What To Do If A Baby Is Choking

Firstly it is important to understand that chocking is very rare but it is good to be prepared. Knowing the difference between gagging and chocking is also important as it can dispel a lot of the fear when you start introducing solids. 

Gagging
All babies will gag when learning to eat solids and it is actually a very good thing as it prevents choking. It can however be scary to watch your child gag the first few times. But understanding why they gag will hopefully ease any fears you have. Babies are born with their gag reflex at the front of their tongue this is because when drinking milk the nipple or teat is at the back of a babies mouth. Between 3-6 months (on average) a babies gag reflex will move to the back of their mouth just like us adults. This is partly why babies are so keen to put anything and everything into their mouths at this age and by doing this they are helping their gag reflex move to get ready to start eating solid food. Some babies gag reflexes take longer to move back so they will be the babies who gag more when weaning. As long as there are no other developmental delays then it will just take a bit more practice and their gag reflex will eventually move fully to the back of their mouths. So with gagging the food never leaves the mouth apart from through the lips or once they have stopped gagging and safely swallow the food. 

Chocking is where a foreign object such as a piece of food or small toy leaves the mouth and obstructs the airway.
When we talk about dealing with a chocking baby we have to assess the situation and first of all work out if they have an effective cough or an ineffective cough.
With an effective cough the baby will be crying loudly, their face will go red, they will be able to take a breath before a cough and their cough will be loud.
With an ineffective cough the baby will be silent, their lips and the skin around them may go blue, their cough will be quiet or non existent.

If your baby’s cough is effective then the safest thing to do is make sure they are sat upright and let them get on with it as their cough should be able to dislodge the object as long as it stays an effective cough.

If your baby’s cough is ineffective or becomes ineffective then it is time for us to help them. First we need to call 999 or better yet if you have someone else with you for them to call 999. Then if your baby is still conscious you will need to perform up to 5 back blows and if the object is still stuck then up to 5 chest thrusts. You will need to continue with up to 5 back blows followed by up to 5 chest thrusts until the obstruction is dislodged and your baby is no longer choking or the paramedics arrive and take over or until your baby looses consciousness. 

To do the back blows, sit on a chair or kneel on the floor. Lay your child across your lap tummy down. Make sure their head is lower than the rest of their body so gravity can help. Using the hand closest to their head to support them by holding their jaw between your thumb and first finger. Deliver up to 5 sharp back blows with the heel of your other hand in the middle of the back between the shoulder blades.
To do the chest thrusts you need to turn your baby over, support their head with your hand and using two fingers from the other hand deliver up to 5 chest thrusts in the centre of their chest on the lower part of their breast bone. These are similar to chest compressions but sharper and delivered at a slower rate.

If you baby looses consciousness then we need to perform CPR as we need to get oxygen to their brain.
Lie you baby down on a hard flat surface, tilt their head slightly with a finger under their chin and your other hand on their forehead and look for any obstruction and if you see anything attempt to remove it with a single finger sweep. Do not attempt blind or repeated finger sweeps as you could push the object further into the airway. Give 5 rescue breaths. Then do 30 chest compressions followed by 2 breaths and then repeat 30 chest compressions and 2 breaths until your child either regains consciousness, the paramedics arrive or you become too exhausted to continue. If for any reason you can’t do the breaths then you should just do the compressions. You should be aiming to do the compressions at a speed of around 100-120 compressions a minute. 

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