As a parent or caregiver, there are a plethora of things that one must consider in order to maintain a safe environment for a child in any setting. You hear of childproofing doors, windows, medicine cabinets, and dressers, but do you often hear about childproofing food? It seems counterintuitive that the food that provides us all with sustenance also poses such a risk for young children. Food, when not prepared or supervised mindfully, can pose an especially fatal threat to children under the age of 5. 

With the risks in mind, what can parents and caregivers do to ensure that the children that are under their charge are set up for success when it comes to eating? Three simple things come to mind: Awareness, Recognition, and Response.

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Baby Choking Awareness

When does choking pose a risk for children? To put it simply, choking poses a risk from the time a baby starts eating solids. Babies start eating solids around the age of 6 months, depending on each child’s developmental milestones achieved and the medical advice from their pediatricians.

Many babies start solids in the form of purees, but some parents or caregivers decide to go with a more modern approach known as “Baby-Led Weaning”. There are risks and benefits to both that caregivers must consider and ultimately decide what is best for their child; however, the risks are not to be ignored. Anyone who is feeding the baby must be knowledgeable about the chosen method of feeding and knowledgeable about how to respond and intervene if/when needed.

Risks of Purees

• Must transition baby to table whole foods around 9 months of age, so purees only last for a short amount of time
• Does not encourage baby’s motor development 
• May increase pickiness 

Risks of Baby-Led Weaning

• It is difficult to know exactly how much food the baby is in taking to account for nutritional value
• If food is not prepared correctly, the risk of choking is higher than feeding purees

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Recognition of Choking in Babies

Feeding time can be a fun and exciting time in a baby’s milestone journey, but all caregivers must remain vigilant and mindful of how food is prepared and given to the child. Children as young as 6 months of age may be introduced to foods, so it is essential that all personnel that provide care for children are well versed in what to look for when children are eating to prevent incidents or choking. 

Children who are eating should NEVER be left unattended. The caregiver must also eliminate distractions for both the child and the caregiver (this could include TV, phone, etc.) to ensure that all attention and awareness is on the child while eating. Seconds matter when it comes to choking, so that the caregiver may respond in a timely manner.

Signs of Choking in Children: What to look for during mealtimes

• SILENCE: This is a large indicator of choking
• Child is turning blue or gray (skin or lips)
• Gasping/Wheezing
• Child may grab at throat 

Infant Choking Prevention

Research which foods are best suited to your child’s age. For example, mashed raspberries are suitable for an 8-month-old learning to eat solids. Yogurt is also a great example for children of a similar age. 

Cut up foods to ensure that they do not present a choking hazard. For example, cut up grapes into quarters for children up until the age of 5. It may seem unnecessary at the age of 3 to give whole grapes to a toddler, especially to avoid a tantrum, but it is essential that the grapes are cut to prevent choking. As the saying goes, better safe than sorry. 

Avoid Food That Are Common Choking Hazards: 

• Popcorn
• Hard candies
• Cherry tomatoes (unless cut correctly into quarters)
• Raw carrots
• Large chunks of meat
• Hot dogs (unless cut correctly) 
• Nuts
• Dried fruits/foods
• Candy
• Gum

Prevention is half the battle. As Benjamin Franklin once stated, “An ounce of prevention is worth a pound of cure”. 

Infant Choking Response

How one responds can quite simply be the difference between life and death. Panicking may be an instinctual response, but its intended purpose is to invoke urgency. Now I know what you may be thinking! This is all great information, but what do I do if it happens? We provide good visual support on our Youtube page, but taking an in-person class is always the best way to set yourself up for success if/when you need the skills. Our website has a large library of resources that will be of great use to you on this journey. 

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What to Do If Your Infant Is Choking

1. Pick up your baby immediately and hold the infant over your knee face down. Support the infant’s head, neck, and body with your forearm with the infant’s head facing outward towards your hand. Ensure that the head is angled lower than the body.
2. Deliver 5 back blows in the center of the infant’s back between the shoulder blades with the heel of one hand.
3. Then carefully flip the baby over so it is on your other arm on its back, and deliver 5 chest compressions.
4. Repeat this process until the item is dislodged. Once the item dislodges, take one finger and sweep it out of the child’s mouth.
5. Call 911 if the child loses consciousness and begin CPR compressions immediately.

Check out the video below to see these steps demonstrated. Additionally, here is how to respond if an adult or child (over age of 1) is choking. However, taking a CPR and First Aid course with hands-on choking and CPR practice is the best way to learn. Learn more about our CPR and First Aid course here, request one at your facility, or join an existing class here. 

Next Steps for Parents & Caregivers

In conclusion, all parents and caregivers should have awareness, the ability to recognize choking, and the skills ready to respond. According to the FDA, “Always follow established choking rescue protocols approved by the American Red Cross and the American Heart Association before considering other interventions [such as the LifeVac], as these protocols have a high rate of success and can be carried out immediately without devices, saving valuable time.” 

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Being trained in CPR, Choking, and First Aid and being aware of the risks of choking can make the difference between life and death. We offer both completely in person options, and blended online. In both options you will get hands-on practice. Learn more about our CPR and First Aid training here, or sign up for a class here. If you would like to request a class for a group of parents or your facility request one here.