Safeguarding children from the danger of choking


April 11, 2016

Take these smart steps to prevent children from choking, but know what to do if it occurs.


My littlest recently turned 1. I must say this is an endearing age – everything is filled with such wonder and curiosity. He has this desire to learn so much about the world around him, which is why anything and everything ends up first in his hands and then in his mouth. While many times this exploration is cute, like when he first tried to eat dirt and then decided it wasn’t as palatable, my guard is always up so we avoid a situation that could lead to choking.

Choking occurs when an object gets stuck in a child’s airway, making it difficult for oxygen to get to the lungs. Children younger than 3 are most at risk for choking. That’s because toddlers have a propensity for placing things in their mouths; children get distracted while they are eating and laugh and move around; and because they have smaller airways than adults.

Unfortunately kids most frequently choke on items close at hand: toys and food. There are ways to minimize the chances that they’ll choke:

  • Pay attention to labels when purchasing toys for your child.
  • Be aware that if it is smaller than a golf ball, it is a choking hazard.
  • Encourage older children to play with their toys (this means all those Legos, marbles and beads!) in a separate area or at a high table so younger kids cannot grab them.
  • Make sure foods are eaten at the table (not elsewhere in the house where a toddler may like to wander).
  • Encourage children to eat slowly and not talk or laugh while chewing.
  • Give special consideration to certain foods (like hot dogs, grapes and popcorn). These should be cut into smaller pieces before being served. Other foods, including gum, raisins and whole nuts, should be saved for older children.

If you think a child is choking and he is able to cough (meaning an object is likely only partially obstructing his airway):

  • Calmly encourage the child to keep coughing. Most times he can bring the item up after a good cough and either expel it or swallow it. This can be uncomfortable and scary, but the child is fine in a few minutes.
  • Do not try to pull the object out, because you might accidentally push it farther down into their airway.

If the child puts his hands to his throat or cannot cough or talk:

  • You need to help. In children older than 1 year of age, complete the Heimlich maneuver with back blows.
  • For those younger than 1 year, combine chest thrusts with back blows.
  • Continue these maneuvers until the object comes out and the child can breathe, or they become limp and you need to do CPR.
  • Ask for help and call 911 as soon as possible.

It is frightening to even think about the possibility of such a scenario but knowing what to do in such an event is important. There are various online resources (including tutorials and videos) by the American Red Cross that can help you feel more prepared and it is better still to get certified in child CPR through your local chapter.

One day my fear came true and our son appeared to have difficulty breathing. Immediately my husband and I picked him up to deliver back blows. Out of his mouth came a leaf! That’s not a typo; unfortunately anything and everything can be a choking hazard depending on the size. Those seconds were some of the scariest I have ever experienced and I am thankful that we knew exactly what to do. Hopefully now you will, too.


Maya Neeley, M.D., is a board-certified pediatrician specializing in hospital medicine at Monroe Carell Jr. Children’s Hospital at Vanderbilt. She adores her husband and four young boys and loves spending time with family and good friends. As a child, she always dreamed of becoming a children’s book illustrator but for now she just dreams of getting a good night’s sleep.

Vanderbilt’s Children’s After-Hours Clinics offer the convenience of a walk-in clinic with care provided by a board-certified pediatrician from Children’s Hospital. No appointment is necessary, but we recommend calling your pediatrician first. Learn more about services and find locations for Children’s Hospital After Hours Clinics.