Choking In Children

Overview

What is choking?

When someone is choking, their airway is partly or completely blocked, meaning they may be unable to breathe properly. 

Choking in young children most often happens while they’re playing or eating. Children, particularly those aged from 1 to 5, often put objects in their mouth. This is a normal part of how they explore the world.

Some small objects, such as marbles, beads and button batteries, are just the right size to get stuck in a child's airway and cause choking.

The best way to avoid this is to make sure that small objects like these are kept out of your child's reach.

To avoid choking while eating, always cut food into small pieces before giving it to your child.

No matter how careful you are, your child may choke on something. In most cases, you or someone else will see your child swallow the object that causes choking. 

Signs and Symptoms

Signs of choking:

• difficulty breathing, speaking, crying or coughing
• signs of distress; they may point to their throat or grasp their neck

If your child suddenly starts coughing, isn't ill and has been eating or has a habit of putting small objects in their mouth, there's a good chance that they're choking.

Immediate First Aid Steps (Babies Under 1 Year)

Helping a choking child:

• If you can see the object, try to remove it. Don't poke blindly or repeatedly with your fingers. You could make things worse by pushing the object further in and making it harder to remove.
• If your child's coughing loudly, encourage them to carry on coughing to bring up what they're choking on and don't leave them.
• If your child's coughing isn't effective (it's silent or they can't breathe in properly), shout for help immediately and decide whether they're still conscious.
• If your child's still conscious, but they're either not coughing or their coughing isn't effective, use: 
• • back blows or chest thrusts (for babies under 1 year)
• You may need to use more than 1 method to stop choking. It doesn’t matter which order you do them in. If one method doesn’t work, try the other method. Keep trying each method until the object comes out.

How to give back blows and chest thrusts

To use back blows for babies under 1 year:

• sit down and lay your baby face down along your thigh or forearm, supporting their head and neck with your hand
• give up to 5 sharp back blows with the heel of your hand in the middle of your baby's back between their shoulder blades
• check if the object has come out between each blow (you may not need to use all 5 blows)

If back blows don't relieve the choking and your baby or child is still conscious, give chest thrusts to babies under 1 year.

This will create an artificial cough, increasing pressure in the chest and helping to dislodge the object.

To use chest thrusts for children under 1 year:

• lay your baby face up along the length of your thighs with their feet closest to you and their head furthest away and lower than their feet
• place 2 fingers in the middle of their chest just below the nipple line
• give up to 5 sharp chest thrusts (pushes) –
  check to see if the object has come out between each thrust (you may not need to use all 5 thrusts)

Reassessing your child

Following back blows and chest thrusts, reassess your child as follows:

• if the object still isn't dislodged and your child's still conscious, continue the sequence of back blows and chest thrusts
• call out or send for help, if you're still on your own
• don't leave the child

Call for an ambulance if the blockage doesn't come out after trying back blows and either chest thrusts. Keep trying this cycle until help arrives.

Even if the object has come out, get medical help. Part of the object might have been left behind, or your child might have been hurt by the procedure.

Immediate First Aid Steps (Children Over 1 Year)

Helping a choking child:

• If you can see the object, try to remove it. Don't poke blindly or repeatedly with your fingers. You could make things worse by pushing the object further in and making it harder to remove.
• If your child's coughing loudly, encourage them to carry on coughing to bring up what they're choking on and don't leave them.
• If your child's coughing isn't effective (it's silent or they can't breathe in properly), shout for help immediately and decide whether they're still conscious.
• If your child's still conscious, but they're either not coughing or their coughing isn't effective, use: 
• • back blows or abdominal thrusts (for children over 1 year)
• You may need to use more than 1 method to stop choking. It doesn’t matter which order you do them in. If one method doesn’t work, try the other method. Keep trying each method until the object comes out.

How to give back blows and abdominal thrusts 

To use back blows for children over 1 year:

• lay a small child face down on your lap as you would a baby
• if this isn't possible, support your child in a forward-leaning position and give 5 back blows from behind

If back blows don't relieve the choking and your baby or child is still conscious, give abdominal thrusts to children over 1 year.

This will create an artificial cough, increasing pressure in the chest and helping to dislodge the object.

To use abdominal thrusts for children over 1 year:

• stand or kneel behind your child, place your arms under the child's arms and around their upper abdomen
• clench your fist and place it between the navel and ribs
• grasp this hand with your other hand and pull sharply inwards and upwards
• repeat up to 5 times – check to see if the object has come out between each thrust (you may not need to use all 5 thrusts)
• make sure you don't apply pressure to the lower ribcage, as this may cause damage

Reassessing your child

Following back blows and abdominal thrusts, reassess your child as follows:

• if the object still isn't dislodged and your child's still conscious, continue the sequence of back blows and abdominal thrusts
• call out or send for help, if you're still on your own
• don't leave the child

Call for an ambulance if the blockage doesn't come out after trying back blows and abdominal thrusts. Keep trying this cycle until help arrives.

Even if the object has come out, get medical help. Part of the object might have been left behind, or your child might have been hurt by the procedure.

Unconscious child with choking

If a choking child is, or becomes, unconscious:

• put them on a firm, flat surface and shout for help
• call an ambulance, putting the phone on speakerphone so your hands are free 
• don't leave the child at any stage
• open the child's mouth and if the object is clearly visible and you can grasp it easily, remove it
• start cardiopulmonary resuscitation (CPR) on the child

When To Seek Medical Help

Call an ambulance or seek immediate medical help (e.g. Emergency Department) if:

• a choking child is, or becomes, unconscious
• the blockage doesn't come out after trying back blows and either chest or abdominal thrusts

Get medical help if:

• a child has choked