Preventing Choking in Babies

As a parent, you worry about everything that goes into your baby’s mouth. You want to make sure they’re eating a healthy diet that includes a wide variety of nutrients, textures and tastes. But you need to be just as careful about what shouldn’t go into your child’s mouth.

Babies love to explore by touching things and putting them in their mouths. So it’s no surprise that choking is a common cause of injury, and even death, for babies and young children. Knowing what things are choking hazards, and how to get a stuck object out of your child’s airway, will help keep them safe.

What causes babies to choke?

If your baby tries to swallow something too large for their throat, the object can get stuck. When something lodges in your baby’s airway (trachea), it causes choking. A blocked airway means that oxygen can’t get to your baby’s lungs or brain.

In many cases, a choking baby can still breathe. If your baby is coughing or crying, air is still passing through their airway, despite the stuck object.

What objects are choking hazards for babies?

Any object that is smaller than 1¼ inches in diameter or 2¼ inches in length can get stuck in your baby’s airway and cause choking. Food, toys, rocks, coins and other objects a baby finds around the house can all be choking hazards.

It’s also important to tell older children which foods or objects can be dangerous for your baby. Choking accidents often happen when an older child gives an unsafe item to an infant.

Some of the most common choking hazards for babies include:

• Food (such as grapes, raisins, hot dogs, hard candy and raw carrots)
• Small toy parts
• Beads
• Coins
• Rocks
• Pen caps
• Button batteries

How to prevent your baby from choking

Found objects and food are the biggest choking hazards for babies. Keep small objects out of your baby’s reach. And talk to your child’s pediatrician about when it’s safe to introduce solid foods.

When giving your child solid foods, cut them into small pieces. As a general rule, pieces should be no larger than your fingertip. Foods that require chewing (like meat or cheese) should be in smaller pieces than soft foods (like avocado or watermelon).

Other ways to reduce your baby’s risk of choking include:

• Placing your child in a highchair during meals whenever possible
• Keeping your child upright if they not in a highchair while eating
• Not giving your child food to eat while they’re in a stroller or car seat

What to do if your baby is choking

If your baby is choking, but is able to breathe, cough and cry:

• Try to calm your child down. In many cases, the child can clear the blockage on their own.
• Let your baby cough. Coughing naturally helps clear whatever is blocking their airway.
• Check your child’s mouth, but don’t reach in and try to remove the object unless you can see and grasp it easily. You could accidentally push it farther down their airway.
• If your baby stops making noise or breathing, follow the next steps and call 911.

If your baby is awake (conscious) but can’t breathe or make noise, try to dislodge the stuck object:

• Hold your baby face down on your forearm or lap, with their head lower than their body.
  
• Use the heel of your hand to slap them on the back five times. Start at the low back and thrust upward toward the shoulders.
• If the back blows don’t dislodge the object, flip your baby over and lie them on the floor.
• Find the spot centered between the nipples and move one finger’s width lower. Use your thumbs or two fingers next to each other to deliver five quick chest thrusts.
  
• Repeat the sequence of back blows and chest thrusts until the object dislodges or your baby becomes unconscious.

If your baby becomes unconscious, call 911 and start CPR immediately. Do not leave them alone.

• Place your baby on a hard, flat surface such as the floor.
• Find an imaginary line between your baby’s nipples. Go down one finger’s width below that line and use two fingers to push down on their chest 30 times. Push down into their body about 1 ½ inches and allow the chest to come back to its normal position after each push.
• Tilt your baby’s head slightly back to open their airway. Make a tight seal over their mouth and nose with your mouth. Give two slow breaths (1 second each). Try to blow in just enough air to see your baby’s chest rise slightly. If you do not see their chest rise, reposition your baby’s head and try two additional breaths.
  
• Continue performing the sequence of 30 chest compressions and two breaths until your baby starts breathing or medical help arrives.
  

If the blockage clears during CPR, check to see if your baby is breathing and has signs of blood circulation, such as normal color returning to their skin.

When your baby is breathing normally, you can stop CPR. The situation is no longer an emergency, but you should follow up with your child’s pediatrician. The doctor may want to have a checkup to make sure the incident didn’t cause any harm.