Suffocation, Strangulation and Threat to Breathing
In just one week nearly 300 under-5s are rushed to A&E after choking on something, or swallowing a dangerous item. More likely than not, food can be the main cause of this risk. But small objects and toys also pose a hazard to a young child’s well-being.
Suffocation, Choking, and Strangulation pose the greatest risk to babies, crawlers and toddlers. More than 12 young babies have suffocated from grabbing a nappy sack and it sticking to the face and prevented breathing. Food is the main culprit for choking in babies and young children – and 31 toddlers and young children have died to date and others have had serious life changing injury from strangulation by playing with a window blind cord. In addition, there are key risk factors that have now been identified to help you reduce cot death risks. Please see the extensive advice from The Lullaby Trust about cot deaths here.
DID YOU KNOW…?
- Babies and toddlers learn to chew, swallow and breathe, with practice and time. There will, of course, be failed attempts at doing this – which can lead to a threat to their ability to breathe.
- As previously stated, babies learn about everything life is about by putting things in their mouths.
- When a child is choking it can be silent, Ensuring food is cut into small pieces, that will not lodge in their airways, will lead to a reduction in the choke risk.
- Foods like peanuts should not be given to children in this age group. Smaller fruits like grapes should not be given to a child whole and should be diced into smaller pieces.
- Asphyxia (choking, suffocation and strangulation) is the third most common cause for child accidental deaths in the UK. Most of these incidents involve under 5s.
- Choking mostly occurs from food, particularly when babies are being introduced to solid food for the first time. Older children should be encouraged to sit down when eating food, as this reduces the risk of choking.
- Suffocation mostly occurs in a cot or bed and occasionally on the sofa. Babies are unable to move out of a position where they can’t breathe or when they become tangled in bedding. In addition, more than 12 young babies have suffocated from nappy sacks. Keep them well away from changing areas and cots.
- Strangulation can occur from cords on clothing, chains on jewellery, ribbons on dummies and amber beads. Drawstrings on bags and cords from window blinds, and chains all pose a threat to your young child who may become entangled if the cord is left hanging, where a toddler can reach. A total of 31 children have died from strangulation from blind cords to date.
- Most modern blinds now come with safety features to reduce this risk. The shop you purchase it from should provide you with the hooks or safety tools which aim to keep the cords out of your child’s reach. Some new blinds don’t have cords at all!
To make the advice quick and easy to access, we will divide the information into age categories.
Babies are unable to move away from danger and rely on an adult to keep them safe. They have not developed the physical or cognitive skills to move away from danger. Suffocation is the biggest threat to a baby when it’s sleeping or from nappy sacks.
A babies’ throat is so narrow that they can easily choke when drinking or when eating small pieces of food. It is also extremely dangerous to prop a baby up with their bottle. If the child is choking it would be unable to push the bottle away. It’s best practice to always remain with your baby when feeding it.
Small objects and toys are an obvious danger to your babies and crawlers. Things left around the home like buttons, coins, small parts like screws all pose a risk to your little one’s life. Button batteries are a major risk. Not only could your child choke, but windpipes and stomachs can be burned due to the chemicals in the batteries that will react with the tissues inside their body. Click on Button batteries for an example of the damage that can happen to a child if it swallows one.
Placing your baby in it’s own cot to sleep, is the most effective way of reducing the risk of suffocation. There can be a temptation to bring your baby into bed with you – but this should be avoided. Some babies have suffocated when being put in an adult bed or next to a sleeping grown up. The Lullaby Trust which leads on providing advice regarding the prevention of cot deaths, recommend that if parents have been drinking or taking drugs, or are smokers or extremely tired, that they do not co sleep with their baby as the risk increases.
Bedding can also pose a risk to a baby. Duvets or pillows are best avoided, for babies under a year as babies are not able to push them away from their faces. The latest guidance for sleep says to place babies with their feet at the foot of the cot, as this prevents them from wriggling down and being covered with the blanket which may make them overheat and restrict their breathing.
Nappy Sacks pose a suffocation risk to young babies as they are light and will stick to the face if a baby grabs one and pulls it towards the mouth, which will be an involuntary reaction in young babies. We advise you to keep nappy sacks well out of a baby’s reach and never store them under the cot mattress.
Choking – Young babies should not be left alone with a feeding bottle, particularly when it is propped up and they are too young to hold it. This is a choking risk. When babies start first foods, cut food up. Food that is round in shape like grapes, little tomatoes and sausages, are best cut into quarters, to prevent choking. Other choking hazards are when a baby starts to pick up small items and put them in the mouth, as part of exploring new things. Anything smaller than a two pence piece, can cause a baby to choke and button batteries are particularly dangerous to a young child if they get stuck in the throat.
Your child has mastered the crawl, moved onto walking, and now follows you around – everywhere! They copy what you do and when you do it. This means this age group is at more risk of poisoning than any other age group. The below advise will help you be able to make sure your toddler stays safe from poisoning.
Choking – At this stage it is the time to create a routine where your child always sits down to eat, this helps to introduce good eating habits and prevent choking. Young children should have their food cut into small pieces to prevent choking. Adults need to be vigilent about leaving small items around that a young child could choke on. Children do like to imitate at this age so be aware of your own behaviour around your child. When buying toys make sure you read the age warning symbols, to ensure they are suitable. Small parts can be a choking risk at this age.
Strangulation – Your child at this age is at greatest risk of strangulation from blind cords, as they will be on the move, exploring the world around them and will not be able to predict danger. It’s safer to keep cots, beds and furniture away from windows, as your child may try and climb up to windows. Make sure you tie the cords up with the fixings provided by the manufacturer and keep them out of reach of young hands.
There have been a number of injuries from young children getting tangled in drawstring bag cords, it’s best not to leave them on the back of door handles, hung over a cot or left on hooks at child height.
Parents should avoid buying clothing for their child with drawstring fastenings around the neck, as this has the potential to leave the child dangling, if caught on an object.
Suffocation – at this age the main risk of suffocation is during play and exploring. Parents will need to recognise potentially hazardous items and keep them out of reach. A toddler should not be allowed to play with plastic bags or use them to keep toys in. Plastic packaging from new products can also be attractive to toddlers and will need to be discarded straight away.
Even once they have started to learn to walk, toddlers still won’t have mastered the action of chew, swallow, breathe.
The information above in the babies section regarding food applies to this age group as well. There may be a temptation to give your child hard or boiled sweets due to their increase in size and age. Don’t do it!
The same advice applies to when they are eating. Many toddlers wriggle or move when they eat. If you’re not able to see them when they are eating something, then there could be a risk of them choking. Education would be a great tool to use here. Teach them to sit still when eating and concentrate on what they are doing.
Educational advice will also teach your toddler to stop putting everything, they pick up, in their mouths. They may also put things in their ears or nose. It’s normal for them to try but try to teach them not to quickly and avoid them taking a trip to A&E with a crumbled up biscuit packed into their nose! Make sure your toddle also only plays with suitable toys. Toys for this age group will have no small parts that can be removed and swallowed or choked on. Any toys that are for older children to use should be kept out of reach of under 5s.
Just as stated above for babies, keeping your medicines and cleaning products locked away up out of reach and out of sight – it’s the safest way to protect your toddler. Ideally put them in a high lockable cupboard. It’s also best to keep them in a room which people use a lot. This means if your child has climbed up onto a chair or worktop, and is exploring in cupboards, they are more likely to be seen by an adult or older brother/sister.
Always remember, child resistant caps are not ‘child proof’. Some 3-4 year olds can open them in seconds, so make sure these are locked away as well.
Always try to take your medicine when your child isn’t watching. They try to copy exactly what you do. If they can’t see what you do – they won’t know.
Avoid pretending your child’s medicine is a sweet, even if it’s hard to get them to take it. It can be confusing for your toddler.
Always check out a friend or family member’s house as well, when visiting. Just take a few moments to look out for medicines or cleaning products lying around the home – so you’re not taken by surprise.
Running Free/School Children
At this stage, blind cords will pose the greatest risk, therefore, follow the advice above. Adults will need to be extra aware, as children will be curious and may experiment with items that can still cause choking, strangulation and suffocation risks.