Dr Phil Kieran: I'm afraid my year-old granddaughter will choke

The mouth is a very sensitive area and infants learn a lot about their world by putting things in their mouths

Dr. Phil Kieran

GENERAL PRACTITIONER

I look after my year-old granddaughter once a week. She’s very lively and puts almost everything into her mouth, which I find frightening. What steps should I take if she starts to choke?

Choking in children is a terrifying prospect. I remember when my son was weaning, a friend of mine had a kid the same age who was self-feeding finger food. This led to a lot of spitting as they learned to eat. I still remember how scared I felt; I thought I would have to step in and help remedy a choking episode.

I now know baby-led weaning is as safe as any other form of weaning and is every bit as valid a choice as spoonfeeding.

Children around your granddaughter’s age are exploring the world, and they do this through touch, sight, smell and taste.

The mouth is a very sensitive area and infants learn a lot about their world by putting things in their mouths. Thankfully choking is pretty rare.

There are several things you can do to reduce this risk. Generally, large objects are far less likely to cause choking. Small things like nuts, seeds, marbles and batteries or small chunks of fruit or veg can cause choking so ensure they aren’t within the child’s reach, and cut foods into very small pieces. 

Grapes are particularly dangerous as the oval shape can easily become lodged in the windpipe if inhaled, and should be cut in quarters for children up to age two and in half lengthways up to age four.

Signs that would suggest choking are trouble breathing, gasping or wheezing or inability to cough or cry. 

If the child can cough, the first thing to do is to calm them, as panic can exacerbate the problem. Encourage them to cough, as most times this will resolve the situation. If they are unable to cough, try some back slaps. Lie the child face down on one arm if they are small enough or lean them forward if they are too big to hold. Then deliver up to five firm slaps between the shoulder blades with the heel of your hand.

For older kids, if this doesn’t work, you can try a Heimlich manoeuvre, where you stand behind the person, place your hand just above their belly button and pull in and up under their ribs sharply. This can produce enough air to force the object free of the airway.

If at any stage the child loses consciousness or if you feel you are not succeeding in clearing the obstruction, call an ambulance immediately (112/999). If you want to feel more confident, doing a first aid course for parents and childminders is an excellent idea.

This may seem scary, but the risk of choking in a well-supervised child is pretty low. Children need to be allowed to explore the world around them, which also means putting things in their mouths.

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