Risk Management: Tips for Preventing Choking and What to Do if Someone is Choking

Boys bed Bed Diving

"OK, so Brother can go down head first." That was our first clue we should check to see what the Darling Boys were doing in their room. They had been quietly reading books. Reading is about the only thing they slow down for during the day. Darling 1 had piled all the cushions, pillows and blankets at the end of the Darling 2's bed. Darling 1 was having Darling 2 take the inaugural jump, supposedly diving head first, from the footboard into the puffy mound of bedding. Darling 2 happily tried it out. Fortunately he emerged without injury after the first and last time he took the plunge. We quickly stopped this experiment in gravity.

This is not the first time the Darling Boys have tried such a feat. The pieces of furniture commandeered to attempt the daring acts may change, but the general idea is always the same: climb as high as possible, jump over, onto or into something that is intended to cushion the fall. Darling 2 is always the test pilot, and Darling 1 is always the engineer of the plan. So far, no great injuries have befallen the Darling Boys during these daredevil stunts. I am generally nearby in the kitchen preparing a meal, downstairs doing laundry, in the shower, etc., and am able to put a halt to the activities before something other than a bump or bruise occurs.

Safe Home Environment

I take as many precautions as necessary to create a safe environment for them to live, play and sleep. I do the same when buying food for them and preparing meals for them. But the truth is that even if I am careful about what they eat and how it is prepared, i.e. cut in small pieces, cooked to the correct doneness and texture for their ages, they could still choke on something. This could happen even if I am sitting right next to them.

Tips for Preventing Choking

Therefore, it's vital to know not only to how to prevent choking, as much as possible, but also what to do in the event of choking. This risk is highest for kids under 4. They are still getting teeth and developing their biting, chewing and swallowing skills. Babies generally get their first teeth somewhere between the age of 5 to 9 months, which enables them to bite off bits of food, but the first molars don't come in until 15 months or so, and the second set of molars don't come in until much later, around 26 months old. It's the molars that allow the tots to grind the food down, which aids in preventing choking. Additionally, the airways of children younger than 4 are quite small, narrowing to the diameter of a straw at the back of the throat.

If your kiddos are anything like my Darling Boys, they go through a time that they cram as much food as possible into their mouths, thereby increasing their chances of choking. Darling 2 is in that stage right now. When young children chew foods like peanuts, raw carrots and popcorn, some is ground down and some is not, and they tend to swallow unchewed bits of food that can block the airway or be inhaled into the bronchial tubes and lungs.

There are a variety of tips on this topic. Some choking hazards are food, others are small household objects and still others are toys that are inappropriate for the age of the child or made poorly with pieces that can detach and be swallowed by a young child. There are tips on how to avoid each of these hazards.

General Choking Prevention Tips

  • Test small objects using a small parts tester or toilet paper tube to find out whether they are choking hazard.
  • Avoid giving children small round foods.  Check with your pediatrician about your child's particular needs.
  • Keep small items, toys and toy parts away from young children and older children who continue mouthing objects.
  • Store toys separately.  Those made for older children may have small parts that put younger children or children that may be developmentally challenged at risk. 
  • Learn child CPR.
  • Children should be taught to eat at a table, not when walking or playing.

Source: www.safekids.org

Tips for Feeding Babies Safely

  • Your baby should sit up while eating, and be supervised at all times.
  • Teach babies from an early age to "chew" (or gum) food well.
  • Don't hurry your child when eating—allow plenty of time for meals.
  • Only put a small amount of food on the tray at a time.
  • Avoid peanut butter—it's a greater allergy risk at early ages, anyway.
  • Avoid round, firm foods and chunks (hot dogs, nuts, meat/cheese chunks, whole grapes, hard or sticky candy, popcorn, raw carrots, other firm, raw fruit or vegetable chunks).
  • Hot dogs are not healthy or safe for babies.  
  • Avoid stringy foods like string beans and celery.
  • Avoid commercial white bread products—they can form pasty globs in your baby's mouth, and aren't healthy anyway.
  • Offer only a few pieces of food at a time.
  • Cut meat and poultry across the grain, and into tiny fingertip-sized pieces.
  • Food pieces should be no larger than one-half inch in any direction.  If in doubt, cut food into smaller pieces

Source: http://www.med.umich.edu

The New York State Department of Health provides a list of common food and household item choking hazards:

Foods:

  • Hot dogs (especially cut into a coin shape), meats, sausages, and fish with bones
  • Popcorn, chips, pretzel nuggets, and snack foods
  • Candy (especially hard or sticky candy), cough drops, gum, lollipops, marshmallows, caramels, hard candies, and jelly beans
  • Whole grapes, raw vegetables, raw peas, fruits, fruits with skins, seeds, carrots, celery, and cherries
  • Raisins, dried fruits, sunflower seeds, all nuts, including peanuts
  • Peanut butter, (especially in spoonfuls or with soft white bread)
  • Ice cubes and cheese cubes
  • Foods that clump, are sticky or slippery, or dry and hard textured
  • Food size and shape, especially round or a shape that could conform to the shape and size of the trachea (windpipe). A small child's trachea is approximately 1.25 inches diameter
  • Combinations of food size, texture, and shape can pose a threat. For example, a slippery hard candy with a round shape about the size of a drinking straw could block an airway (windpipe)

Household Items/Toys:

  • Latex balloons, coins, marbles, toys with small parts, small balls, pen or marker caps, button type batteries, medicine syringes, screws, stuffing from a bean bag chair, rings, earrings, crayons, erasers, staples, safety pins, small stones, tiny figures, and holiday decorations including tinsel, or ornaments and lights
  • Any toy or other object that is labeled as a potential choking hazard

So, what food is safe for your little one? This list provides some suggestions for safe finger foods:

  • O-shaped cereals
  • Well-cooked carrots
  • Whole-wheat toast (remove crust)
  • Scrambled egg yolk
  • French toast (without egg white)
  • Cooked peas (no pod)
  • Very ripe pear chunks
  • Well-cooked apple chunks
  • Cooked pasta pieces (consider using whole-grain pasta)
  • Tofu chunks
  • Avocado dip or chunks
  • Soft-cooked peas and beans

Source: http://www.med.umich.edu

Here are some great resources for finding additional information on choking hazards, preventing choking and babyproofing your home:

  1. American Academy of Pediatrics
    The AAP offers toy safety
    guidelines for parents which include tips for preventing choking. They also offer a fact sheet on choking prevention and first aid (www.aap.org/family/choking.htm). AAP's phone number is 847-228-5097 begin_of_the_skype_highlighting              847-228-5097      end_of_the_skype_highlighting.
  2. Consumer Product Safety Commission
    Visit the CPSC home page (
    www.cpsc.gov) to search for information about toy safety and choking hazards. Call CPSC at 1-800-638-2772 begin_of_the_skype_highlighting              1-800-638-2772      end_of_the_skype_highlighting.
  3. National Safety Council
    NSC offers a fact sheet on baby-proofing your home (
    http://www.nsc.org/library/facts/babyprf.htm). Call NSC at 1-800-621- 7619 begin_of_the_skype_highlighting              1-800-621- 7619      end_of_the_skype_highlighting.

Source: http://mercyweb.org

Websites for What to Do If Your Child IS Choking

Here is a good site for information about what to do if you, another adult, a child over the age of 1 year old or a pregnant or obese person is choking: http://firstaid.webmd.com/choking-treatment

This site has illustrated information about what to do if you baby under 1 year old is choking: http://www.babycenter.com/0_infant-first-aid-for-choking-and-cpr-an-illustrated-guide_9298.bc

The Scoop

It all comes down to this: You can't shield your child from every danger out in the world, but there are many hazards you can avoid, or at least minimize. The risk of choking can be reduced by childproofing your home; preparing age appropriate foods; teaching your child to eat slowly, thoroughly chewing each bite while sitting down; and knowing how to react should your child (or you) choke. Thanks for sharing your opinions about the AAP calling for the FDA to require choking hazard warning labels on many foods, etc. I always appreciate a good discussion, and love to hear from readers. On Friday, I will post a bit of Motherly Advice. Over and out…

Anna

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