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Choking Hazards in Children: Causes, First Aid, and Prevention

Introduction


Choking is a serious and potentially life-threatening emergency that occurs when food or an object blocks the airway, preventing air from entering the lungs. Children 5 years old or younger are at the greatest risk, because they are at a stage where they explore their environment by putting objects into their mouths, while their chewing and swallowing skills are still developing. 



Common causes of choking in children


Certain foods are choking hazards for young children, including:


  • Hot dogs

  • Grapes

  • Cherry tomatoes

  • Popcorn

  • Nuts and seeds

  • Hard candies

  • Meat and cheese

  • Raw vegetable chunks


Children may also choke on non-food items, including:


  • Coins

  • Buttons

  • Marbles

  • Beads

  • Small toy parts


Signs of choking in children


A child who is choking may suddenly have difficulty breathing, or unable to cough, speak or make sounds.  They may be clutching at their throat, gasping for air, or developing a bluish face/lips due to lack of oxygen. A child may become unconscious or unresponsive in severe cases of choking. Prompt recognition of these warning signs and immediate action can help prevent a life-threatening emergency.


First Aid: Giving general care to a choking child older than 1 year of age


  1. Call 9-1-1 or emergency services (or ask someone else for help to call while giving first aid)

  2. Stand or kneel behind the child

  3. Deliver 5 firm back blows between the shoulder blades using the heel of the hand

  4. Give 5 abdominal thrusts (Heimlich maneuver)

    1. Place a fist just above the child’s belly button and below the breastbone

    2. Grasp your fist with the opposite hand

    3. Give 5 quick inward and upward thrusts


  1. Continue giving repeated cycles of 5 back blows and 5 abdominal thrusts until:

    1. The object comes out

    2. The child starts breathing or coughing

    3. The child becomes unresponsive


  1. If the child becomes unresponsive at any point:

    1. Gently lower the child to the ground and begin CPR immediately (chest compressions)

    2. Each time you open the airway, look for a visible object inside the child’s mouth 

    3. Remove the object using a finger only if you can see it clearly


First Aid: For choking infants under 1 year of age


  1. Call 9-1-1 or emergency services (or ask someone else for help to call while giving first aid)

  2. Place the child face down on your forearm, using the thumb and index finger to grip the chin while supporting the head and neck

  3. Place 5 firm back blows between the shoulder blades using the heel of the hand

  4. Turn the infant over face up while supporting the head and neck

  5. Give 5 chest compressions

    1. Place two fingers in the center of the chest, just above the nipple line

    2. Press the chest about 1.5 inches or 4 centimeters deep

  6. Continue giving repeated cycles of 5 back blows and 5 chest compressions until:

    1. The object comes out

    2. The infant starts breathing or coughing

    3. The infant becomes unresponsive

  7. If the infant becomes unresponsive at any point:

    1. Lower the infant onto a firm, flat surface and begin CPR immediately

    2. Open the infant's mouth and look for a visible object

    3. Remove the object using your pinky finger only if you can see it clearly


Choking prevention


Parents and caregivers can play an important role in preventing choking by creating an environment that encourages safe play and feeding practices. Young children should be provided with age-appropriate foods that are cut up small enough and given only a few pieces at a time. Parents and caregivers should avoid giving high-risk foods such as whole grapes, popcorn, nuts, hard candy, and large chunks of meat or raw vegetables. Always supervise young children during meals, and encourage them to sit down while eating, avoiding running, playing, lying down, or talking with food in their mouths. 


As young children begin to explore the world with their mouths, it is important for parents and caregivers to choose toys and objects that are age-appropriate for children. This includes regularly checking for broken or loose parts that could become choking hazards. Keep coins, small batteries, buttons, beads, and small toy parts out of children’s reach. 


Learning basic first aid and cardiopulmonary resuscitation (CPR) equips parents and caregivers with the knowledge and skills to respond effectively during a choking emergency. When combined with safe feeding practices and close supervision, these preventive measures can significantly reduce the risk of choking and promote the safety and well-being of children. 

 


References





Korycka, K., Mormul, A., Korab, M., & Smalira, J. (2024). Choking in children: causes, prevention and intervention strategies. Wiadomosci lekarskie (Warsaw, Poland : 1960), 77(9), 1802–1807. https://doi.org/10.36740/WLek202409123 


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©2025 by The MedReport Foundation, a Washington state non-profit organization operating under the UBI 605-019-306

 

​​The information provided by the MedReport Foundation is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. The MedReport Foundation's resources are solely for informational, educational, and entertainment purposes. Always seek professional care from a licensed provider for any emergency or medical condition. 
 

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