Choking is a very common hazard for children. It can happen at any age, but children under four are especially at risk. At this age, kids are less likely to chew their food properly and more likely to explore new objects with their mouths. When the food or object gets lodged in their trachea (windpipe), they choke. This is a scary situation for both child and parent, but it doesn’t have to be life-threatening if you’re prepared. First, minimise the risk of choking by following these safety guidelines:

• Ensure you, your spouse, and all caregivers are trained in first aid. The best way to help a choking child is by being prepared. In case your efforts are unsuccessful in dislodging the object, the child’s ability to breathe will be compromised and you may need to administer CPR. A full course on first aid is recommended.
• Give your child food that is soft or cut into thin slices and remove all seeds and stones. Small pieces of food and soft foods are easier for a child to chew and swallow, especially if she is not chewing properly. Seeds and stones are as dangerous and should be removed.
• Always supervise your child when she is eating. That way, you can remind her to chew thoroughly if needed, and respond immediately if she begins choking.
• Keep your child sitting in one place while she eats and drinks. The risk of choking increases if your child is eating while moving around.
• Do not rush your child through the meal. Speedy eating usually means chewing less, which increases the risk of choking on large pieces of food.
• Avoid baby toys with small parts or parts that can be easily removed or broken. If your child puts these in her mouth, she may choke.
• Do not keep coins, burst balloons, or other small items where your child can reach them. Children explore everyday objects by putting them in their mouths, too. These can be easily caught in their windpipes and cause them to choke.

CHOKING VERSUS BEING UNABLE TO BREATHE

There is a crucial distinction between choking and being unable to breathe. If your child is doing any of the following, he is choking:

• Prolonged coughing
• Gasping or wheezing
• Inability to talk
• The child’s face turns red
• The child clutches his throat (toddlers and older children)

In all these scenarios, your child’s windpipe is only partially blocked. In this case, it is best to wait a few seconds to see if he can dislodge the object on his own, commonly through coughing or vomiting. Although it is frightening to watch your child choke, it is essential that you remain calm. Children emulate their parents; if you are panicking, it is likely that your child will, too, and will be less able to cough and dislodge the object by himself.

However, if you need to intervene to help him dislodge the object, the first aid box won’t help. Instead, follow the steps outlined in the next section. Note that the procedures differ for infants (aged 0-1) and children (1-8).

Finally, begin CPR procedures immediately if your child has stopped breathing – that is, if he has turned blue or pale, is unable to make a sound, faints or collapses.

HOW TO HELP A CHOKING INFANT

1. Lay the infant face-down on your forearm (with her head slightly lower than her body, supporting her neck with your hand) and give five sharp back blows between her shoulder blades with the palm of your free hand.
2. Look in the infant’s mouth and remove any obstructions in it. Do not put your fingers inside her mouth to dislodge an object at the back; your fingers are too big and her mouth too small to enable you to grip and remove it. You are more likely to push the object further into the throat.
3. Lay the infant on her back and, using two fingers on the breastbone just below the nipples, compress her chest by 1/3 to 1/2 its depth in five, quick thrusts.
4. Check the infant’s mouth and remove any obstructions near the opening.

Repeat steps 1 – 4 until the object is dislodged. If the infant stops breathing, administer CPR, call for help, and take her to nearest hospital.

HOW TO HELP A CHOKING CHILD (OR ADULT)

1. Lean the child forward, facing away from you, and support him around the abdomen. Give five sharp back blows between his shoulder blades using the palm of your free hand.
2. Look in the child’s mouth and remove any obstructions near the opening of the mouth. Do not put your fingers inside his mouth to dislodge an object at the back; your fingers are too big and his mouth too small to enable you to grip and remove it. You are more likely to push the object further into the throat.
3. Stand the child in front of you, still facing away. Brace him against yourself and join both of your hands in a fist. Placing them under his rib cage, quickly pull inwards and upwards five times. Note that you may need to sit, kneel or stand for this, depending on his height.
4. Check his mouth and remove any obstructions near the opening.

Continue to repeat steps 1 – 4 until the object is dislodged. If the child (or adult) stops breathing, administer CPR, call for help, and take him to nearest hospital.