By: Stuart Bradin, DO, FAAP, FACEP
Once your baby starts crawling or eating table food, it’s time to think about choking risks. Young children can choke easily on food or small objects that they can reach. Babies and toddlers are at the highest risk. That’s because they love to explore the world by putting things in their mouths, which can then get stuck in their small airways.
Here’s what to know about common choking hazards, symptoms to watch for and how to keep your child safe.
What causes choking?
Choking happens when food or a small object gets stuck in the throat and blocks the airway. This prevents normal breathing and keeps oxygen from reaching the lungs and brain. Being without oxygen for more than 4 minutes can cause brain damage or even death.
How common is child choking?
Choking is a leading cause of death for infants and children. Most children who die from choking are under age 5—and two-thirds are babies under a year old. Some children who survive a severe choking episode have permanent, life-changing brain injuries. but knowing the signs of choking and how to respond quickly can help prevent tragedy.
Signs your child may be choking
Knowing the symptoms of choking helps you act fast.
A child may be choking and need help right away if they:
can't breathe
are gasping or wheezing
can't talk, cry or make noise
turn a bluish color
grab at their throat or wave their arms, appear panicked
become limp or unconscious
What if your child is coughing while choking?
Coughing during a choking episode often settles within about 15 minutes, whether the object is coughed out or not. Keep watching your child closely during this time and be ready to act if symptoms worsen.
Common choking hazards
Balloons, balls, marbles, pieces of toys and foods (small round objects) cause the most choking deaths. Some other choking risks to know:
Foods that can cause choking
Keep high-risk foods from children until 4 years of age or older, depending on each child's development and maturity level. But keep in mind that round, firm foods, such as hot dogs or grapes, can be served if completely chopped into tiny pieces. When infants and young children do not grind or chew their food well, they may try to swallow it whole.
Foods to avoid or modify for young children include:
Hot dogs
Hard, gooey, or sticky candy
Chewing gum
Nuts and seeds (especially sunflower seeds)
Whole grapes
Raw vegetables, such as carrot sticks
Raw fruit chunks, such as apple pieces
Popcorn
Thick chunks of peanut butter or other nut butters (be sure to spread thinly instead)
Marshmallows
Meat sticks or sausages
Chunks of meat
Chunks of cheese or string cheese
Household items that are choking hazards
Keep the following household items away from infants and children:
How to prevent choking in children
Take a certified CPR and first aid course. Sign up for an approved class in basic first aid, CPR (cardiopulmonary resuscitation) or emergency prevention. Contact your local American Red Cross or the American Heart Association to find classes in your area.
Remember that balloons pose a choking risk to children up to 8 years of age.
Keep dangerous foods from children until 4 years of age or older, depending on each child's development and maturity level.
Insist that children eat at the table or sit down when they eat. Never let them 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 mealtimes for infants and young children.
Be aware of what older children are doing. Many choking incidents happen when older brothers or sisters give dangerous foods, toys or small objects to a younger child.
Avoid toys with small or detachable 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. They are based on any possible choking hazard, as well as a child's physical and mental abilities at various ages.
Check under furniture and between cushions for small items such as coins, small toys, batteries and other small objects that children could find and put in their mouths.
Remember
Talk with your child's pediatrician for more tips to protect your child from choking hazards.
More information
About Dr. Bradin
Stuart Bradin, DO, FAAP, FACEP, is a board-certified pediatric emergency medicine physician at CS Mott Children's Hospital and an assistant medical director for Survival Flight. He is a professor of Emergency Medicine and Pediatrics and is involved locally, regionally and nationally in pediatric disaster preparedness, with special clinical interest in critical care, trauma and sepsis.
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