Working as a paediatric emergency nurse you have the absolute privilege of sharing and learning from the experiences of countless kids and their families. This tends to make you a cautious parent in some situations, and throw caution to the wind in others. At Save a Kid we share information, so parents can make informed decisions. There are no lectures – we’re parents just like you. In my past 10 years as a mum my kids have rolled off the bed onto the floor (well, 2 out of 3), pulled drawers onto themselves, unstrapped car seats without my knowledge and yes…as you’ll soon see, eaten things they shouldn’t. Fear of not knowing what to do when a baby or child chokes is one of the most common reasons for parents to enroll in a first aid course. In most sessions parents speak of a near miss they’ve experienced, or are about to start solids and want to feel prepared. Babies and toddlers love to explore, and equally love to shove everything they come across in their mouths. This is why children under 5 are at the greatest risk of choking.
Things to consider with food
Kids’ airways are round and narrow. Their teeth pop up slowly over time, and the whole eating thing is new to them – so they can’t chew properly. The shape of foods themselves can pose a danger, particularly if they’re round and narrow (matching the shape and size of their airway). Always cut round and cylinder-shaped foods longways. Grapes, Frankfurts and cheese sticks are good examples. I once discovered my middle son at about 5 months in his bouncer with bulging cheeks. When I squeezed them, out fell a pile of little cherry tomatoes. His big brother fed them to him (siblings can be the biggest hazard going around!).
As well as shape, texture needs to be considered. Soft, sticky or dense foods like marshmallows and meat are more likely to become stuck. Similarly, foods like apples and carrots, that are crunchy and may have a hard skin, can be hazardous. Crispy foods like popcorn, nuts and corn chips can shatter and be inhaled. Consider grating, grinding or cooking hard, crunchy and crispy foods, and chopping dense things like meat up into small pieces. A less common hazard identified by my eldest (again) at age 2, was feeding his helpless baby brother dried dog poo (again, poor boy was strapped into the bouncer).
As with food, we need to think about the shape of toys and common household items you have laying around (especially if you have older kids…this makes things tricky!). Coins are one of the most common choking hazards for children, because of their shape and easy accessibility. Often when swallowed kids poo them out, but they can easily become lodged in their airway or esophagus. Just last month my 3-year-old pooed out a glass marble (I did catch him with it, and saw him swallow it, so was on the lookout for it at the other end).
Ingestion of a button battery can be fatal as little as 2 hours, if it becomes stuck. Be aware of things like remotes, toys, scales and thermometers that may use them. It’s best not to store button batteries at home, rather purchase singularly when they need replacing, and dispose of the old one carefully. If parents ever suspect a child might have swallowed a button battery, they should take them to the nearest Emergency Department to check immediately. Plastic shopping and dry-cleaning bags should be tied in a knot before storing them to stop kids putting them over their heads (or even better – ditch the plastic all together!).
Most importantly, remember choking is silent. So, supervision whilst eating and playing is really important. It’s tempting to get things done when kids are settled and eating in their highchair (i.e. trapped and can’t interrupt you), but someone with a complete airway obstruction can’t make a sound – so they can’t call out for help.
If a child is choking, you need to be able to act immediately. Make sure that not just you, but anyone looking after your kids know choking first aid, and how to do CPR. If you know the hazards, the signs of when your child is choking, and how to act, choking shouldn’t be something that you fear.
Megan is the founder of Save a Kid Infant & Child First Aid, paediatric emergency nurse of 16 years, and mum of 3 wild boys. Save a Kid run public sessions at MAMA Kensington every 8 weeks, and also take private group and corporate bookings.