Swallowed Objects and Infant Choking: Mayo Expert Offers Tips for Parents and Caregivers

Babies and young children learn a great deal about the world through their mouths. Unfortunately, this can lead to choking or swallowing dangerous objects. Choking is a leading cause of injury and death among children, especially children 3 years of age or younger. Food, toys and coins account for most of the choking-related events in young children, who put objects in their mouths as they explore new environments, according to the American Academy of Pediatrics.
MULTIMEDIA ALERT: For English-language and Spanish-language video of Dr. Grace Arteaga talking about swallowed objects and infant choking along with a PSA video: "Saving Lives with Gus — Heimlich Maneuver," please visit the Mayo Clinic News Network.
"Should a child choke or swallow something dangerous, parents and caregivers may want to offer liquids and/or solids, but this is not recommended. Also, parents should not force the child to vomit. Have the child see the doctor as soon as possible or take the child to the emergency room," says Grace Arteaga, M.D., a pediatrician at the Mayo Clinic Children's Center.
If a child is coughing forcefully after swallowing an object, parents and caregivers should encourage him or her to continue coughing and not interfere. But, if the swallowed object blocks the airway, and the child's condition worsens (the cough becomes silent or breathing becomes more difficult), Mayo Clinic experts recommend the "five-and-five" approach to first aid:

• Give 5 back blows. First, deliver five back blows between the victim's shoulder blades with the heel of your hand.
• Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver). For infants, use chest compressions because abdominal thrusts may cause injury.
• Alternate between 5 back blows and 5 abdominal thrusts until the blockage is dislodged, while someone calls for emergency assistance.

The advice for choking infants is different. Dr. Arteaga warns that objects can also cause infant choking, however food is the most common cause. She advises against the use of a finger sweep, which could lodge the object farther down in the airway.
Instead, if an infant is choking, Dr. Arteaga advises: Hold the infant or young child facedown on a forearm. The baby's head should be lower than his or her body. Then thump the baby firmly on the middle of the back using the heel of your other hand. The combination of gravity and the force from the hand helps to dislodge the object that's blocking a baby's airway. If there are any concerns about the baby's breathing, call 911 or a local emergency services provider.
Not everything that is swallowed requires medical attention. Many objects may pass through the gastrointestinal tract without causing harm. Other objects may injure or endanger the life of the child. An object that gets stuck in the esophagus — the muscular tube that connects your throat and stomach — may need to be removed, particularly if it is a pointed object or a battery that can rapidly cause nearby tissue injury. Usually the signs that an object is stuck include chest or abdominal pain, vomiting or fever.