Baby Choking:  What to Know, when to Worry, How to Prevent, and How to Prepare

Baby Choking

A choking episode in a baby is one of the most terrifying things a parent can witness.  A choking infant’s caregiver has to make some decisions very quickly:  What to do?  Do I do anything?  And what will happen if I don’t?

While there are relatively harmless choking-type behaviors that will clear up on their own, parents do need to be prepared for the worst.  And that preparation starts with taking every step possible to prevent the problem.

Preventing Choking

Parents can lower the risk of baby choking by being aware of the causes and doing everything possible to reduce their presence in their new arrival’s life.  While it’s impossible to totally eliminate every hazard, a little childproofing will go a long way.  Here are some steps to take:

  • Secure small objects. In early infancy it’s a little easier to keep everything out of a baby’s reach.  However, be aware that siblings may leave risky items nearby and may even try to “feed” the baby a food item.  Older infants, of course, are usually more mobile; during this period it’s time to be especially vigilant about what accessible.
  • Don’t feed infants solid foods until they’re ready. They should be able to sit upright with support and swallow small amounts of food given by spoon.  Keep in mind that swallowing isn’t fully coordinated until about four years of age; thus, certain foods such as nuts, hot dogs, spoonfuls of peanut butter, and many raw fruits and vegetables are no-nos in infancy and beyond.
  • Although technically a different cause of infant airway problems, while childproofing, take steps to eliminate the risk of strangulation. Be aware of the hazards that strings and cords pose.  Secure electrical cords and Venetian blind cords.  Consider not putting a necklace, medallion with chain, or similar item around your baby’s neck.

And If the Worst Happens…

Despite parents’ best intentions to make surroundings safe, infants have a way of getting into trouble when we least expect it.  If an infant does experience a true choking episode, would you know how to respond?

A description of the steps to take when a baby seems to be choking is beyond the scope of this blog, but parents can do their best to be prepared for the event.  One of the best ways to prepare is to enroll in an infant CPR class.  The course will cover such topics as recognizing a true choking emergency, giving back blows and abdominal (“belly”) thrusts, and determining whether the baby is breathing effectively.

When to Worry Less

Lots of babies have brief choking events now and then, especially when nursing or formula feeding.  While such episodes can be a little frightening to new parents, if the choking is just for a moment, the baby is breathing well, and her color is good, there may not be a need to do anything.

If the baby has repeated choking episodes, she may have an additional medical problem.  Sometimes there’s a small abnormality in the nose, larynx (lower part of the throat that contains the vocal cords), or esophagus (“food tube”; where the food goes after swallowing).  Most of these would be diagnosed shortly after birth, but some may go undetected until the infant gets home or even until a few months have passed and the baby feeds more.  Other issues include reflux or a nerve disorder.  These are problems that can be diagnosed and, usually, treated by your pediatric provider and the appropriate specialists.

Most of the time, however, brief choking-type behaviors are just nature’s way of clearing material from where it shouldn’t be.  If your little one seems to choke during feeds, try feeding upright, and try gently suctioning the nose (babies must breathe through their nose).  However, one thing NOT to do—at least not without consulting your pediatric provider—is put the baby to sleep on his stomach.  Well-meaning parents will often do this with the idea that there is less risk of formula coming up and causing a choking episode.  However, in otherwise healthy infants it doesn’t seem to be very helpful.  And putting babies on their back (i.e. facing upward) has been shown to have a real effect on reducing the risk of sudden infant death syndrome.

Stan Sack
Dr. Stan Sack has 29 years’ experience as a primary care pediatrician in Massachusetts and Florida. A medical writer since 2015, he enjoys blogging on topics that are on parents’ minds but are covered less often in books and on websites. He lives in the Florida Keys with his family and enjoys healthy cooking, fitness activities and singing in his spare time.

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