How to help a choking baby

How to avoid a choking incident during mealtimes

Choking is very common among young children, but should always be taken seriously as it claims the lives of many under fives every year. One of the best things you can do is try to prevent choking happening, because babies will put anything in their mouths indiscriminately so it is your job to make the home a safe environment.

Mealtimes are probably the most dangerous time for choking. A baby or young child should never be left to eat without supervision. You should cut food up into very small pieces, no bigger than a pea, particularly for young children. Babies tend to swallow without chewing, so it is essential that the food is small enough not to cause a blockage. Avoid giving the baby lots of pieces of food at once, on their feeding tray for example, because they will stuff their mouths rather than eating one piece at a time. You should also establish rules about behaviour at the table, so that children know they cannot run around, play or lay down while eating, which reduces the choking risk.

There are certain foods which children more commonly choke on than others. Some examples are:

  • Raisins
  • Grapes
  • Lumps of peanut butter or mashed banana
  • Hotdogs
  • Popcorn
  • Cherry tomatoes
  • Marshmallow
  • Sticky sweets

Some of these may surprise parents, but foods which are chewy, or very thick (like peanut butter), or which parents often don’t cut small enough (such as small fruits), are particularly dangerous. You can give your baby the above foods, but make sure they are appropriately prepared. You should never give a baby whole nuts or chewing gum.

How to avoid other choking incidents

Mealtimes are the biggest hazard, but not the only one. Avoid leaving small items such as coins, paperclips, batteries, pen caps or buttons lying around on low surfaces. Anything with small, detachable pieces is unsuitable for a baby to play with and should be kept out of reach. When buying toys, take the manufacturers’  age guidelines seriously; they are there for a reason. Balloons can be dangerous if they pop, because the rubber film can block an airway. Similarly, be extremely careful with any plastic such as polythene or cling film which can form an invisible seal over your baby’s airways.

How to recognise a choking baby

If your infant is coughing, crying and breathing, leave them to try and cough the blockage up while monitoring them, as this is a mild case of choking and coughing is still the most effective way of dislodging a blockage. If your infant is unable to cough, breathe, cry or speak, this is more dangerous. The baby may be choking. The airways may be completely or partly clogged-up, and you need to act quickly to remove the blockage.

What to try first

If you have been on a course for first aid, remember the skills you learnt there. For parents who have not, the first thing to try is this. Grip your baby with their face down at the width of your forearm with your hand supporting the head. With your other hand, give five blows between the shoulder blades on the back. Check the baby’s mouth between each one to check if the blockage has been dislodged, and take away any obvious block. Do not put your finger in their mouth unless you can clearly see and reach the blockage, because you may push it deeper.

If the back slaps do not work, move on to try chest thrusts. Lay the baby on his/her back either on a stable surface or along your arm and give no more than five chest pushes. Use two fingers to thrust inwardly and outwardly along the baby’s breastbone towards the head, one finger’s width below the baby’s nipples. Try to displace the object each time, and avoid doing all five at once automatically. Check your baby’s mouth to see if you can see and reach the obstruction after each thrust.

What to do if this doesn’t work

If your baby is still choking, call the emergency services. Do not leave your baby alone to do this, take him/her with you. While you wait for an ambulance you can continue administering blows to the back and chest thrusts, or if the airway is obviously devoid of blockage but the baby is unresponsive or still having trouble breathing, you may have to try CPR.

How to give CPR to a baby

First, kneel down at a right angle position to your baby’s chest, lift the chin using a hand and thrust downwards on the baby’s brow using your other hand to incline the head back gently. Support the rear of the neck and keep tilting the head backwards in order to unlock the airway. This is sometimes enough to resume normal breathing, so listen for sounds of gulps of breath and exhales. Monitor the pulse either on the neck or the in the baby’s elbow. If the baby is not breathing, or there is no sign of a pulse, or the lips have turned blue, start through mouth to mouth.

First, double check that the airway is devoid of blockage. Then allow yourself to get a good breath of air and seal the baby’s mouth and nose with your lips. Blow softly to allow air to their lungs, watching the baby’s chest to see it rise. As it rises, end blowing and let it drop. Each time fill your cheeks with air and repeat up to five times.

Next, give thirty chest compressions. Make sure your baby is on a sturdy surface before you do this. Find the middle of your baby’s chest, directly between the nipples and one finger’s width below them. Using two fingers, apply force slightly to a third the deepness of the chest, thirty times in quick succession. After doing so thirty times give two breaths then continue the cycle; thirty compressions, two rescue breaths. Do so until the emergency service arrive.

After a choking incident

Whether your baby appears fully recovered after a choking incident or not, take him/her to the doctor. Any baby who has been given chest thrusts will need to be checked over. Also, bear in mind that some of the blockage may have remained and can cause problems later on. If the baby is still coughing persistently or has difficulty swallowing, they urgently need to see a doctor.

Caring for your newborn:

Mother, Baby and Beyond

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