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Choking Prevention


Choking Prevention

Heather Zimmerman, M.D.​
Boys Town Pediatrics

​Choking, whether it's just a simple gagging on a small piece of food or a more dangerous choking on a food or a toy, it's  a really common cause of clinic, emergency room, hospitalization, those kinds of visits in children under 3 years old.

I think the most important steps in preventing choking are thinking about age-appropriate feeding and play.

With feeding, your pediatrician and others will give you advice about when it's appropriate to introduce solid foods, when your baby is ready to try finger and table food, where they're actually picking up small pieces of food and eating it themselves. 

Early on the rules that I give parents include nothing like a really, chewy meat, until they have their molars and have had them in for a while and are really learning how to chew properly with them.

Then as they get older, by 18 months, kids absolutely do not want you feeding them. They want to do it all by themselves.

The most important thing for you to do is to make sure you serve them nothing shaped like a coin. A coin is the shape they can choke on, most commonly.

If you're going to serve a hot dog, instead of cutting it in little coins, make it into long spears and let them pick it up and bite off little pieces with their teeth, or cut those spears into bites for them already.

Don't serve toddlers whole grapes, cut the grapes in halves or even quarters to make sure you don't have that ball shape that they could choke on.

The other thing is going to be appropriate play. This is why all toys come with recommendations that say, not recommended for children under 3 years or things like that.

Toys that either have really small parts, like little wheels on LEGO cars, or toys that are very small and the entire toy can fit in the mouth, like those new little tiny squinky dolls. Those should not be given to kids under 3. They cannot be trusted to not put it in their mouth.

What do you do if your child is choking?

Babies often choke as a part of their first few times learning to pick something up and eat it, especially, things like dry cereals or those little infant puff products that dissolve with their saliva.

If one of those items gets to the back too quickly, they'll kind of gag. If they're gagging on it but they're breathing and their color looks good, you might tell them, oh you need a little drink of water. Just pick up their Sippy cup with water and tilt it towards their face and get them to take a little drink to swallow it down.

If a child is ever changing color, turning blue, unable to speak or cough, those are your signs that you probably need intervene very urgently.

With a baby or a very young toddler, the easiest thing to do is to lift them out of the high chair if possible,  or even just in the high chair, use the heel of your hand to give a few, sharp back blows.

You just want to hit them in the middle of their back a couple of times and often times, that will dislodge something so it will either go up or down.

If it doesn't immediately work then call 911.​​

Choking is scary, but it’s largely preventable. Dr. Heather Zimmerman, pediatrician at Boys Town Pediatrics, explains ways to prevent your infant from choking and what parents should do if an infant begins to choke.