Choking hazards you may not suspect

The first 18 months of your child’s life is known as the oral phase, with good reason. Babies are busy discovering their world, and initially they do it largely by putting things in their mouths.

It’s frighteningly easy for something to lodge in their little throats and cause choking.

The American Academy of Paediatrics (AAP) reports that choking is one of the most common causes of death for children under the age of three.

Most of us are aware of the dangers of nuts, hard sweets and granny’s loose beads, but not all choking hazards are as obvious. Watch out for these, and alert your little one’s caregivers:

Hot dog sausage. Believe it or not, the AAP reports that these are the food most commonly associated with fatal choking in children. 

Abdul Jaffer, training manager for St John, Johannesburg Centre, confirms they deal with cases here too. “Pieces are perfectly shaped to get stuck in small throats,” he says. Be sure to quarter sausages lengthwise.

Bananas, grapes, strawberries and other rounded fruits, and carrots. These too should be quartered.

Meat. Take care to remove small bones in fish and chicken, and dice or mince all meat into small pieces. There have been instances of children choking on chicken nuggets.

Marshmallows. Harmless as they may seem, these soft, sticky treats can expand and block airways, warns Jaffer.

Peanut butter. Spread it quite thinly, or it too can clog airways.

Peanuts. other nuts and popcorn all need to be avoided for the first three years.

Beyond foods, watch for any small objects around your home or yard that can be swallowed, however unlikely you may think it. 

Paramedics and first-aiders have encountered all of these at some stage:

• Coins
• Small toys or broken toy parts
• Marbles
• Hair clips, rings, earrings and loose beads
• Buttons
• Batteries, especially button ones – store them and the gadgets they come in out of reach.
• Bottle tops 
• Magnets – keep those fridge ones well above reach.
• Popped or deflated balloons, or corners cut off plastic milk packets: These are particularly risky as they can easily block airways, and are too light to be expelled with blows, jabs or even the Heimlich manoeuvre in older children.
• Beanbag pellets: It takes just a few that escape a hole and catch baby’s eye, to block their airway.

TAKE ACTION

If, despite your vigilance, your little one chokes on something, take action immediately. “Never put your fingers in a choking baby’s mouth until you visually check for an obstructing object,” says Jaffer. “People instinctively do it, invariably leading to the obstruction moving deeper.”

Instead:

Pull open baby’s jaw, and if you can see the object, sweep one finger along the inside cheek and back behind the object to pop it out.
If it’s too far back in the throat to see or safely remove, support baby’s head under their chin and lie them face-down along your forearm with their head lower than their bottom. Use the heel of your hand to give five quick blows between their shoulder blades.

If that doesn’t work, turn them on to their back on a firm surface and give them up to five chest thrusts. Place two fingers on their breastbone about a finger-width below the nipple line. Push downwards and upwards (towards their head). After each thrust check for an object in their mouth and, remove it if possible. 

If baby’s airway is still blocked after five chest thrusts, repeat three cycles of back blows and chest thrusts and call for an ambulance. Continue the cycles until the airway clears or help arrives, says Jaffer.