Tips to avoid choking

By Dr. Lisa Thornton
Friday, August 31, 2012

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Parenting

Every five days in the U.S. a child chokes to death while eating, making choking one of the leading causes of death for children from birth to age 5. Yet every hour of every day parents feed their children without a second thought as to this immediate danger because few know the risks until it's too late.

Babies are born with an automatic suck/swallow reflex that allows them to drink liquids like breast milk immediately at birth, but the ability to chew and manage food in the mouth is a skill acquired over the first several years of life. As children grow, they gradually learn to handle pureed foods like baby food, then small, soft, chopped foods, then all kinds of food.

But children often don't chew well and don't move the food in their mouths correctly so they are at a much higher risk of trying to swallow something that's too big or sending food toward the windpipe or trachea instead of down to the stomach.

The trachea in a young child is about the size of a straw. Imagine if you were drinking through a straw and a grape plugged one end. You could suck and suck and still no liquid would get through. That's what can happen when a child chokes on a piece of food.

The child will try to breathe, but the food blocks the trachea. This is an emergency and requires immediate action like the Heimlich Maneuver to dislodge the food or in a very short time the child will lose consciousness from a lack of oxygen and die from suffocation.

Sometimes the brain is starved for oxygen for a long time, but the child is revived. The result is permanent brain damage and a lifelong disability.

These are awful and frightening facts, but parents can do a lot to reduce their child's risk. Here are some important tips:

Always supervise young children while they are eating and keep small objects that are potential choking hazards out of their reach.
Do not allow children under 3 to eat small, round or hard foods including cheese sticks/chunks, hard candy, nuts, seeds, marshmallows, popcorn, hard, raw vegetables, jelly beans or other jelly candies, raw unpeeled fruit slices, dried fruits or chunks of meat. Even large dollops of peanut butter can be a hazard.
If you feel you must serve hot dogs, cut them into tiny pieces by slicing them lengthwise, then into quarters. It's better to avoid them altogether.
Cut grapes into quarters.
Grate uncooked carrots instead of serving them as sticks or coin-shaped.
Cut all foods into small pieces for toddlers.
Give infants soft foods that they do not need to chew.
Do not let your child eat or suck on anything like candy or gum while lying down or playing.
Have children sit in a high chair or at a table while they eat.
Take a class in basic CPR where you can learn the Heimlich Maneuver.

For more information visit healthychildren.org.

This column is not a replacement for medical advice.

This article appeared in the September 2012 edition of Chicago Parent.

Dr. Lisa Thornton, a mother of three, is director of pediatric rehabilitation at Schwab Rehabilitation Hospital and LaRabida Children’s Hospital. She also is assistant professor of pediatrics at the University of Chicago.

See more of Dr. Thornton's stories here.

Contact Dr. Thornton at drlisathornton@gmail.com