Choking is a scary thing to think about when it comes to your child. The good news is that there are some things you can do to prevent choking from occurring.

• Keep small objects out of reach from your child such as coins, small toys and game pieces, peanuts, balloons, and beads. A good rule of thumb is if the object fits inside a toilet paper roll cylinder, it is small enough to choke on.
• Hold off feeding your child peanuts, grapes, hot dogs, tough meats, and any other food that could lodge in your child’s windpipe until your child is old enough to handle eating these foods. If you want to feed your toddler grapes or hot dogs, cut them lengthwise and quarter them so they are not the diameter of your child’s windpipe.
• Do not let your child eat away from the table. Many children choke because they are eating and playing at the same time.
• Be sure you learn and practice the Heimlich maneuver and child CPR. Be sure your child’s caregivers are certified in these rescue procedures too.
• Keep your child in your sight while he is eating.

The universal signs of choking include:

• Inability to speak
• Weak, ineffective cough
• Noisy breathing or high pitch when inhaling
• Difficulty breathing
• Bluish skin color
• Loss of consciousness if airway is not cleared

If your child (over age 1) is choking, do the following:

• Ask, “Are you choking? Can you speak?”
• If he cannot cough, cry, or speak, he is choking.
• Place him on the floor or on a chair standing up. Stand behind him with his back to you. Wrap your arms around his waist.
• Make a fist with one hand. Place the thumb side of your fist just above the child’s naval and well below the breastbone.
• Grasp the fist with your other hand.
• Make quick upward and inward thrusts with your fist. Do not thrust hard enough to lift the child off the floor.
• Continue these thrusts until the object is dislodged or the child loses consciousness.
• If he loses consciousness, lower him to the floor, then call 911. Begin CPR. If you can reach the object in the airway, try to grab it out of his throat.

If your child is under age 1 and is choking, do the following:

• Do not perform these steps if she is coughing forcefully or has a strong cry.
• Lay the infant face down on your forearm. Use your thigh or lap for support. Hold the baby’s chest in your hand and her jaw with your fingers. Point the baby’s head downward so that it is lower than the body.
• Give up to 5 forceful blows between the baby’s shoulder blades. Use the heel of your free hand.

If the object is not free after 5 blows:

• Turn the baby face up and support the head.
• Place 2 fingers on the middle of her breastbone just below the nipples.
• Give up to 5 quick thrusts down, compressing the chest 1/3 to ½ the depth of the chest.
• Repeat the process of the 5 back blows and the 5 chest thrusts until the object is dislodged.
• If the baby becomes unconscious, see if you can reach the object. Start infant CPR and call 911 one minute after beginning CPR.

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