Choking Risks for Kids

The risk of a child choking is a silent fear for many parents. Infants and young children are at higher risk for choking-related injuries as they develop eating skils and learn the dos and don’ts about what to put in their mouths. Our pediatric expert, Dr. Tara Kotagal from Lurie Children's Primary Care Town & Country Pediatrics, answers some common questions parents may have about choking hazards for young children and explains what what to do if an emergency happens.

Top Choking Hazards for Toddlers 

Older infants and toddlers are developing oral-motor skills, like learning how to chew and swallow different shapes and sizes of food properly. Certain foods served uncooked, whole or in certain shapes or sizes can be at risk for lodging in the airway. Here are some of the most common food-related choking hazards:

• Uncut cherry or grape tomatoes
• Uncut whole grapes, berries or cherries
• Hot dogs or sausages
• Pieces of hard, raw fruits and vegetables like apples or carrots
• Popcorn, nuts or whole corn kernels 
• Uncooked dried vegetables or fruit, such as raisins
• Hard candies

Parents should always evaluate the size, shape and texture of food to determine if it is appropriate to feed to your child. Cutting food into smaller pieces and mashing foods can help prevent choking. When in doubt,  contact your child's pediatrician or care team for further guidance. 

Infants and toddlers are also becoming more curious about the world, and often put non-food-related items in their nose or mouth. Here are some of the common culprits for non-food related choking hazards:

• Balloons
• Batteries
• Beads
• Buttons
• Coins
• Marbles
• Pen or marker caps
• Small toys

If you are concerned that your child has swallowed a non-food related item, please contact your pediatrician immediately. 

How to Prevent Choking

Prevention is the most important step in protecting your child. By creating a safe environment and practicing these habits, you can significantly reduce the risk of a choking incident.

• Childproof your home. Reduce the risk of choking on non-food-related items by safety proofing and conducting surveillance of items accessible to young children. Many parents find it helpful to get down on the floor and view the space from a toddler’s eye level to spot potential hazards. This can help you spot small, easily missed items that have rolled under furniture or been dropped. 
• Prepare with care. Make sure food is appropriately prepared for your child. Cut grapes and cherry tomatoes into quarters lengthwise, shred or cook hard vegetables and avoid serving foods like popcorn or whole nuts to kids under four years old.
• Create a safe eating environment. Encourage your child to sit calmly in a high chair or at a table during meals and teach them eat slowly and chew thoroughly. Avoid letting them walk or play while eating.
• Keep a close eye. To help prevent choking, always supervise your child during meals. At home, keep small items and toys with removable parts well out of reach. Follow the age recommendations on toy packages and be aware of what older children are doing. Many choking incidents happen when older siblings give dangerous foods, toys or small objects to a younger child.

Talk with your child's pediatrician for more tips to protect your child from choking hazards.

Signs of Choking in Infants and Toddlers 

Signs of choking can range from being subtle to very obvious. You might notice that your baby suddenly becomes quiet or can't cry or makes high-pitched noises while trying to breathe. Watch for signs of skin color change. Purple or grey discoloration around the mouth is always a warning sign. For toddlers and older children, the signs can be a bit more obvious. A toddler who is choking may clutch at their throat, gag, cough, wheeze or gasp.  

How to Perform the Heimlich Maneuver (Abdominal Thrusts) 

If your infant (under 1 year) is choking and cannot breathe or cry, hold the baby face down on your forearm with their head supported. Deliver five firm back blows between the shoulder blades using the heel of your hand. If the object doesn't come out, turn the infant face-up and perform five chest thrusts using two fingers placed just below the nipple line. Alternate between back blows and chest thrusts until the object is expelled or the baby becomes unresponsive. If unresponsive, begin CPR and call 911. 

For a toddler or child over 1 year, stand or kneel behind them and wrap your arms around their waist. Make a fist with one hand and place it just above their belly button. Grasp your fist with your other hand and give quick, inward and upward thrusts. Repeat until the object is dislodged. If the child loses consciousness, begin CPR immediately and call 911. 

What to Do After a Choking Incident 

It’s important to have your child checked by a medical professional after a choking incident. Watch for signs of continued cough, wheeze, hoarseness or difficulty breathing. We recommend all parents and caregivers familiarize themselves with signs of choking and are well versed in infant and child CPR. Education is key, the more you know about choking and its related risks, the better you are able to help in case of an emergency! 

Learn more about Lurie Children's pediatric emergency care.

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