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Avoiding infant choking hazards

Last Modified: September 21, 2021

Safety & Prevention, Family Medicine

September is Baby Safety Month – an opportunity to brush up on the basics of newborn and baby care in an effort to protect your little bundle of joy. This week, Tony GiaQuinta, MD, PPG – Pediatrics, talks about infant choking risks and what parents can do in the event of an emergency.

Common hazards

Foods account for 50 percent of all choking episodes, most commonly from foods that have firm, smooth, round edges. These common culprits include grapes, hot dogs, peanuts and raw carrots. Hot dogs are always the No. 1 food choking hazard.

Common non-food choking hazards include coins, buttons, toys with small parts, balloons, refrigerator magnets and toys that can fit entirely in a child's mouth. Parents should be on high alert when these items are around.

Minimizing risk

Parents should make sure that the more dangerous foods are cut into pieces to give the food an “edge” that helps the mouth control the food. These pieces should be no larger than 1/2 inch. In general, we recommend kids younger than 4 not eat high risk foods unsupervised, including hot dogs, chunks of meat or cheese, whole grapes, hard or sticky candy, and chewing gum.

For most toys, heed the age range warnings and don't let children play with toys that are designed for older children. 

Signs of choking

Remember, if your child is still able to speak or has a strong cough, do nothing! The cough is stronger than any intervention you can perform. However, call 911 so that an expert can assess the episode. They may recommend taking the child to an emergency room so that a partial blockage of the airway doesn't turn into a complete blockage.

A “complete blockage” choking episode would present as a child that is quiet, because they cannot pass any air through the airway. They may appear pale, distressed or have a weak cough.

What to do

First things first, try to stay calm. Direct someone to immediately dial 911. After that, we recommend performing a maneuver that uses the air already in the lungs to “blow” the object back out of the airway. Because choking is a leading cause of morbidity and mortality among children, it makes sense that all parents and babysitters should be trained in these maneuvers, in addition to CPR. (Check the schedule for classes available through Parkview.)

The National Safety Council recommends that caregivers clear the airway, and do the following only if the infant cannot cry, cough or breathe:

  • Support the infant face down by holding the head in one hand with the torso on your forearm against your thigh.
  • Give up to five back slaps between the shoulder blades with the heel of your other hand.
  • If the object is not expelled, roll the infant face up, supporting the back of the infant's head with your hand.
  • Place two fingers on the breastbone just below the nipple line.
  • Give five chest thrusts about one per second about 1 ½ inches deep.
  • Continue cycles of five back slaps and five chest thrusts until the object is expelled or the infant becomes unresponsive.
  • If the infant becomes unresponsive or is found unresponsive, begin CPR.



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