WATCHING your child choke is one of every parent’s worst nightmares – and rightly so.
Young children have narrow airways and are still learning to chew, breathe and swallow in the right order.
Choking can happen with any foods, but ‘firm foods’, bones and small round foods present a higher risk.
This is because they have more chance of getting lodged in your little one’s airway.
Fabulous spoke James McNulty-Akroyd at St John Ambulance to find out everything you need to know about safe eating and choking hazards.
"With so much conflicting advice online preparing food for little ones can seem like a daunting task but it needn’t be," says James.
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"Understanding what foods could pose as a choking risk and how to mitigate this risk can help both you and your child by reducing anxiety and making mealtimes more enjoyable."
What is food safety?
Due to their narrower airways, children can’t eat food presented the same way as you would for an adult.
Make sure food is suitably prepared and served for babies and children under five-years-old by thinking about size, shape and texture.
Cut food into narrow batons for them and soften any ‘firm foods’, such as carrots or peppers, by cooking them first.
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"I’d recommend washing and peeling fruit and vegetables," says James. "Particularly those that are hard-skinned like apples, grapes and carrots.
"Food should be chopped into larger more manageable chunks to avoid choking risks, particularly if you’re practicing baby-led weaning or you have a child who has difficulty chewing."
Babies should also be seated upright in a safe chair, preferably a high chair, while eating.
Foods to avoid
A lot of foods are off the cards for your little one until they've got their chewing, breathing and swallowing right.
These include popcorn, marshmallows, jelly cubes, nuts and a number of fruits.
"Care should be taken when considering appropriate food choices for children," says James.
"And many smaller foods such as grapes, blueberries, cherry tomatoes, nuts, chewing gum, raw carrot and jelly cubes should not be fed to young children.
"The main risk of choking comes from these foods being round, firm, or slippery – making them more difficult to chew which increases the risk of choking."
He particularly urged parents to stay away from popcorn "as the kernels are lightweight and pose a risk of aspiration".
This is because the kernels can be breathed into the windpipe and block the airway, or cause choking if they get stuck in the throat.
Non-food related choking
It's not just food your child may choke on as they learn to explore the world through their mouths – small toys also pose a risk.
"Always make sure your child is supervised while playing and follow age guidance on the toy box to reduce this risk," says James.
"Batteries, particularly 'button batteries' you might find in your watch or remote controls, pose a serious health risk to children and should be kept safely out of reach as they can cause serious damage to your child’s digestive system if swallowed.
"If you think your child has swallowed a battery, you should make your way to the nearest A&E department as quickly as possible."
What to do in the event of choking
Witnessing your child choking can be scary, but it’s important to act quickly to help remove the obstruction from their airway.
The warning signs to look out for are difficulty breathing, speaking or coughing, a red puffy face or showing signs of distress, such as pointing to their throat or grasping their neck.
Your child will need urgent help, so James outlined three key actions to take which could help save their life.
Firstly, ask them ‘Are you choking?'. If they can breathe, speak, or cough then they might be able to clear their own throat.
If they cannot breathe, cough, or make any noise, then they need your help straight away.
Cough it out: Encourage the child to cough and remove any obvious obstruction from their mouth
Give back blows: If coughing fails to work, give five sharp back blows with the heel of your hand, between their shoulder blades. After each back blow, check their mouth for any obstruction.
Do not sweep the mouth as this could push the object further down the throat.
Give abdominal thrusts: If back blows fail to clear the obstruction, give five abdominal thrusts by standing behind them and putting your arms around the child’s waist.
Place one hand in a clenched fist between their belly button and the bottom of their chest. With your other hand, grasp your first and pull sharply inwards and upwards up to five times. You should check their mouth after each thrust.
If the blockage still hasn’t cleared, call 999 or 112 for emergency help. Repeat five back blows and five abdominal thrusts until help arrives – rechecking their mouth each time.
If your child becomes unresponsive after choking, prepare to start child CPR.
What to do if a baby chokes
"If your child is a baby or young toddler, the advice is slightly different," James says. "You should follow the first aid advice for a choking child."
For a baby, you should turn them over in your lap so they’re facing downwards, along your forearm and thigh, while making sure to support their head and neck.
"Give five sharp back blows between the shoulder blades with the heel of your hand," James advises.
"Turn them over on your thigh and check their mouth, picking out any obvious obstructions with your fingertips.
"It’s important not to sweep the mouth as this could push the object further into the throat.
"If back blows fail to clear the obstruction, give five chest thrusts with your baby facing upwards, making sure you support their head and neck.
"Place two fingers in the centre of their chest and give five sharp chest thrusts, checking their mouth each time."
If the obstruction won't clear, it's time to call 999 but James urged parents to "take the baby with you to make the call".
Keep repeating five back blows and five chest thrusts until help arrives, checking their mouth each time.
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If the baby becomes unresponsive at any point, prepare to start baby CPR.
More first aid advice and information is available on the St John Ambulance website.
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