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Choking is the coughing and puttering that occurs when liquids or solids get on the vocal cords or into the airway. It is also called aspiration.


  • The main symptom is struggling to breathe in.
  • Inhaled liquids: A child’s cough reflex normally will clear the windpipe of liquid within 10-30 seconds.
  • Inhaled foreign body: Complete blockage occurs when solid food or a foreign object becomes lodged in the voice box (glottis).
  • If choking occurs, a child is unable to breathe, cry, or speak. If the obstruction isn’t removed in 1 or 2 minutes, the child will pass out.

Causes (Types of foreign bodies)

Peanuts are the most common food inhaled into a bronchus (30%). Other foods that can cause choking are sunflower seeds, orange seeds, cheery pits, watermelon seeds, gum, hard candies, popcorn, raw carrot, raw peas, and raw celery. These foods should not be given to children younger than 4 years of age. Foods that can completely block the larynx or trachea such as hot dogs, sausage, large pieces of any meat, grapes, gummy candy, and caramels can cause sudden death. These foods must be chopped up before serving. Other items that can cause choking besides food are balloon pieces, candy wrappers, or plastic materials.

First AID advice for choking

Encourage coughing. As long as the child is breathing and coughing, just encourage him to cough the material up by himself. Don’t offer anything to drink because fluids take up space needed for air passage.

If BREATHING STOPS in a child OLDER THAN 1 YEAR, give ABDOMINAL THRUSTS (Heimlich maneuver)

  • If the child can’t breathe, cough, or make a sound, proceed with high abdominal thrusts.
  • Grasp the child from behind, just below the lower ribs but above the navel, in bear-hug fashion. Make a fist with one hand and fold the other hand over it.
  • Give a sudden upward and backward jerk (at a 45˚ angle) to try to squeeze all the air out of the chest and pop the lodged object out of the windpipe.
  • Repeat this upward abdominal thrust 10 times in rapid succession, until the object comes out.
  • If the child is too heavy for you to suspend from your arms, lay him on his back on the floor. Put your hands on both sides of the abdomen, just below the ribs, and apply    sudden, strong bursts of upward pressure.

If BREATHING STOPS in a child YOUNGER THAN 1 YEAR, give back blows and chest compressions

  • Place her facedown in a 60˚ incline over your knees or on your forearm.
  • Deliver 5 blows with your hand between the shoulder blades in rapid succession.
  • If breathing has not resumed, lay the child on the floor and apply 5 rapid chest compressions over the lower breast bone (sternum) using 2 fingers (chest thrusts). Alternate back blows and chest thrusts until the object comes out.
  • Reason to avoid abdominal thrusts until 1 year old: risk of liver or spleen laceration.

If the child PASSES OUT (Unresponsive), give Mouth-to-mouth Breathing

  • Quickly open the mouth and look inside to see if there is any object that can be removed with a sweep of your finger (usually there is not). Avoid “blind” sweeps.
  • Begin resuscitation. Air can usually be forced past the foreign object temporarily until help arrives. Do not continue abdominal thrusts.


Information on this site is intended for Angel Kids Pediatrics patients only. Always consult your doctor before beginning, modifying, or discontinuing any treatment plan.

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