Twitter Facebook RSS Feed Print
Your Child

What to Do If Your Child Is Choking

2.30 to read

It’s more common than you probably think. On average over 12,000 children a year, under the age of 14, are treated in hospital emergency rooms for food-related choking. That’s about 34 kids a day according to a new study.

The most common choking hazards appear to be hard candy, followed by other types of candy, then meat and bones. The study noted that most of the young patients were treated and released, but around 10 per cent were hospitalized.

"These numbers are high," said Dr. Gary Smith, who worked on the study at Nationwide Children's Hospital in Columbus, Ohio.

What's more, he added, "This is an underestimate. This doesn't include children who were treated in urgent care, by a primary care physician or who had a serious choking incident and were able to expel the food and never sought care."

The estimated 12,435 children ages 14 and younger that were treated for choking on food each year also doesn't include the average 57 pediatric food-choking deaths reported by the U.S. Centers for Disease Control and Prevention annually, the researchers noted.

Smith and his colleagues analyzed injury surveillance data covering 2001 through 2009.

They found that babies one year old and younger accounted for about 38 percent of all childhood ER visits for choking on food. Many of those infants choked on formula or breast milk.

Children who choked on hotdogs, nuts and seeds were the most likely to be hospitalized.

"We know that because hot dogs are the shape and size of a child's airway that they can completely block a child's airway," Smith told Reuters Health, noting that seeds and nuts are also difficult to swallow when children put a lot in their mouths at once.

Supervision is the most important choking prevention. Parents or guardians should make sure that a small child’s food is cut up into manageable bites that can be easily chewed and swallowed. An example might be grapes and raisins. A whole raisin is probably okay to be given to a toddler, but a grape should be sliced.

What should you do if your child is choking?

For children ages 1 to 12:

1. Assess the situation quickly.

If a child is suddenly unable to cry, cough, or speak, something is probably blocking her airway, and you'll need to help her get it out. She may make odd noises or no sound at all while opening her mouth. Her skin may turn bright red or blue.

If she's coughing or gagging, it means her airway is only partially blocked. If that's the case, encourage her to cough. Coughing is the most effective way to dislodge a blockage. If the child isn't able to cough up the object, ask someone to call 911 or the local emergency number as you begin back blows and chest thrusts. If you're alone with the child, give two minutes of care, then call 911.

On the other hand, if you suspect that the child's airway is closed because her throat has swollen shut, call 911 immediately. She may be having an allergic reaction to the food.

Call 911 immediately is your child is turning blue, unconscious or appears to be in severe distress.

2. Try to dislodge the object with back blows and abdominal thrusts.

If a child is conscious but can't cough, talk, or breathe, or is beginning to turn blue, stand or kneel slightly behind him. Provide support by placing one arm diagonally across his chest and lean him forward.
Firmly strike the child between the shoulder blades with the heel of your other hand. Each back blow should be a separate and distinct attempt to dislodge the obstruction.

Give five of these back blows.

Then do abdominal thrusts

Stand or kneel behind the child and wrap your arms around his waist.

Locate his belly button with one or two fingers. Make a fist with the other hand and place the thumb side against the middle of the child's abdomen, just above the navel and well below the lower tip of his breastbone.
Grab your fist with your other hand and give five quick, upward thrusts into the abdomen. Each abdominal thrust should be a separate and distinct attempt to dislodge the obstruction.

Repeat back blows and abdominal thrusts Continue alternating five back blows and five abdominal thrusts until the object is forced out or the child starts to cough forcefully. If he's coughing, encourage him to cough up the object.

If the child becomes unconscious If a child who is choking on something becomes unconscious, you'll need to do what's called modified CPR. Here's how to do modified CPR on a child:

Place the child on his back on a firm, flat surface. Kneel beside his upper chest. Place the heel of one hand on his sternum (breastbone), at the center of his chest. Place your other hand directly on top of the first hand. Try to keep your fingers off the chest by interlacing them or holding them upward.

Perform 30 compressions by pushing the child's sternum down about 2 inches. Allow the chest to return to its normal position before starting the next compression.

Open the child's mouth and look for an object. If you see something, remove it with your fingers. Next, give him two rescue breaths. If the breaths don't go in (you don't see his chest rise), repeat the cycle of giving 30 compressions, checking for the object, and trying to give two rescue breaths until the object is removed, the child starts to breathe on his own, or help arrives.

A good rule of thumb for parents and guardians is to take a CPR class. Many hospitals and clinics also offer classes on what to do if your child is choking.

Sources: Genevra Pittman, http://www.reuters.com/article/2013/07/29/us-choking-food-idUSBRE96S04K20130729

http://www.babycenter.com/0_first-aid-for-choking-and-cpr-an-illustrated-guide-for-child_11241.bc

 

Your Toddler

Recall: Strollers and Rumble Seats Due to Choking Hazards

1:45

UPPAbaby is recalling about 71,000 of its’ 2015 CRUZ, 2015 VISTA strollers and 2015 RumbleSeat. The strollers’ and RumbleSeats’ bumper bar poses a choking hazard when a child bites the bumper bar and removes a piece of the foam covering.

UPPAbaby has received 22 reports of children biting off a piece of the bumper bar foam. No injuries have been reported.

The strollers and rumble seats were sold at BuyBuy Baby and other juvenile product retailers nationwide and online at Amazon.com from December 2014 through July 2015 for about $500 for the CRUZ stroller, $860 for the VISTA stroller and $170 for the RumbleSeat.

Consumers should immediately remove and stop using the bumper bar on these recalled strollers and RumbleSeats and contact the firm to receive a free bumper bar cover and warning label.

The CRUZ strollers have an aluminum alloy grey or black frame with a black fabric toddler seat with a colored fabric sunshade canopy and a black basket under the seat. The UPPAbaby name and logo are printed on the side of the canopy and “CRUZ” is printed in white lettering on the handlebars of the stroller.

The VISTA strollers have grey or black aluminum frames, colored sunshade canopy and are made to hold one, two or up to three children. VISTA is printed in white lettering on the handlebars of the stroller and UPPAbaby is printed across the bottom diagonal rail of the stroller frame next to a black, fabric basket.

The RumbleSeat is a separate seat attachment that can be attached to the stroller frame. RumbleSeats have manufacture dates stamped on the bottom of the seat from September 2014 through May 2015. The RumbleSeat comes in various colors and allows the child to ride rear facing, forward facing or reclined.

All of the strollers and RumbleSeats have a foam bumper bar across the middle of the product for the child to hold.

The recalled stroller and rumble seat model numbers are listed online at http://www.cpsc.gov/en/Recalls/2015/UPPAbaby-Recalls-Strollers-and-RumbleSeats/#remedy.

Consumers can also contact UPPAbaby customer service toll-free at (844) 540-8694 from 9 a.m. to 5 p.m. ET Monday through Friday, email contact@uppababy.com or online at www.UPPAbaby.com and click on Safety Notice on the lower right hand corner of the page for more information.

Your Toddler

Uncut Grapes Can Choke Young Children

1:30

While good nutrition involves plenty of fresh fruits and vegetables, there’s one fruit that should not be given to children 5 and under; grapes.

Uncut grapes are dangerous for young children because their size and smooth texture can cause choking and even death.

There have already been three choking cases in Scotland, out of which two turned out to be fatal, involving boys who were 5 or younger.

A report published in the journal Archives of Disease in Childhood notes that food is responsible for more than half of the choking incidents, which end in deaths when it comes to children under the age of 5.

"There is general awareness of the need to supervise young children when they are eating ... but knowledge of the dangers posed by grapes and other similar foods is not widespread," noted Dr. Jamie Cooper, co-author of the report, from the emergency department at Royal Aberdeen Children's Hospital.

According to the same report, there is no awareness concerning the specific risks that soft fruits raise, and the relatively small numbers of cases per hospital, which occur every year, don't fully reflect the extent to which this issue can affect young children.

Kids that have choked on grapes don’t often make the news, but according to research conducted in the United States and Canada, grapes occupy third place when it comes to deaths caused by food-related incidents, after hotdogs and sweets.

There are two reasons why grapes are so dangerous, especially in very young children: first, because the airways of the children are small and their swallow reflex is not fully developed, and second due to the smooth texture of the fruit.

Other foods with similar texture can pose a choking hazard, such as tomatoes.  Health experts suggest that grapes and tomatoes be cut in half twice. Anytime a child (or an adult for that matter) is eating uncut grapes or small tomatoes they should pay attention to their eating and not mechanically pop them into their mouths – like when watching TV or playing video games.

Grapes and tomatoes are good sources of fiber and healthy nutrients, just make sure that your little one has his or hers’ cut up so they are not easily choked when eating them.

Story source: Livia Rusu, http://www.techtimes.com/articles/189851/20161224/grapes-as-a-choking-hazard-doctors-say-lack-of-awareness-puts-young-children-at-risk.htm

 

 

Daily Dose

Kids And Choking Dangers

There are so many foods that can cause choking in your children. Dr. Sue tells you which ones.It has been a difficult week for my group practice as we have had a small child sustain a terrible accident after choking on an apple.  As a pediatrician, I talk about choking with parents beginning at the first visit, and encourage all new parents to take a CPR course.

When you discuss this with young parents you never dream that they will actually ever have to perform CPR. Choking hazards in young children are very real. A toddler’s airway is about the size of their “pinky” finger and there are many ominous objects just waiting for an active toddler to put into their mouths. Children like to explore with their mouths, so nothing is off limits!  With that being said, child proofing the house from choking hazards such as small toys, and objects is imperative. It is also important that when beginning to offer a toddler table foods that parents and caregivers think about choking hazards.  Parents worry about a child choking if they are beginning table food and don’t have teeth. It is not commonly known that teeth really have nothing to do with a toddler eating table foods, as even toddlers with a full mouth of teeth do not know to chew.  They just take big bites and swallow. So, think about foods being mushy and well cooked, in order that chewing is not necessary. It is like older folks, who often do not have a lot of teeth to chew with, so their food is all well cooked and cut into small pieces, which does not necessitate chewing. Every food that is offered to a toddler needs to be well cooked and think about being able to mush it up with a fork or between your fingers. The concerns about food allergies and the risks of giving a child a food “too soon” are no longer thought to be valid. The biggest concern about new foods for toddlers and children is really more about choking risks. With that being said, think about some of these foods.  Peanut butter is fine, but never a peanut or other nut that could easily cause airway obstruction. Melons that are mushy and given in small pieces would be fine too, but never a melon ball. Chips, popcorn, hard candies and hot dogs are a no-no too. So are uncooked carrots, celery sticks, apple slices, and chunks of meat like steak or pork.  Remember, can you mush it between your fingers? Well cooked peas, carrots, squash, eggplant, this list goes on and on and well cooked food are usually okay. So too are ground meats, shredded lunch meats and flaky fish.  It is important for toddlers to have a well balanced diet, while at the same time being aware of the risks of choking. Grapes should be cut into pieces, strawberries too.  Don’t let a toddler take a “bite” out of a hard fruit, rather cut it all up and give them small mushy pieces, several at a time. Lastly, remember to have your child sitting at a table for meals and snacks and do not allow them to walk around the house carrying food that might cause choking. It may be something that takes a little thought and reminding in the beginning, but your child will quickly learn that they eat at a table, rather than while “cruising”. It’s a really a good rule for all of us! So if you have a young child, and do not know CPR, call and sign up now!  At the same time be aware of choking hazards and the rare but deadly accidents that may occur. That's your daily dose for today.  We'll chat again tomorrow. Send your question to Dr. Sue!

Daily Dose

Hot Dogs: A Choking Hazard

The AAP recommends the food industry change the shape of a hot dog as it causes choking in children. Dr. Sue says other foods are just as hazardous. Did you read the latest AAP (American Academy of Pediatrics) position statement which addressed the issue of choking among children?   Choking is unfortunately a common problem in the pediatric population and prevention of choking is a topic I discuss with all parents as their children begin eating table food.

Children under the age of 3 have the greatest frequency of choking and hot dogs are a major concern for causing choking.  Due to this, the AAP has recommended that food manufacturers “design new food and redesign existing food to minimize choking risk”. They also state that foods that pose a high choking risk (peanuts, hard candy, grapes, apples, popcorn and chewing gum) should also get warning labels. But this may sound crazy, while knowing that choking is a problem in the pediatric population, I cannot understand a recommendation to change the shape of a hot dog.  A hot dog is a hot dog and if flattened it will then be called bologna. Hot dogs are not the issue, as grapes and peanuts cause choking and we cannot advocate changing their shapes.  Rather, it seems to me to be an issue with educating parents and making parents responsible for cutting up their children’s food. Parents need to be parents and take responsibility for protecting their children but not by changing the shape of a hot dog.  Think of all of the different objects that can cause choking, coins, toys, buttons, weird small objects that toddlers find on the floor. We cannot protect our children from all small objects and at the same time, things that we have control over, such as a hot dog or a grape, should be cut into small pieces before giving them to a child.  Lollipops also cause choking and some pediatricians still give lollipops after an office visit.  Hotdogs and lollipops are just what they are, they cannot be changed. We educate parents about using sunscreen (but we did not change the sun) and we are concerned about drowning and advocate fences and pool safety, but we don’t stop going outside or playing in a pool in the summer. Keep talking to parents about the risk of choking, advocate that all parents take infant and child CPR, cut up a child’s food until they are old enough to tell you that they know how to use a knife, but don’t outlaw hot dogs.  I will eat a hotdog at the ballpark or state fair, but not bologna. That's your daily dose for today.  We'll chat again soon.

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

DR SUE'S DAILY DOSE

Your child has Coronavirus. Now what?

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.