My daughter was 4 and sitting in the back seat of our van when we were driving down the road. I heard a distinct sound that I won’t readily forget. In a blur, my husband pulled over as I realized she was crying and choking on a peppermint that I thought she had long finished before entering our vehicle.
To this day, even many years later, she won’t eat peppermints. For us, it was a huge wake-up call that as parents we needed to do a better job of educating our children about how to respond when they’re choking.
Just this last month a local girl, only ten years old, died from choking on a carrot. A couple of years ago I remember a 12 year old child made the news from choking on a marshmallow at a friend’s party. There was even a time at my own house, a friend’s daughter was choking on an apple bite while no one was watching.
What is striking is that many of the news stories that stick in my mind are of children that are older — not even toddlers, but kids that can read and ride bikes, even children that are sitting in algebra classes. Clearly choking happen often because we all eat. Every day. And even tragedies and scares happen often as well.
Therefore, one thing that’s not happening often enough is talking about is not just how to prevent choking, but also how to teach our children to react and be “choke safe”.
How to teach kids a choke-safe plan
From the time children can eat grapes, cherry tomatoes, and hard carrots, it’s important that we talk to them about what to do in an emergency choking situation.
1. Teach your child to bang a tray, water bottle, or whatever is around them.
If a child is choking is often hard or impossible to actually make a noise. Thus, it’s important that they use what’s around them in order to get an adult’s attention to themselves. That saves precious seconds in getting help.
2. Use the universal sign for choking
Two hands at the neck — In every language this means someone is choking, especially if they also have their tongue out. It’s important that we teach our children this because again, if they cannot speak or communicate, this does the trick.
3. STAY PUT
Teach your children to not leave where they are unless they know for a fact that no one could possibly hear them doing step #1.
Why? They need to stay where they are because usually it’s faster for someone to get to a person in need rather than vice versa. Also, the movement could cause food to lodge itself further into the throat, especially since one might run in an awkward manner trying to seek help.
Unfortunately, I have read a lot of stories of both children and adults who tried to run to a restroom or away from a crowd and it kept their problem silent. No one knew they were choking so no one could help.
If your children attend school you could also ask them to implement a “Choking Bell” in the cafeteria where the child never leaves the room but can go to it to ring for emergency help – ideally it would also be close to a cafeteria worker who knows emergency protocol.
4. Self-Heimlich
Please read this note of warning first: I am not trying to train you on how to do or teach this. This is something you need to study on your own.
If our children are old enough, there are strategies to teach to help themselves while choking. The one I was taught in 5th grade involved using your fist and placing it in the soft spot right under the ribs and forcing yourself on a table. When I took some of CPR trainings, I was also taught about using a table corner.
Look up Red Cross training classes here.
Preventative measures for Choking
Be mindful of the time of year.
This may seem odd to say, but if you’re more aware of what’s happening in a certain season, you could help your child navigate it better.
Halloween is actually high choking season — little bits on costumes, hard candies getting lodged in the throat, marshmallows getting stuck, small toys as the “treat” or other reasons.
Christmas is another one because of all the little decorations and such. Ultimately you could probably lump in any holiday because as I am typing this, those chalky Valentine hearts come to mind too. But it’s like anything else, you simply have to be smart about it.
No mouth rule. Small parts rules.
My kids never put things in their mouths. Then my son out of nowhere swallowed and almost choked on a small piece. We have a firm rule now that any time anything gets near anyone’s mouth no matter their age, the toy, game, or other gets put away immediately. It becomes a natural consequence to teach them to not do it.
Related: Teaching Toddlers Consequences for their Choices
Know the problem foods
Realistically this is going to be the same for almost all kids. However, some children have a harder time with certain soft foods that could cause a problem. This means knowing your child’s typically level of chewing and how much they move around while eating is also important.
- Nuts and seeds
- Foods with pits or “hidden” choking hazards like cherries
- Peanut butter, nut butter, sun butter
- popcorn
- raw carrots
- hard candy and peppermints
- raw apples, pears, nectarines, etc.
- hot dogs
- cheese cubes
- grapes and cherry tomatoes
- marshmallows
Cutting up the foods that could be an issue is the easiest and most obvious answer. It wasn’t until I had four kids of my own that I actually got a grape cutter (probably because at this point I realized I couldn’t watch all my kids all the time), but I found one that works well and was pretty inexpensive on Hollar. You can get $2 off your first purchase through my referral link. It’s called a “veggie spear cutter” and I like it because it’s useful for far more than just grapes.
Be mindful of the car
We definitely have a “no grape” policy in our vehicle, but we try to limit other foods as well. Especially for rear-facing kids, their incline means they’re more likely to choke on food while riding and the availability of a place to stop on the highway and help your child could be a problem.
Related: Do you need to see research behind Extended Rear Facing car seats? Here it is.
Take CPR and Heimlich Training – and be an advocate for schools
Did you know many schools don’t require teachers to know it if they have a nurse on campus? Or that teachers have to have a certain amount of professional development hours each year, meaning they could do an hour class every year at each school as a part of this?
Take a local first aid class for yourself and ask for your schools, childcare providers, etc. to do the same. Doing is one things, but also being an advocate for others to have life-saving skills is such a blessing to more than just themselves! (But could also save their own life too. Did you know many courses teach self-Heimlich techniques?)
Teach your children to sit while eating and chew before speaking
If in school, lunch can be a rush and their only social outlet for the day. This is why it’s even more important to reiterate to our kids that to practice good choking prevention, they need to chew thoroughly before talking.
Know the difference between gagging and choking and what to do
When kids gag, it’s a natural reflex to get something moving. This is a GOOD THING and we should allow our kids bodies to work this way. Similarly, if a child is gagging or choking, it’s never ok to hit their back. This typically forces the food to move further down. This is why most Heimlich instructor teach you to turn an infant more horizontal when they choke. But again, please don’t take training advice from this article. I want this to inspire you to go out and get the appropriate training!
Educate your friends and family!
It’s always great to keep an open line of communication with all of those around you that have regular care of your children. Of course we mentioned schools before, but think wider.
Below, you can get a free PDF that is a high-resolution printable to display in your home, classroom, or other.
References and Resources
Abdullat, E., Ader-Rahman, H., Ali, R., & Hudaib, A. (2015). Choking among infants and young children. Jordan Journal of Biological Sciences, 8(3), 205-209.
Towner, E., & Mytton, J. (2009). Prevention of unintentional injuries in children. Paediatrics and Child Health, 19(11), 517-521.
Watson, M.C., & Errington, G. (2016). Preventing unintentional injuries in children: Successful approaches. Paediatrics and Child Health, 26(5), 194-199.
More helpful resources
Kara is an author and advocate for positive, grace-filled parenting. She is homeschooler to her 5 children living on a farm in New England. She believes in creative educational approaches to help kids dive deeper into a rich learning experience and has her degree in Secondary Education & Adolescent Childhood Development. She is passionate about connecting with and helping other parents on their journey to raise awesome kids!
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