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How to Prevent Choking or Save a Choking Infant or Child

Infants tend to bring almost anything to their mouths as they explore their surroundings. Young children can eat food too quickly or run around with food in their mouths. While these are normal habits they can increase the risk of choking. The most common items that children choke on include coins, small toys, and food.

Steps to Take

Choking prevention for infants and toddlers:

Choking is an accident. Not all accidents are avoidable but there are some steps to help decrease the risk of choking.

  • Check that toys are safe:
    • Look for age-specific cautions on toys. Follow your own judgement on questionable toys.
    • Regularly check toys for small loose parts.
    • If you have older children, let them know that their younger siblings can choke on small toys. Teach them to keep these safely stored after playtime.
  • Always keep small objects away from infants and toddlers:
    • Keep coins, small button-type batteries, screws, jewelry, and pen caps safely stored away.
    • Make sure you child can not get into trash or discarded items like tops from beverages or styrofoam packing material.
  • Think ahead. Get down on the floor. Look for dangerous items before your child begins to crawl.
  • For young children, avoid the following foods:
    • Hot dogs—do not slice in small circles, split them down the length of the hot dog, and then cut them into pieces
    • Nuts and seeds
    • Marshmallows
    • Chunks of meat or cheese
    • Round candies
    • Whole grapes
    • Popcorn
    • Small pieces of candy
    • Chunks of peanut butter, which can build up in the roof of the mouth
    • Raw vegetables
    • Chewing gum
    • Gummy candy
  • Cut food into bite-size pieces. Pieces should be one-half inch (1.27 centimeters) or smaller.
  • Never let children of any age run, walk, or lie down while they are eating. Supervise your children while they eat. Always insist that they eat at a table, or at least while sitting down.
  • Avoid keeping latex balloons. Deflated or burst balloons are a common cause of choking in young children of any age.

The following steps should be done for an infant who is choking and cannot cough or breathe:

If the infant can breathe or cough, do not interfere. If the infant is not moving air or making noises, perform the following steps:

  1. Call for emergency medical services right away. (If you are alone, perform these steps first.)
  2. How To Save a Choking Victim\JPG\Choking_2b .jpg Lay the infant, face down, across your forearm. Support the head with one hand.
  3. Keep their head slightly lower than the body. Let gravity help.
  4. Give 5 blows to the infant's back with the heel of your hand.
  5. Turn the infant over and give five chest compressions.
  6. Repeat the cycle until the object comes out or the infant becomes unconscious.
  7. If the infant becomes unconscious and stops breathing, begin cardiopulmonary resuscitation (CPR).

The following steps should be done for a child (more than one year old) who is choking and cannot cough or breathe:

If the child can breathe or cough, do not interfere. If the child is not moving air or making noises, perform the Heimlich maneuver. Perform the following steps:

  1. Call for emergency medical services right away. (If you are alone, perform these steps first.)
  2. How To Save a Choking Victim\JPG\Choking_3.jpg Stand or kneel behind the child.
  3. How To Save a Choking Victim\JPG\Choking_4a.jpg Make a fist with one hand. Place the thumb side of your fist just above the belly button. Place your other hand over your fist.
  4. How To Save a Choking Victim\JPG\Choking_4b.jpg Pull your fist up and in with a fast, firm movement. Then release. Repeat these steps until the object comes out or the child becomes unconscious. Be gentle but firm. Do not squeeze the rib cage because this may injure the ribs.
  5. If the child becomes unconscious and stops breathing, begin CPR.

If the child is unconscious and stops breathing, perform the following steps:

  1. Call for emergency medical services right away. (If you are alone, perform these steps first.)
  2. Lie the child on their back.
  3. Open the child's mouth with your thumb over their tongue while wrapping your fingers around their jaw.
  4. Once the airway is clear, and if you can see the object, carefully swipe your finger to the side in an attempt to dislodge it. Be careful not to push it farther down the airway. If you do not see an object, do not put your fingers in the child's mouth.
  5. If the object remains or removing the object does not result in breathing, begin CPR . Alternate it with the Heimlich maneuver and finger sweep until breathing resumes or emergency medical services arrives.

Common Question

Q. Does slapping the back of older children help get the object out?

A. This usually does not help and could make matters worse. Use the above steps instead if the person is choking and cannot cough or breathe.

Call Your Doctor

Contact your doctor any time you or another person has been rescued from choking. The doctor will make sure the object is completely out and check for injuries.

Possible mishaps to watch out for include giving up too soon. The above steps can be very successful in getting the object out. It may take several tries. Don’t give up trying to help.

RESOURCES:

American Red Cross
http://www.redcross.org

Healthy Children—American Academy of Pediatrics
https://www.healthychildren.org

CANADIAN RESOURCES:

Canadian Red Cross
http://www.redcross.ca

Toronto Paramedic Services
http://torontoparamedicservices.ca

REFERENCES:

Berg MD, Schexnayder SM, Chameides L, et al. Part 13: pediatric basic life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18 Suppl 3):S862-S875.

Committee on injury, voilence and poison prevention. Prevention of choking among children. Pediatrics. 2010;125(3):601-607.

Choking prevention. American Academy of Pediatrics Healthy Children website. Available at: http://www.healthychildren.org/English/health-issues/injuries-emergencies/pages/Choking-Prevention.aspx. Accessed August 19, 2020.

Foreign body aspiration. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Accessed August 19, 2020.

Responding to a choking emergency. American Academy of Pediatrics Healthy Children website. Available at: http://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/Responding-to-a-Choking-Emergency.aspx. Accessed August 19, 2020.

Last reviewed January 2020 by EBSCO Medical Review Board Chelsea Skucek, MSN, BS, RNC-NIC