Signs of a Child Choking & How to Help

Do you cut your young child’s food into pieces to reduce their choking risk? Choking is common among children, but it doesn’t always happen at the dinner table.

“It could be food particles or toys or any other foreign object,” says Marie G. Ponce, M.D., a pediatric emergency medicine physician in Neptune, New Jersey. “Kids tend to put everything in their mouths.”

Unfortunately, some children can’t – or won’t – admit that they’re choking. Some are too young to seek help, while others are reluctant to admit wrongdoing.

“Unfortunately, kids are learning how to communicate and may not realize the severity of the situation,” Dr. Ponce says. “They might not necessarily tell their parents that they swallowed something if they’re afraid that they might get in trouble.”

Food or non-food items that get stuck in a child’s throat may be in:

• The windpipe (trachea) or airway, which brings air in and out of the lungs
• The “food pipe” (esophagus), which brings food to the stomach

If the windpipe is partially or completely blocked, it limits breathing. If the food pipe is partially or completely blocked, swallowing becomes difficult or impossible.

The most dangerous choking scenario is a complete airway obstruction, which prevents breathing. If your child turns blue or passes out, their situation becomes life-threatening.

Here’s how to recognize whether a child is choking, plus what to do.

Signs That Your Child May Be Choking

A child who’s choking may:

• Develop a sudden, persistent cough that sounds hoarser than usual
• Make gagging, wheezing or choking sounds
• Begin drooling, because they’re unable to swallow their saliva
• Turn pale, red or blue, possibly losing consciousness

Often, a parent’s first instinct to help may do more harm than good.

“One of the tendencies of parents is to do a finger sweep, trying to remove it,” Dr. Ponce says. “But most of the time, they end up pushing it further.” 

How to Help a Child Who’s Choking

If your child is turning blue and can’t breathe, call 911. Then, try to remove the item from their airway.

“Call first, because you aren’t sure that you’re able to remove the foreign body,” Dr. Ponce says. 

Dr. Ponce recommends back blows and abdominal thrusts (similar to the Heimlich maneuver).

“Lean the child forward and tap on the back as forcefully as you can, trying not to cause harm,” Dr. Ponce says. “You can also try to compress their upper abdomen, lower chest, to try to push it out.”

If your child is coughing, or struggling but still able to breathe, use back blows.

“We recommend tapping the back to try to stimulate them to cough it out,” Dr. Ponce says. 

How to Reduce the Risk of Choking

It isn’t possible to watch your child constantly, despite your best efforts. To reduce choking risk, limit what they eat and keep certain items out of reach.

“Don’t expose kids younger than 4 or 5 to anything that’s less than an inch in size, whether it’s a food article or a toy,” Dr. Ponce says. 

Choking hazards include:

• Chunks of hard fruits and vegetables (apples, pears, carrots, cauliflower)
• Whole grapes, blueberries or cherry tomatoes
• Small, round candies (Skittles, M&M’s)
• Chewy candy (gummy bears, Twizzlers)
• Nuts
• Hot dogs
• String cheese
• Medication (pills, capsules)
• Small toys or beads (less than 1-inch diameter)
• Toys with small parts (belonging to an older sibling)
• Gel water beads or marbles (in toy sensory kits or flower vases)
• Button batteries (inside remote controls and electronic toys)

To reduce choking risk:

• Cut food into small pieces for children under 2.
• Avoid giving hot dogs to kids under 3; after age 3, slice them lengthwise.
• Peel string cheese into shreds; don’t serve chunks.
• Offer cookies and other foods that crumble.
• Save nuts until kids are 4 or 5.
  
  

Next Steps & Resources:

• Meet our source: Marie G. Ponce, M.D.
• To make an appointment with Dr. Ponce or a doctor near you, call 800-822-8905 or visit our website. 

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.