“I always thought choking would have been more obvious. But the silence and the panic in his eyes will stay with me forever.”
Choking usually tops parents’ fears when it comes to accidents. And rightly so.
Young children have narrow airways and are still learning to chew, breathe and swallow in the right order (add talking or moving around and it gets really complicated).
Knowing some simple steps puts you in the driving seat and lessens the worry.
Food
- STAY – Stay with children when they’re eating – it’s the biggest thing you can do for them
- STILL – Get children to sit still – it can be a battle but it’s much safer
Avoid these foods – for babies and young children
While it’s possible for a child to choke on anything, some foods pose more of a risk than others and should be avoided until your child is a more competent eater.
Hard food like popcorn can easily get stuck.
Marshmallows get sticky when wet so can seal the airway and may not come out with back blows.
Round hard sweets (including mini-eggs) are slippery so can easily be swallowed and completely block the airway.
Jelly cubes can get sticky when wet so seal the airway.
Peanut butter on its own – globs of peanut butter can seal the airway, so only use it as a spread.
Whole grapes are the perfect size to block the airway and can be difficult to dislodge because of their flexible texture. Always cut them up. Learn more
A note about lollipops – if a lollipop comes off a stick, it in effect becomes a hard boiled sweet. So they’re best avoided for under-threes.
“I look at the ventilated child we resuscitated after he choked on a grape. All I can see is my son: same age, same blonde hair. I go home and check his pulse as he sleeps. I cut up grapes for years to come.”
Becky, Advanced Clinical Practitioner
Foods to cut up
Think anything round, hard, chunky, doughy or stodgy.
Sausages or hot dogs – cut into short, narrow strips lengthways as thin as possible. Removing the skin makes them easier to swallow.
Meat – cut into strips and remove any bones, skin or fat.
Fruit – check for pips or stones and remove them.
Round fruit like grapes, blueberries, cherries, strawberries and cherry tomatoes – cut lengthways and then into quarters.
Vegetables and larger fruit like melon, apple, mango, carrot and cucumber – cut into thin strips. You can grate or mash soft food or steam or simmer harder food to soften it, especially for weaning or very young children.
Removing skin from fruits or vegetables makes them easier to swallow and reduces the risk of your child choking on the skin.
Legumes like chickpeas and butter beans – mash or steam to soften them.
Whole nuts should not be given to children under five. Chop or flake nuts and seeds.
Cheese – cut into narrow batons or strips.
White bread can form a doughy ball in the throat, so brown or toasted bread is a good option. Cut all types of bread into narrow strips.
Remember – cutting up food does not reduce the need to stay with young children when they’re eating!
Gagging or choking?
It can be alarming seeing your child gag. But gagging is normal and is a part of learning how much food they can chew and swallow.
Whereas choking is silent (because the food has blocked the airway), gagging is noisy. Your child may stick their tongue out while gagging and their eyes may water.
Never prop feed a baby
If a baby is left alone with their bottle propped up to feed, there’s a serious risk of them choking.
Babies need an adult to help them feed.
Using a self-feeding baby pillow or cushions to prop up your baby’s bottle is extremely dangerous. The baby can choke on the milk or breathe the milk into their lungs causing aspiration pneumonia. Left untreated, aspiration pneumonia can kill a small baby within hours.
Balloons
If inhaled, a balloon or bits of a broken balloon can seal a child’s airway. They can be very hard to remove.
So, avoid giving young children balloons to blow up and clear away any broken bits straight away. Keep crawlers off the floor until bits of balloon are cleared away.
Small objects and toys
Remember, anything smaller than a 2 pence piece can choke a young child.
Toys for under 36 months, made to proper safety standards, won’t have small parts that can choke.
But cheap toys bought online might not meet those standards. If you’re not sure, give your child’s toys a check over for loose small parts.
Keep older children’s toys with small parts out of reach and keep coins and buttons stored out of reach.
First aid for choking
Knowing what to do if your child is choking means you give your child the best chance of recovery. You can watch the St John’s Ambulance videos on first aid for a choking child and first aid for a choking baby here.
A note about button batteries…
There’s a common misconception that button batteries are a choking hazard. In fact, if a button battery gets stuck in a small child’s food pipe, it doesn’t stop them breathing. Instead, it can burn through to the main artery, with potentially fatal consequences.
If your child swallows one, get them to the nearest A&E without delay.
Related pages
Related pages
Breathe easy fact sheet
Download our free breathe easy fact sheet to learn more about choking, suffocation and strangulation risks.
Why are grapes so dangerous?
Whole grapes are one of the biggest choking hazards for children. Learn why they’re so dangerous here.
