Twelve thousand children get rushed to emergency rooms every year for injuries related to choking on food, the New York State Department of Health (NY DOH) reports. Every five days, at least one child dies from this form of choking. Toddlers may also choke on non-food items. This leaves many wondering how to prevent choking in toddlers. Here are some precautionary steps to take.

Identify Choking Hazards

Dr. Bryan Hoynak is the medical director of California’s Placentia-Linda Hospital’s emergency room. He cautions that, especially with the holidays just around the corner, to be careful about leaving items easily accessible to little ones. Here are some of the potential choking hazards he identified:

• Beads and ornaments
• LEGO blocks
• Coins
• Gum

The NY DOH adds to these items to the list:

• Latex balloons
• Button-type batteries
• Small stones
• Marker caps may also pose risks.

Upon identifying potential choking hazards in the home, managing babies’ and toddlers’ access to them becomes easier.

Reduce Choking Hazards

It’s important to focus beyond objects to behaviors. In terms of food and choking, children should have unhurried meals and sit upright. And it’s best not to allow them to eat unsupervised until they’re older.

Hoynak recommends parents lock choking hazards in a bin, box or drawer that’s inaccessible to children. Overall child-proofing of the home, such as restricting access to certain spaces, may provide additional protection. Finally, remember to clean even hard-to-reach places, such as behind the couch.

What To Do in the Worst-Case Scenarios

The NY DOH points out that children aren’t the only ones who could use some tips. Parents and caregivers should take a CPR course for babies and toddlers through organizations like the Red Cross or American Heart Association (see links below).

In spite of best efforts, toddlers may still gain access to choking hazards or choke during a meal. In these instances, it’s important not to panic, but to act swiftly to clear the obstruction.

WebMD recommends the following protocols in a choking situation:

• Unconscious
• Not able to breathe because something is blocking the airway or has caused it to close off
• Wheezing or gasping
• Not able to cry, talk, or make noise
• Turning blue in the face
• Grabbing at the throat
• Looking panicked

Young children are prone to choking. If the child is coughing and gagging but can breathe and talk, don’t do anything. But if he can’t breathe, you must act quickly to stop a life-threatening situation.

While Waiting for 911

If the Child Is Unconscious:

1. Start CPR

• Move the child to the floor and start CPR. Take the object out of his mouth only if you can see it.

For a Child Younger Than 1 Year Who Is Conscious but Not Breathing:

1. Get the Child Into Position

• Hold the child face down on your forearm, supported by your thigh.
• Keep the child’s torso higher than the head.

2. Give Forceful Blows

• Use the heel of your free hand to thump the child in between the shoulder blades up to five times.

3. Turn the Child Over

• Turn the child face-up, and keep supporting the head and neck. If the object is not out yet, go to step 4.

4. Press the Chest

• Place the child on a firm surface, which may still be your forearm.
• Put two or three fingers in the center of the child’s breastbone and push quickly up to five times.
• Repeat the back thumping and chest pushes until the object comes out or the child loses consciousness.
• If the child is still not breathing, open the airway by putting your thumb in the child’s mouth and grasping the lower incisors or gums. The jaw should lift up so you can look for the object. Do not do a finger sweep.
• Do not try to pull the object out unless you see it clearly. You could accidentally push the object deeper into the child’s throat.

5. Start CPR, If Needed

• If the child loses consciousness, perform CPR and take the object out of his mouth only if you can see it. Never do a finger sweep unless you can see the object in the child’s mouth.

For a Child Older Than 1 Year Who Is Conscious:

1. Get the Child Into Position

• Stand behind the child and wrap your arms around his waist.
• Place a fist just above the child’s belly button.

2. Try to Dislodge the Object

• Hold the fist with your free hand and quickly push in and up.
• Repeat until the object comes out or the child loses consciousness.

3. Start CPR, If Needed

• If the child loses consciousness, move the child to the floor and start CPR. Take the object out of his mouth only if you can see it. Never do a finger sweep unless you can see the object in the child’s mouth.

How To Prevent Choking in Toddlers — Sources

Red Cross
American Heart Association
New York State Department of Health: Choking Prevention for Children
Dr. Bryan Hoynak, Placentia-Linda Hospital
WebMD: First Aid Steps for Children Who Are Choking