You’re sitting at the kitchen table, enjoying lunch and taking a quick scroll on social media while your baby sits content next to you in their high chair nibbling on some lunch of their own. Suddenly you’re snatched back to reality when you hear your baby gagging, and when you whip your head around to face them you find a red-faced teary-eyed baby looking back at you. Luckily, they spit the food out and their face returns to normal as they resume their snacking, but you are rattled!
In those terrifying moments, it can be difficult to think straight, especially if you aren’t sure how to react. We’ve put together a short guide on what to do when your baby is choking and how to avoid choking in the first place, so you’ll never be caught off-guard again.
This post is for informational purposes only. It in no way replaces official medical training. The best way to prepare to help your child if they are choking is to take a first aid class with a certified trainer.
How to Perform Choking First Aid:
You may have seen the Heimlich maneuver in movies when someone in a restaurant is choking and someone comes behind them and gives their belly some firm squeezes before the offending chunk of food comes flying out of the victim's mouth and they are saved. Even if you are familiar with how to perform the Heimlich maneuver yourself, you may be surprised to learn that the same method is not appropriate for infants.
If your baby is choking, the first things you should do are:
- Turn them over, their belly on your forearm, using your thigh for support. Their chest should be in your palm, and their jaw supported by your fingers.
- Point your baby downward so their head is below their body and give up to five quick, forceful blows between their shoulder blades with your free palm.
If the food is not dislodged after five blows and your baby is still choking:
- Turn them face up. Continue using your thigh for support and supporting their head.
- Use two fingers on the middle of their breastbone, just below the nipples, and give up to five quick thrusts down. You are aiming to compress their chest one-third to one-half of the depth of the chest.
Continue repeating these steps, alternating between back blows and chest thrusts until the food is dislodged. If the infant loses consciousness, immediately shout for help (they can call 911) and proceed with infant CPR. If you are alone, take a moment to call 911, and then proceed with infant CPR. If your baby is alert and conscious, do not try to reach/pull out the object that is lodged in their throat as you can easily push it further in the airway and block breathing completely. However, if they are unconscious and you can SEE the object, you may try to remove it with your finger, but only if it is clearly visible.
When to NOT Perform Choking First Aid:
No one wants to see their baby choking, but many parents are quick to confuse “choking” with “gagging”. Gagging can be scary, but is often a normal part of the learning-to-eat process and is not inherently dangerous in and of itself. Gagging is your body’s natural protective mechanism to avoid choking. Choking is when the airway is blocked, preventing breathing and immediately threatening life.
Do not perform choking first aid if your baby is coughing forcefully, crying loudly, or breathing without obstruction. Watch them closely, and be ready to act if symptoms get worse.
There may also be other causes for a baby to stop breathing such as an allergic reaction, asthma, or a blow to the head. If your baby is not choking, do not perform choking first aid; call 911 and move directly to infant CPR instead.
How to Avoid Choking:
The best response to choking is prevention. When your baby is eating, ensure they are sitting upright in a high chair or other infant restraint seat. They should not be reclined (like, in an infant swing) or allowed to crawl/walk around while eating. Always remain near and alert to your baby, especially while they are eating. You will want to be able to respond quickly if the need arises.
Make an effort to prepare foods that are easy to chew. Cook or steam hard foods, like carrots, until they are soft enough to puncture with a fork. Remove seeds, pits, and tough skins or peels from fruits and vegetables. Finely chop foods to no larger than half an inch, or grate/mash/puree foods that are difficult to chew, such as raw vegetables. Remove all bones from fish and meat before cooking or serving.
Avoid giving your baby foods that are common choking hazards to minimize the risk of choking while eating.
Common choking hazard foods according to The US States Dept. of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC):
- Whole corn kernels (even cooked)
- Uncut cherry or grape tomatoes
- Pieces of hard raw vegetables, like carrots or apples
- Uncut grapes, berries, cherries, or melon balls
- Uncooked dried vegetables or fruit, like raisins
- Whole or chopped nuts and seeds
- Chunks or spoonfuls of nut/seed butter, such as peanut butter
- Tough or large pieces of meat
- Hot dogs, meat sticks, or sausages
- Large pieces of cheese, especially string cheese
- Bones in meat or fish
- Whole beans
- Cookies or granola bars
- Potato or corn chips, pretzels, popcorn, or similar snacks
- Crackers or breads with seeds, nut pieces, or whole grain kernels
- Plain wheat germ
- Round or hard candy, jelly beans, caramels, gummy candies, or fruit snacks
- Chewing gum
- Marshmallows
While it is important to be aware of potential dangers associated with your baby choking while eating, it is also important to not parent from a place of fear. By being educated on the potential risks and preventative measures, you will be able to confidently guide your child into the world of eating solids, solidifying a strong and healthy relationship with food and meal times.
