Perhaps one of the biggest fears for parents raising children is choking. And for good reason. Babies and toddlers tend to find the tiny things around the home that parents miss. After all, they’re much closer to the ground than you are.
Of course, it’s important to know what to do if your baby does accidentally begin choking, which is why we provide CPR and choking relief training. But equally important, all parents must invest in prevention. Both can save lives, but by creating a safe home, parents avoid many of the pitfalls that often lead to choking. We want all parents and caregivers to have the confidence both to step up and act in an emergency situation as well as have the knowhow to provide a safe, hazard-free environment.
(After all, it’s best for everyone if you never have to actually use your CPR or choking relief training, right?)
That’s why we believe in preparation beyond taking our certification courses, like creating a safe sleeping area and making sure your home is “babyproofed” as much as possible.
Choking is very serious at any age and can cause lasting damage or death. But an infant is at a higher risk because their tracheas (the windpipe between their mouth and lungs) is about as wide as a drinking straw. That means that even a stray popcorn kernel could be life-threatening. Therefore, you must become familiar with common choking hazards so you can eliminate them from your home or keep them far out of the baby’s reach.
We all may have an intuitive sense for some of these choking hazards, but there are many, less obvious things that you may have not considered before.
Take a look at this list of top choking hazards for infants and children:
Top choking hazards—food items
When considering food items and risk of choking, remember, it’s all about size. Keep the pinky rule in mind: if it’s smaller than your pinky is wide, then it’s a hazard.
Here is a list of common foods that babies choke on:
- Hot dogs (often because parents don’t cut it small enough)
- Candy (hard or sticky/chewy)
- Small raw or frozen vegetables, like peas or chopped carrots
- Blueberries and other small berries
- Small pieces of ice
Note: infants and children more commonly choke on food items than on non-food items, so keep a close and vigilant eye on the baby while she’s eating.
Choking: a common problem
According to the Mayo Clinic, “choking is a common cause of injury and death in young children, primarily because their small airways are easily obstructed.”
The American Academy of Pediatrics describes choking as a “leading cause of morbidity and mortality among children, especially those aged 3 years or younger.”
Babies and young children tend to explore their environment in many different ways, including with their mouths. This can lead to a choking incident if an object they place in their mouth ends up blocking the airway.
The dangers of choking
Choking cuts off air supply, which can have disastrous or even fatal consequences in as little as 4 minutes. Even a partial blockage of the airway can cause a problem, since it diminishes air supply.
The inability to properly chew food contributes to the problem of choking in infants and young children. This is why food items are the most common choking hazards for this age group. Common culprits include hot dogs, uncut grapes, corn, nuts, raw fruits, popcorn, and hard candies.
What are the top choking hazards—non-food items?
While food items make up a major part of the choking hazard list, non-food items are just as bad. One major reason: Babies are still learning what food is. You may not have given it much thought, but babies put things in their mouths so much because they are trying to figure out if it’s edible. Things that have appealing colors and shapes naturally seem food-like to a baby. We all have an instinct to eat things that look pretty (think of an icecream sundae), but babies lack the wisdom of experience to rule out things like puzzle pieces, for example. Below, we break down some common choking hazards to be mindful of:
- Small Batteries
Toys often come with small lithium batteries. Batteries are particularly dangerous because they not only pose a choking threat but can cause internal bleeding that will sometimes lead to death. Store batteries far out of reach.
- Safety Pins
Safety pins are often misplaced and forgotten. They are small enough to lodge in the trachea and if unhinged, can poke and cause bleeding. Put them away!
- Legos & Other Small Toys
Families with older children need to be particularly aware of small toys. Many toys, especially Legos, look bright and appealing, and babies go straight for them. Train your older child to always clean up his or her toys and keep a watchful eye out for stray Lego pieces.
A favorite decoration at every birthday party, balloons pose an extreme choking threat. A deflated balloon is easy to swallow and will conform to the shape of the trachea, cutting off airflow and making it almost impossible to dislodge. In fact, from 1972 to 1992, 29% of choking deaths caused by nonfood items were caused by latex balloons. Pop and throw away your old balloons immediately after any party.
- Pen Caps
Pen caps are commonplace and very easy to lose. Many standard disposable pens have an integrated hole at the end. Ever wonder why? Because they are a major choking hazard, and the hole can save a life. But don’t assume all pen caps have the hole. Double check your couch cushions every once in a while. Also, the average home “junk drawer” contains lots of hazards for babies beyond pen caps: batteries, thumbtacks, you name it. If you haven’t already, be sure to add a child safety lock to your junk drawer.
Jewelry is small, shiny, and irresistible. If your toddler can pull herself upright, it’s time to organize your nightstand! No more plopping your earring on the nightstand at the end of the evening. Put rings, earrings, necklaces, and other jewelry items in a drawer or in a hard-to-reach cabinet
Not only do marbles look like candy, but they are perfectly shaped to slip into the esophagus. Because they are so dangerous, we recommend that you simply remove toys or games that involve marbles. The kids can find something else to do!
- Small Rocks
Do you have gravel? Do your toddlers like to explore outside? It isn’t practical, of course, to redo your entire landscaping, but it does imply two important things:
- Keep vigilant watch over your carpet and floors, especially near doorways. Little stones can stick between treads of boots and fall out indoors, or just get scuffed over the threshold. Always pick up any little stones you find inside.
- If you take your child outside near small stones, never take your eyes off them. Treat it like you were playing near a pool. Any time they reach for something on the ground, take it away and replace it with a safe baby toy to keep them occupied.
- Board Game Pieces
Every game from Settlers of Catan to Monopoly includes small, chokable pieces. Make sure to double-check your table and floors after your epic victory. Those colorful little pieces are perfect toddler bait and are easy to swallow.
- Refrigerator Magnets
From a toddler’s perspective, refrigerator magnets are like tiny treasures begging to be taste-tested. Don’t overburden your magnets with Aunt May’s extra thick Christmas card. Secure them high above the stretching hands of little toddlers. Even better, remove any that are smaller than your thumb and stick to using big magnets that can’t fit in the baby’s mouth.
Tips for choking prevention
In addition to being aware of the top choking hazards for infants and children, there are a couple other things you should do in the name of choking prevention.
- Cut foods into small pieces. Even “easy” to chew foods, like hot dogs and grapes, should be cut into very small pieces to prevent choking.
- Cook vegetables to make them softer. Crunchy vegetables are harder for young children to chew completely, making them a common choking hazard. Cooking vegetables (by steaming, for example) makes them softer and easier to chew.
- Avoid eating on-the-go (e.g. in the car). When a child is distracted, they are less likely to focus on chewing their food completely. More importantly, you can’t always give them your full attention (especially if you’re driving). It is safest to eat at a table at home and then go out. That way the child can chew food completely before swallowing.
- Keep small toy parts out of reach. You should even keep small toys and toy parts out of reach of older children, as older children may leave them out where a younger child or infant could reach the object and put it in their mouth.
- Be extra cautious with children with certain disabilities or illnesses. Some disabilities (notably cerebral palsy, epilepsy, and chronic asthma) can make children more susceptible to choking. If you’re caring for an infant or child with these problems or others, take special care when it comes to choking prevention.
What are the Warning Signs that Your Child is Choking?
When you become a parent for the first time, or when you find yourself caring for infants regularly, you suddenly become acutely aware of everything that could go wrong with the baby. They seem so fragile and helpless, and you want to do everything you can to be prepared to help them should an emergency situation arise.
Most of the time, it’s relatively clear when your infant is suffering, hurt, or in danger. Other times, however, the signs of danger are more subtle. This can sometimes be the case with choking.
Young babies cannot help themselves while choking, nor can they even let you know that they are choking. In fact, when in distress due to choking, babies often freeze up and don’t make any noise at all. This leaves it entirely up to the parent or caregiver to recognize the signs of choking and take immediate steps to clear the infant’s airway.
Infant CPR provides choking relief training in each of our CPR certification courses, including the course for infants. The best way to be prepared for a choking emergency is comprehensive training. That said, every parent and caregiver should be able to recognize the warning signs of a choking infant, so we discuss the most common signs below.
The baby’s lips and/or skin turn blue.
When a baby’s lips or skin turn blue, it’s due to lack of oxygen. There can be other causes for this, but most commonly, a baby turns blue because of choking. This blue tint can be very alarming to parents and caregivers. If you see this, check for choking, and call 911 right away.
The baby can’t cry or make noise.
We’d like to think that someone who is choking would cry out for help, but the fact is, when the airway is blocked, it’s impossible to make noise. For the same reason, a choking infant won’t be able to scream or cry. If your infant looks like he/she is in distress, but is making no sound, they could be choking.
The baby can’t breathe, or has to make an effort to breathe.
If your baby isn’t breathing, or is gasping or wheezing heavily, they could very well be choking. Important: if the baby can actually cough, the airway isn’t completely blocked. Allow the baby to continue coughing. They may be able to clear their own airway (but you should still call 911 for help).
The baby appears panicked or troubled, and may wave their arms.
If your infant begins flailing their arms or seems otherwise distressed or panicked, it could be a warning sign of choking, especially when combined with one of the other signs.
The infant loses consciousness or goes limp.
Another symptom of choking is loss of consciousness. You may discover the child unconscious, or if the baby continues to choke without relief, they could pass out. If the baby goes unconscious, you may need to perform infant CPR.
If you see any of these signs of choking, it’s easy to panic. Resist the feeling and remain as calm as possible. You need a clear head in order to perform choking relief procedures quickly and effectively.
To provide choking relief to infants:
- Make sure the baby is not coughing or crying. Assess the situation to make sure the baby is truly at risk for choking. If the baby has a strong cough or is crying, the airway is likely only partially blocked, and it will be easier for the baby to cough out the blockage. Anything you might do (including back blows) could actually make the situation worse. Do not administer choking relief if the baby is choking or crying.
- Do not try to remove the object with your fingers. Trying to pull an object out of the infant’s airway is more likely to make the situation worse.
- Call 911. If you are not sure how to help relieve your baby’s choking, call 911 immediately. They may be able to walk you through life-saving procedures, and will also send professional help your way.
- Administer back blows. Hold the infant face down on your forearm, with their head lower than their body. Hold their mouth open with your hand on that same arm. Using the heel of your free hand, give up to five quick blows to the infant’s back, right between the shoulder blades.
- Perform chest thrusts. If the back blows don’t dislodge the item, turn the baby over on its back, holding the infant in your lap. Make sure the head is supported. Place two fingers in the middle of the chest, and give five quick thrusts downward (about one-third of the depth of the chest).
- Repeat back blows and chest thrusts. Repeat these steps until the blockage is removed, help arrives, or the baby loses consciousness (in which case you would need to start performing CPR).
No parent or caregiver wants to think about the possibility of performing choking relief procedures or CPR on their infant, but accidents happen, and it’s always best to be prepared.
Register for our certification course for Infant CPR to learn more about the specifics of CPR and choking relief for infants. We hope you never have to use your training, but if you do, you’ll be glad you have it.