child until they are at least 4 years old and they can consistently chew and swallow crusty bread without coughing. Hard, crunchy foods include hard candies, peanuts, other nuts, raw carrots, apples, celery, popcorn and sunflower seeds. Un-popped corn kernels are especially dangerous.
- Spread peanut butter or other nut butters thinly on crackers or bread. A chunk of nut butter can form a “plug” that can block 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 until the child is at least 4 years old, and can chew their food well.
- Make sure the child is awake and alert before offering them food.
- Do not prop or leave a baby alone with a bottle. They could choke on the liquid.
- Have the child sit up while eating and drinking.
- Do not give a child anything to eat or drink while they are walking, playing, or sitting in a moving car, bus or stroller.
- Do not feed babies while they are sitting in a car seat or reclining baby seat.
- If a child is laughing or crying, settle them before offering them food. Have them sit down and eat in a calm, quiet environment.
- Teach the child to chew their food well. Sit down and eat with them. Be a positive 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 the child not to catch foods in their mouths.
How can I be prepared to help a child if they choke?
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. Contact a 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.
For More Information
- Toddler’s First Steps www.health.gov.bc.ca/library/publications/year/2015/toddlers-first-steps-2015.pdf (PDF 7.68 MB)
- Ministry of Health: Child Care Licensing Regulation www2.gov.bc.ca/gov/topic.page?id=83785931C8854381849E4208B4EBBAFB
Contact your community nutritionist, or call 8-1-1 and speak to a registered dietitian.