Children, particularly those aged from one to five, often put objects in their mouth. This is a normal part of how they explore the world. Some small objects, such as marbles, beads and button batteries, are just the right size to get stuck in a child’s airway and cause choking.
The best way to avoid this is to make sure that small objects like these are kept out of your child’s reach.
No matter how careful you are, your child may choke on something. In most cases, you or someone else will see your child swallow the object that causes choking.
There can be other reasons why your child starts coughing. However, if your child suddenly starts coughing, is not ill, and has a habit of putting small objects in their mouth, there's a good chance that they're choking.
Tips on helping a choking child
- If you can see the object, try to remove it. Don’t poke blindly or repeatedly with your fingers. You could make things worse by pushing the object further in and making it harder to remove.
- If your child is coughing loudly, there’s no need to do anything. Encourage them to carry on coughing and don’t leave them.
- If your child’s coughing is not effective (it’s silent or they can’t breathe in properly), shout for help immediately and decide whether they’re still conscious.
- If your child is still conscious, but they’re either not coughing or their coughing is not effective, use back blows (see below).
Back blows for babies under one year
- Sit down and lay your baby face down along your thighs, supporting their head with your hand.
- Give up to five sharp back blows with the heel of one hand in the middle of the back between the shoulder blades.
Back blows for children over one year
- Lay a small child face down on your lap as you would a baby.
- If this isn't possible, support your child in a forward-leaning position and give five back blows from behind.
If back blows don't relieve the choking and your baby or child is still conscious, give chest thrusts (see below) to infants under one year or abdominal thrusts (see below) to children over one year. This will create an artificial cough, increasing pressure in the chest and helping to dislodge the object.
Chest thrusts for children under one year
- Lay your baby face up along the length of your thighs.
- Find the breastbone, and place two fingers in the middle.
- Give five sharp chest thrusts (pushes), compressing the chest by about a third.
Abdominal thrusts for children over one year
- Stand or kneel behind your child. Place your arms under the child’s arms and around their upper abdomen.
- Clench your fist and place it between the navel and ribs.
- Grasp this hand with your other hand and pull sharply inwards and upwards.
- Repeat up to five times.
- Make sure you don't apply pressure to the lower ribcage, as this may cause damage.
Following chest or abdominal thrusts, reassess your child as follows
- If the object is still not dislodged and your child is still conscious, continue the sequence of back blows and either chest or abdominal thrusts.
- Call out or send for help, if you're still on your own.
- Don't leave the child.
Even if the object has come out, get medical help. Part of the object might have been left behind, or your child might have been hurt by the procedure.
Unconscious child with choking
- If a choking child is, or becomes, unconscious, put them on a firm, flat surface and shout for help.
- Call 999, putting the phone on speakerphone so your hands are free.
- Don't leave the child at any stage.
- Open the child's mouth. If the object is clearly visible and you can grasp it easily, then remove it.
- Start CPR (see How to resuscitate a child).
