Created by Catherine Trammell Revised Spring 2013 Information obtained from “The Developing Child” & Toddler Choking Safety

Choking To help prevent choking, make sure that children stay seated while eating. Encourage small bites of food Swallow before talking or taking another bite Parents need to be near young children when they are eating.

Common Foods Causing Choking Large chunks: A chunk of food larger than a pea can get stuck in your child's throat. Vegetables like carrots, celery, and green beans should be diced, shredded, or cooked and cut up. Cut fruits like grapes, cherry tomatoes, and melon balls into quarters before serving, and shred or cut meats and cheeses into very small pieces. Small, hard foods: Hard candies, cough drops, nuts, and popcorn are potential choking hazards. Seeds may be too small to choke on but can get stuck in a child’s airway and cause an infection. Soft, sticky foods: Avoid chewing gum and soft foods like marshmallows and jelly or gummy candies that might get lodged in your child's throat. Peanut butter: Be careful not to give your toddler large dollops of peanut butter or other nut butters, which can be difficult to swallow. Instead, spread nut butter thinly on bread or crackers. You might want to try thinning it with some applesauce before spreading it.

Prevent Choking Avoid letting your child eat in the car since it's hard to supervise while driving. If you're using a rub-on teething medication, keep a close eye on your toddler as it can numb his throat and interfere with swallowing. Foods to avoid: 24 to 36 months Choking hazards: Even though your child is becoming a more competent eater, there's still a chance he'll choke on his food. Continue to avoid the choking hazards listed above, and discourage your child from eating while walking, watching television, or doing anything else that might distract him from his meal.

Foods to avoid: 3 to 5 years Choking hazards: Your child is a very competent eater now, but you should still be on the lookout for pieces of food that he could choke on. Keep cutting his food into small pieces, especially things like grapes and pieces of hot dog that could completely block his airway if inhaled. Continue to avoid popcorn, whole nuts, hard candies, and chewing gum. And discourage your child from eating when distracted.

Emergency Procedures for Choking (WebMD.com) If child is conscious, encourage them to cough if possible. Choking in a child may sound like wheezing (high-pitch noises in throat) or gurgling sounds. Act quickly!

Baby (Younger Than 1 Year) If the baby can cough or make sounds, let him or her cough to try to get the object out. If you are worried about the baby's breathing, call 911. If a baby can't breathe, cough, or make sounds, then:

Put the baby facedown on your forearm so the baby's head is lower than his or her chest. Support the baby's head in your palm, against your thigh. Don't cover the baby's mouth or twist his or her neck. Use the heel of one hand to give up to 5 back slaps between the baby's shoulder blades. See picture C. If the object does not pop out, support the baby's head and turn him or her faceup on your thigh. Keep the baby's head lower than his or her body.

* Place 2 or 3 fingers just below the nipple line on the baby's breastbone and give 5 quick chest thrusts (same position as chest compressions in CPR for a baby). See picture D. * Keep giving 5 back slaps and 5 chest thrusts until the object comes out or the baby faints.

Choking Rescue Procedure (Heimlich Maneuver) - Adult or Child Older Than 1 Year If the person can cough or make sounds, let him or her cough to try to get the object out. If you are worried about the person's breathing, call 911. If the person can't breathe, cough, or make sounds, then: Stand or kneel behind the person and wrap your arms around his or her waist. If the person is standing, place one of your legs between his or her legs so you can support the person if he or she faints. Make a fist with one hand. Place the thumb side of your fist against the person's belly, just above the belly button but well below the breastbone. See picture A.

Grasp your fist with the other hand. Give a quick upward thrust into the belly. This may cause the object to pop out. You may need to use more force for a large person and less for a child or small adult. See picture B. Repeat thrusts until the object pops out or the person faints.