Expert Health Articles

Choking Prevention in Children

Amy Alt-Coan, MD

Pediatric Hospitalist

On average, a child will die every five days in the United States from choking. Approximately 17,000 children under the age of 14 are treated each year in an emergency room for choking. Food, coins and toys are the primary causes for choking, however, food is the leading cause of choking in children under the age of four.

High risk foods children under that age of four should avoid include:

  • Hot dogs
  • Nuts and seeds
  • Chunks of meat or cheese
  • Whole grapes
  • Hard candy
  • Popcorn
  • Peanut butter
  • Chunks of raw vegetables
  • Gum

Young children’s food should be cut up into pieces no larger than half an inch, with supervision taking place during meals and snacks. Children should be sitting while eating food and candy and should never run, walk, play or lie down with food in their mouths. Children like to imitate what they see, so avoid tossing food into the air and catching it in your mouth.

Non-food choking hazards include:

  • Coins
  • Balloons
  • Buttons
  • Toys with small parts or parts that fit entirely in a child’s mouth
  • Small hair accessories, including bows, barrettes and rubber bands
  • Pen or marker caps
  • Button batteries
  • Pieces of dog food

Also, it’s important to be aware of older children’s toys with small parts and older children giving toys or food to a younger child.

Responding to a Choking Emergency

If your child is having difficulty breathing, but is able to speak or has a strong cough, do nothing yourself. A child’s cough is better than any back blows or the Heimlich maneuver. Call 911 immediately, so that help is on the way and a partial blockage doesn’t turn into a complete one.

If your child cannot breathe at all, first call 911. If you can see the object, carefully try to remove it with a sideways sweep of your finger. Never try this if you cannot easily retrieve the object as it could push the object even farther down the airway. The Heimlich maneuver can be performed by wrapping your arms around the child’s waist, placing your fist on the middle of the child’s abdomen and pressing inward with rapid upward thrusts.

Prevention is the first line of defense. Parents and caregivers should learn first aid for choking and CPR in the event that a choking episode occurs.