In this blog post I wanted to look at how to help an infant who is choking.
As a mom of a 2 year old this topic is especially close to my heart! While there are several reasons why an infant can have a choking emergency or blocked airway, I was inspired to write this due to significant increase in popularity of baby led weaning (BLW).
With the earlier introduction of solids, more and more parents are asking what they should do if their infant starts choking??? As a nurse, I found myself frustrated when reading about baby led weaning. A lot of what I read made it seam like choking could not happen…..but it can, and it does.
I don’t want to scare you out of baby led weaning. I want to provide education that may help you more confidently proceed with BLW if that is the right decision for you and your family.
Yes, there is a difference in a gag response and choking; For now, I want to focus on what choking looks like and what actions to take.
While I hope this provides you with helpful, lifesaving information.....
I highly recommend taking a CPR Course, with in person skills, so you can practice the skills of performing back slaps, chest thrusts, and CPR to build confidence and increase the likelihood you will respond.
Types of blocked airways (choking)
Choking is a type of blocked airway. Airway blocks can be described as partial or compete.
Partial airway blocks – A little bit of air can still get into the lungs.
The infant may be able to speak, cough, cry, or breathe. The hope is they will be able to clear the blockage themselves from the force of coughing. Stand by and keep a close eye on them while they attempt to clear the airway. If their attempts fail and/or worsen: call 911, begin back slaps, chest thrusts, and follow with dispatchers instructions.
Complete airway blocks – No air can pass into the lungs.
The infant will not be able to speak, cry, cough or breathe. They will start to turn blue or dusky in color. This infant needs back blows and chest thrusts started immediately. It is also advisable to call 911 incase your attempts are delayed or not successful. It is better to have EMS in route to your location then to delay this call.
Should they be seen by a healthcare provider?
Any infant that receives back blows and/or chest thrusts should be seen by a health care provider as soon as possible.
Infants trachea (the pipe going to their lungs) is about the size of a straw. It is not uncommon for swelling to occur after these incidents. The swelling is a response to the trauma and irritation from an object being lodged in, and then dislodged, from their airway.
It does not take much swelling for their tiny airway to be blocked again. Since this due to swelling and not a foreign object….back slaps and chest thrusts will not reopen the airway. Always follow the 911 dispatchers instructions.
What are the steps to helping an infant?
To start, position the infant with their head lower than their feet
As a reminder we recommend calling 911 at this point and not waiting to see if your attempts are successful. It is better to have help on the way!
You may need to sit or kneel to support the infants weight
DO NOT hold the infant by the feet and shake them in effort to get the object out.
Perform 5 firm back slaps between the infants shoulder blades
Note: the how the infant is positioned on the instructors arms. Head downward, body supported on leg, and straddled on the arm. This will make flipping them to their back easier.
While bracing the infant between your arms
flip them on to their back and
perform 5 chest thrusts in the center of their chest
Again note: the how the infant is positioned on the instructors arms.
5 back slaps
flip infant5 chest thrust
5 back slaps
5 chest thrusts
Keep repeating these steps until either:
the object comes out
the infant goes unconscious
If the infant goes unconscious:
Place infant on firm flat surface and
Top food related choking hazards
Lets look at few top food related choking hazards.
Some of these hazards can be lessened by cutting food into halves or fourths or given in smaller portions. Others are advisable stay away from until they are older (around 4 or 5).
Remember your infants trachea is about the size of a straw. A toddlers trachea is about the size of your pinky.
- Hot dogs, hot dogs, hot dogs, hot dogs…..did I say hot dogs? Still number one choking hazard.
- Whole grapes
- Candy (think hard or sticky candy). Examples: gum, cough drops, caramels, lollipops, marshmallows, jelly beans, etc.
- Whole cherry tomatoes
- Whole nuts
- Big spoonful of peanut butter
- Big cube of cheese
- Raw vegetables
- Whole blue berries
- Whole olives (kids love to put those on their fingers)
An infants trachea is about the size of a straw.
A toddlers trachea is about the size of your pinky.
My favorite mom tool
This is hands down my favorite purchase for food preparation.
It is an OXO Grape Cutter and it cuts into fourths.
I use it on grapes, cherry tomatoes, blue berries, and olives (my daughters faves).
There is a slicer on the market that cuts these items in half…..I prefer to cut into fourths.