2Choking

How does choking occur?

Children, especially those between the ages of 1 and 5, often put objects in their mouth. This is just a normal part of how they explore their world.

Choking occurs when small objects, toys, or unchewed pieces of food block the throat or lungs from breathing air.   Without oxygen, the body will shut down in a matter of minutes. No matter how careful you are, a child may choke on something.

If a child suddenly starts coughing, is not ill and has a habit of putting small objects in their mouth, there’s a good chance that he or she is choking.

Gagging vs choking

We all have a gagging reflex, but babies have a particularly strong gag reflex that helps them prevent choking. This reflex happens when you are not sure if you can swallow something.

When babies begin eating solids, they will gag more often until they are used to the new texture and size of food. The food will either slide down or dribble out of their mouths.

If the food actually gets stuck in the windpipe and the breathing is obstructed, they are choking!

Coughing or gagging is a normal reaction to something in the throat or airway.

More about food and choking

Certain shapes, sizes and textures of food can present a real choking hazard for children.  Younger children especially can choke if they don’t have all of their teeth to chew, or are still getting used to eating solid foods.  Most children start to eat small bits of food (other than mashed) by the time they are 1 year old.

Watch out for the following hazards:

• Large chunks: A chunk of food larger than a pea can get stuck in a child’s throat. Vegetables, meats, and anything that requires lots of chewing should be cooked to soften and cut up into small pieces.  Cut round foods like sausages and grapes lengthwise to avoid getting stuck in the throat.  Even bread, pizza, cheese or melon should be cut into smaller pieces that are easier to chew and swallow.
• Hard foods: Hard lollies, apples, carrots, celery, nuts, and popcorn are potential choking hazards.  You should only give these items to older children that are practiced at eating hard foods. Seeds may be too small to choke on but can get stuck in a child’s airway.
• Soft, sticky foods: Soft foods like marshmallows, taffy or gummy lollies can easily get lodged in a child’s throat.
• Peanut butter: The sticky consistency of peanut butter and other nut butters can  also cause choking by getting stuck in the throat.

How to prevent choking

• Supervision: There is no better prevention than constant supervision when children are playing, eating or drinking. Choking children are usually silent – they can’t make any noise when their windpipe is blocked.  That means you need to watch children eating with your own eyes.
• Do not allow a child to eat in the car while driving.
• Grate, mash and cut any hard food including fruit and vegetables so they’re soft enough to chew or gum. Finger food should be cut into pieces no bigger than a pea and bones and skin should be removed from meat and fish.  Cut off the ends of sausages, cut food lengthwise to make it narrower for older children under 5, and cut grapes in half.
• Avoid small objects such as  coins, safety pins, balloons, pen tops and marbles.  A good way to  check if there is a choking hazard is to take a toilet roll cylinder and see if an object can fit through it.  If so, it’s not suitable for young children.
• Keep them seated :Make sure the children in your care sit while eating. Children shouldn’t eat while they are laughing crying, walking, climbing, running or lying down.
• Don’t overfeed –if children are force fed , there is a chance the food will come up or get stuck.
• Foods to avoid : seeds, nuts, popcorn, whole grapes, hard or gummy lollies.
• Cot mobile: Make sure your child can’t reach a hanging mobile.
• Keep baby powder away: Don’t allow kids to play with baby powder containers. The powder can shake free and clog your child’s throat.

Blind cords

Australia has strict regulations regarding blind cord safety. Cords should be attached firmly to a wall or window sill, as there is a very big risk of strangulation for children. Children can become entangled if they play near window coverings. Even with raised coverings, children can climb onto window sills or furniture to access the cords. Cords that become tangled around a child’s neck can very quickly cause strangulation, so be sure they are out of reach.

Blind cords can also strangle infants where cords are within reach, or hanging into a cot.  Check that infants’ beds are free of all materials that could cause strangulation, as well as small objects that a child could choke on.

Button batteries

When swallowed, small coin-sized lithium button batteries can get stuck in a child’s throat and cause severe burns or death. If a child swallows a button battery, the battery can get stuck in the child’s throat and burn through the oesophagus in as little as two hours. Repair can require feeding and breathing tubes and multiple surgeries.

Call 000 and seek medical attention immediately if you suspect a lithium battery has been ingested.

First aid for choking

In summary, here’s what you should do in the event of choking.

• Check for breathing. If the child is struggling to breathe or not breathing at all, call emergency immediately for an ambulance.  While you wait for medical help, you can follow the steps for clearing a blockage.
• If the child is breathing you may be able to dislodge the object by asking the child to cough. Do not put your fingers into their throat as this could push the object into a more dangerous position.
• If the child cannot dislodge the object, begin with 5 backblows, following by 5 chest thrusts.  Continue alternating between back blows and chest thrusts (5 each) until the object dislodges or medical help arrives.

Here are helpful diagrams on treating choking children: