According to a 2010 Choking Prevention Policy by the American Academy of Pediatrics (AAP), choking is a leading cause of injury and death among children — especially in children aged four or younger. This is because prior to four years, molars have not come in, chewing is not yet effective, the airway is very narrow, and their cough is not robust. Therefore as parents and caregivers, we must be very mindful of what objects our youngsters interact with as they explore their environments.
To start, know that the most common objects that children choke on are toys, food, and coins.
Choking Hazards: Toys
While the Child Safety Protection Act (CSPA) requires choking-hazard warning labels on packaging for toys that contain small parts and bans any toy intended for children younger than three years that poses a choking risk, the CSPA does not conduct a pre-market testing of toys. This means that consumers need to be proactive in evaluating toys prior to purchasing them for their children.
Toys to watch out for:
- Latex balloons (leading cause of choking-related deaths!)
- Button-type batteries
- Small balls and marbles
- Hair bows and rubber bands
- Pen/marker caps
- Pet food
*You can find some safe toys I’d recommend for your kids at the end of this article.
Choking Hazards: Food
There are more than 10,000 food-related emergency department choking visits in the United States each year. The AAP recommends supplemental baby foods be introduced between 4–6 months of age, so be mindful of these tips:
- For children less than 4 years old, remember to cut food into small pieces.
- While supervising mealtimes, teach your children to chew food well!
- Children should always be seated while eating.
- Kids should never be walking, running, playing or lying down with food in their mouth.
Take a few minutes of your day to watch this important video on choking prevention:
Foods to avoid for children younger than 4:
- Hot dogs (account for about 20% of food related choking events)
- Hard or sticky candy
- Nuts and seeds
- Whole grapes
- Chunks of meat or cheese
- Chunks of peanut butter
- Chunks of raw vegetables
- Chewing gum
Unfortunately, you are likely encounter a choking child. Here is what I want you to know and prepare for:
Responding to a choking emergency
- If the child is still able to speak or has a strong cough, do not touch the child! Immediately call 9–1–1. Do not stick your fingers into the child’s mouth to remove the object! This may cause a partial blockage of the airway turn into a complete one. Simply, continue to encourage the child to cough.
- If the child cannot breathe at all or if they have a weak cough, you need to intervene immediately. Have someone call 9–1–1, while you perform the Heimlich maneuver (Figure 1). Please take a moment to review life-saving videos on how to perform the Heimlich Maneuver for a child and an infant.
- If the child becomes unconscious, lower them to the floor and perform a tongue-jaw lift (Figure 2) by placing our thumb in the mouth and over the tongue, and your other fingers over the jaw. While stabilizing the head with your other hand, lift the jaw up and out to gain visualization of the airway. Only if you can see the object, try removing it with a sideways sweep as to not further push the object into the airway. If the child does not resume breathing begin cardiopulmonary resuscitation (CPR).
CPR is a life-saving skill that requires practice. I would encourage that all parents take a CPR class.
For information on how to enroll in a CPR class, please call your pediatrician, community center, library, or fire department. Remember, CPR is necessary whenever you suspect that a child has no pulse. This may happen in different emergent settings, such as chocking or drowning. For a quick but comprehensive video on CPR for a child, see this video.
This blog serves as a basic summary to familiarize parents with the actions needed to aid a choking child. Gaining a level of comfort with these fundamental lifesaving skills requires practice. All parents should take a CPR course to gain proficiency in the proper steps and techniques of saving a child’s life.