Choking In Babies And Children

Choking occurs when a person's airway becomes partially or fully blocked by a foreign object. In adults this is usually food, but in babies and young children it could also be any pretty or tasty looking object they've found and put in their mouths! In cases of mild choking, where the airway is only partially blocked, a child over one year may be able to cough up the blockage. Babies, however, may require more assistance. If a child or baby's airway is fully blocked and they are choking severely, you will definitely have to intervene. Choking in babies and children can be very frightening, but it's your duty as an adult to keep calm and know what to do.

Techniques For Stopping Choking

Different techniques are used depending on the age of the child and severity of the choking. For babies less than one year old, you use a combination of back slaps and chest thrusts. For children over one year old and indeed for adults, you use a combination of heavier back blows and abdominal thrusts (also known as the 'Heimlich maneuver'). Both of these techniques are explained below. NEVER, EVER USE ABDOMINAL THRUSTS ON A BABY UNDER ONE YEAR; this can cause serious injury.

Babies Under One Year Old - Back Slaps

1. Lie the baby face-down on your forearm or thigh with his head low. Don't forget to support the head.

2. Using the heel of your hand, give a firm slap on the back, between the shoulder blades.

3. Now quickly check if the blockage has come out. Look in the mouth - if you can see and reach whatever's there, take it out. Don't poke your fingers far into the mouth or down the throat because you could push the blockage further down the baby's airway.

4. If the airway is still blocked, continue with up to four more back slaps, stopping after each to check if the blockage has been expelled.

5. If after a total of five back slaps the airway is still blocked, move on to chest thrusts.

Babies Under One Year Old - Chest Thrusts

1. To do chest thrusts, you need to turn the baby onto its back, resting on your forearm. The head should be low and supported.

2. Put the tips of two of your fingers over the baby's breastbone (the place in the chest where the ribcage divides). It should be located about one finger width below the baby's nipple line. Give one thrust by pushing firmly in and up towards the head.

3. Now quickly check if the blockage has come out. Look in the mouth and if you can see and reach whatever's there, take it out. Again, don't poke your fingers far into the mouth or down the throat because you could push the blockage further down the baby's airway.

4. If the airway is still blocked, continue with up to four more chest thrusts. Check after each one whether the blockage has cleared.

5. If after three cycles of five back slaps and five chest thrusts each, the baby is still choking, have someone call an ambulance immediately. If you are alone and have to call yourself, take the baby with you to the telephone.

6. Continue with cycles of five back slaps and five chest thrusts each until help arrives.

Phew! I got it out...

If the baby still has a persistent cough after the blockage has been removed or if he has difficulty swallowing, it could be that some of the material from the blockage has remained behind in the airway. You should take the baby to see a doctor right away. If it's late at night or on the weekend and your regular doctor is not available, take the baby to the emergency room.

Children Over One Year Old

Your technique for stopping choking in children over one year will depend on how serious the choking is.

Mild Choking

For mild choking, when the airway is only partially blocked, the child will probably still be able to cough, speak, cry and even breathe. In this case you should:

1. Encourage him to keep coughing; hopefully he'll be able to clear the blockage himself.

2. Look in the child's mouth and remove anything you can see and easily reach using two fingers and your thumb. Don't poke your fingers far into the mouth or down the throat because you could push the blockage further down the child's airway.

3. Brace yourself in case the whole airway becomes blocked and things get more serious; be ready to act.

Severe Choking

If a child is choking severely and his whole airway is blocked, he won't be able to speak, cry, cough or breathe. You must act quickly as without help the child will lose consciousness and could eventually die.

Children Over One Year Old - Back Blows

1. The first step is to administer five back blows. Stand behind the child. If you are right-handed stand slightly to the left. If you are left-handed stand slightly to the right.

2. Bend the child over forward using one of your hands to support his chest.

3. With the heel of your other hand, give one firm blow to the child's back, between the shoulder blades.

4. Now quickly check if the blockage has come out. Look in the mouth and if you can see and reach whatever's there, take it out. Don't poke your fingers far into the mouth or down the throat because you could push the blockage further down the child's airway.

5. If the airway is still blocked, give up to four more back blows. Check after each one whether the blockage has cleared.

6. If the blockage has still not come out, move on to abdominal thrusts (also known as the Heimlich maneuver).

Children Over One Year Old - Abdominal Thrusts

1. Again, stand behind the child.

2. Put your arms around the child's waist and bend him well forward.

3. Clench your fist and press it into the child's stomach just above his naval. Wrap your other hand around your fist.

4. Thrust both hands back and up into the stomach.

5. Now quickly check if the blockage has come out. Look in the mouth and if you can see and reach whatever's there, take it out. Don't poke your fingers far into the mouth or down the throat because you could push the blockage further down the child's airway.

6. If the airway is still blocked, continue with up to four more abdominal thrusts. Check after each one whether the blockage has cleared.

7. If after three cycles of five back blows and five abdominal thrusts each, the child is still choking, have someone call an ambulance immediately. If you are alone and have to call yourself, do so and return to help the child as quickly as possible.

8. Continue with cycles of five back blows and five abdominal thrusts each until help arrives.

Warning

Even if you have successfully cleared the blockage using abdominal thrusts you still need to take the child to see a doctor. Abdominal thrusts may be necessary in a case of severe choking, but they can cause internal injuries, especially in young children. If no doctor is available, take the child to the emergency room. Likewise, if the child has a cough, difficulty swallowing or pain in the throat, it could be that some of the blockage material has been left behind in the airway. In this case the child also needs to see a doctor as soon as possible.

Take A Class

Reading about how to do something is no substitute for hands-on practice. Ask your health care provider where you can take first aid classes which will give you practical demonstrations of how to deal with choking and other childhood dangers.