Choking: Knowing the Signs and What to Do


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Every five days, one child will die from choking in the United States. Choking is the fourth leading cause of death in children under five years of age.  For parents, these are pretty scary statistics! But the good news is that most of these deaths are preventable. Education on causes, prevention and what to do if your child is choking can impact your child's chance of survival.  This is precisely what I hope to illustrate in this blog post, including helpful information about:

Parents can use a choke tube guide (also known as a small parts tester), a plastic device available in most baby stores, to see if a toy is a choking risk. However, a toilet paper roll works just as well.

  • Prevention
  • Troublesome Foods
  • Dangerous Household Items
  • Signs of Choking
  • What to do When a Child is Choking

What is Choking?

Choking occurs when something is blocking the airway, rendering a child unable to breathe.

Airway Sizes

Children have airways that are 1/3 the size of an adult.  Their windpipes or breathing tubes are approximately the size of a drinking straw.  As they grow, the size of their pinky finger is a good gauge for the size of their airway.

Partial Blockage

If a child can speak or cough the airway is only partially blocked.  If partial blockage occurs, you need to call 911. DO NOT attempt to open airway, but DO encourage the child to cough.

Prevention-Lower Risks in Your Child’s Environment

It's impossible to eliminate every single thing from your environment that might cause your child to choke. But there are many things parents can remove from the environment to lower a child's risk for choking. Some common choking hazards include toys, household items and food.  Of these, food is the most common cause of choking. Safe Eating Practices for Kids Accompanying your child while they eat not only provides an opportunity for bonding, but also ensures you'll see if they're chewing their food properly.  Sitting while eating and not doing anything else—like riding in a car or playing—is the safest way for children to enjoy their meal. An unhurried meal and snack time gives a child ample time to chew their food.  This is also a good time to lead by example with good posture, which is key to helping them chew and swallow solid foods.

Preparing Foods to Avoid Choking Hazards

Food is safest for children when it has been a) cut into small pieces and b) seeds and pits have been removed.  Here are some examples of ways to prepare common foods to make them safer for children:

  • Cut hot dogs into bite-size pieces (cutting both length and width-wise)
  • Soften vegetables by cooking or steaming them (this makes them easier to chew)
  • Sticky foods should be consumed in small amounts (for example, peanut butter or cream cheese consumed in large “globs” can stick to the roof of a child's mouth)
  • Drink liquids between mouthfuls, rather than together with food

Foods That Cause Choking

Foods that are the most commonly associated with children choking include:Nuts, crackers and raisins are some foods that present choking hazards to children.

  • Candy (specifically, hard candy)
  • Caramels
  • Cheese (specifically, cubed cheese)
  • Chips
  • Fruits (specifically, fruit with skins)
  • Grapes (specifically, whole grapes)
  • Gum
  • Ice cubes
  • Lollipops
  • Marshmallows
  • Nuts
  • Peanut butter
  • Popcorn
  • Pretzels
  • Raisins
  • Vegetables (specifically, raw vegetables)

Cutting up foods into small pieces and using methods of food preparation that make it easier to chew can lessen the risk of a child choking while eating these foods.

Household Items that Cause Choking

Toys are a big source of choking hazards.  Deflated or broken latex balloons are especially dangerous since the balloons can stick to the breathing tube and be difficult to remove. Make sure smaller children can't get hold of toys with small parts intended for older kids. Follow the age recommendations on toy packages. Here's a list of more items that can pose a choking hazard to children and should be placed out of reach of little ones. These items should be placed out of the reach of older siblings, who might accidentally give them to younger siblings.

  • Balloons
  • Batteries
  • Bolts
  • Bottle caps (including syrup and soda caps)
  • Coins
  • Crayons (specifically, broken crayons)
  • Doll accessories
  • Erasers
  • Jewelry (rings, earrings, pins, etc.)
  • Nails, bolts, and screws,
  • Paper clips
  • Safety pins
  • Screws
  • Small balls
  • Small office supplies (brads, pushpins, etc.)
  • Tacks
  • Toys with small parts

A toilet paper roll works just as well as a choke tube in testing the safety of small parts.

Use a Choke Tube Guide

Parents can use a choke tube guide (also known as a small parts tester), a plastic device available in most baby stores, to see if a toy is a choking risk. However, a toilet paper roll works just as well. The following websites also have great tips regarding choking prevention for parents.

Recognize Choking Signs and React

Signs of Choking

  • Child begins to cough, gag or has high-pitched, noisy breathing
  • An older child (over 1 year of age) may hold neck with both hands
  • The child's lips and/or skin may turn blue

What to do When a Child is Choking

  • If the child is unable to speak or cough, give the Heimlich Maneuver.
  • If the child is no longer breathing you need to shout for help, place the child on the ground and follow the next steps.
  • If you are alone, start CPR. (Sign up for CPR classes.)
  • Continue CPR until child moves or help arrives.  If you are alone, after 5 cycles or 2 minutes of CPR, leave the child and call 911.
  • Continue to push on the stomach until the object is out and the child can talk and breathe or until the child is no longer breathing.

Saving Lives

Educating yourself with these few, simple steps to ensure a safe environment for your child, could help save their lives. Sharing this information with other parents is a great way to empower others to do the same.