What to Do if Your Child is Choking

If your child were choking, would you know what to do?

A friend of mine recently reminded me how quickly and easily it is for children under the age of four to choke. She had quite the scare the other night with her three year-old when he began choking on a piece of hard candy. He panicked. She panicked. They called 911 and made a late night trip to the ER.

Luckily, after some forceful coughing, he swallowed the candy and was back to his energetic, playful self once he recovered from the emotional trauma.

Nothing is as fear provoking or stressful as watching your young child in distress – choking, struggling to breathe – and wondering if you’re doing the right thing.

A post by Dr. Natasha Burgert on KC Kids Doc comes quickly to mind. She eloquently described the seconds of sheer panic when she witnessed her son choking on a piece of food. Dr. Moms are not immune to freaking out, either. When it comes to our own children, we are in full mom mode.

I’ve had a few close calls myself; happening upon my toddler about to put staples (of all things!) in his mouth. Yikes!

So, what should you do if your child is choking?

First, I think it’s very important to know what NOT to do. If your child is coughing, breathing, talking, or crying…do not do anything. It’s better to let him try to cough it out then to intervene too early. Quite honestly, this has to be the hardest thing: to watch your child struggle and cry, while you’re anxious, panic stricken, and just waiting.

Watch closely, encourage his coughing, and be prepared to intervene if:

• Your child is panicked and cannot talk, cough, or cry.
• Your child’s face starts to turn color, “Pink turned to red, to scarlet, to crimson. No sound.” as Dr. Burgert recounted those horrifying seconds with her son.
• Your child is gasping, wheezing, and unable to cough.

In these cases, it’s important to act quickly and without hesitation, as choking quickly becomes a life threatening medical emergency.

• Instruct someone to call 911 and immediately start performing choking first aid, which consists of a combination of back thrusts and abdominal thrusts.
• This technique – commonly referred to as the Heimlich maneuver – is different for infants less than one, and older children. It entails delivering five quick back blows, followed by five abdominal thrusts (five and five).
• Infants will essentially be placed face down along your arm and at a downward angle while you deliver the back blows. The abdominal thrusts are done with the infant facing you and you using two fingers for the abdominal thrusts. See this informative pictorial by the American Red Cross on performing the Heimlich in infants and children
• This process is repeated until the object is spit out or until the emergency medical team has arrived to take over.
• If your child becomes unconscious, it’s important to start CPR as part of the rescue process.
• This is why I strongly urge all parents to take an infant and child first aid and CPR class. Find one today, and seriously commit to it. Search the American Red Cross for classes in your area

I know this is unpleasant to think about. However, when you are in the heat of the moment and panic takes over, you’ll be so glad you took some time to be prepared.

Now that you know what you would do if your child is choking, and you’ve signed up for a first aid and CPR class, let’s focus on prevention.

Prevent choking in your young child

Food items are responsible for most choking episodes in young children. However, small toys, batteries, and deflated balloons can also pose serious choking hazards.

Children under the age of four should not be given foods such as hot dogs, grapes, or carrots unless they are completely cut into bite sized pieces. Peanuts should not be given to children until seven years or older.

Children under four should also not be given gum, popcorn, or sticky/gooey/hard candy treats.

Keep choking hazards out of reach, such as small button batteries; deflated balloons; coins; and any toys that can fit inside a paper towel roll. It’s so important to remind older siblings not to leave Legos, marbles, or other chokables around when there is a toddler afoot.

Honestly, my children knew how to say “choking hazard” before they were out of diapers. It’s never too early to impress upon them the importance of keeping small objects out of their mouths and to know the potential dangerous consequences.

Make sure all mealtimes are supervised, and that children are not allowed to run and play while eating.

Last, but certainly not least, PLEASE take a first aid and CPR class if you haven’t done so already.

Have you had a choking scare? Did you know what to do?

Melissa Arca, M.D. is a board certified pediatrician, mom of two (ages 5 and 7), writer and speaker. She shares her passion for parent education and child advocacy on her award winning blog, Confessions of a Dr. Mom.