Choking, suffocation and strangulation are major hazards for babies and toddlers for a number of reasons. From as early as a few months of age, infants begin to put things in their mouths. This is one of the ways they learn – by touching, feeling and mouthing any small item within reach. Young children are naturally curious and are always exploring their environment.

Babies and toddlers airways are small and easily blocked. Their reflexes are also not as well developed and their bodies are not as strong, so they are less likely to be able to get themselves out of trouble.

Over the five year period from 2005–2010, 282 children were admitted to The Royal Children’s Hospital for choking related issues.

There are a number of items in the home that present a choking, suffocation or strangulation risk to infants and young children.

Food

Certain foods can be dangerous for young children because they are easily inhaled and block breathing tubes. These include nuts, raw carrots and other hard vegetables, pieces of apple, popcorn, corn chips, lollies and grapes. Remember that young children under the age of three years may not be able to chew properly because they do not yet have their full set of teeth, so anything that is small and firm is a potential hazard.

• Never give nuts to children under five years of age.
• Carrots and other hard fruit and vegetables should be cooked, mashed or grated.
• Stay with young children at eating times and make sure they sit quietly while eating or drinking.
• Meat should be cooked and cut into small pieces.
• Never force young children to eat, as this may cause them to choke.
• Nurse your baby while he/she drinks from a bottle.
• A baby should not be left alone with a propped bottle.

Toys

Any object smaller than a D-size battery can choke children under three years.

Choose age-appropriate toys that are sturdy and well made and avoid selecting toys that have small parts as it is likely that at some stage they will find their way into the mouth of a young child and then can easily be inhaled and cause choking. Remember also that some less sturdy toys can break easily into small parts and can be dangerous.

When outdoors, make sure that young children do not have unsupervised access to rope swings as these can present a strangulation hazard.

Curtain and blind cords

Young children can get caught in dangling curtain cords. Fit blinds and curtains with rods instead of cords.

Where there are cords, wrap them around a cleat (available from hardware stores) attached to the wall. The length of any cord should not be longer than 30cm and must be and out of reach of curious toddlers.

• Do not attach cords, string or ribbons to pacifiers.
• Keep cots away from blind and curtain cords.
• Keep mobiles out of reach of young ones.

Plastics

Plastic bags, dry cleaning bags and plastic wrap are especially dangerous for young children. A child can easily suffocate if these items are pulled over their head.

• Always tie a knot in dry cleaning and plastic bags before throwing them out.
• Plastic bags should be stored out of reach.
• Plastic covers on mattresses should always be removed and discarded before use.  They are not a substitute for waterproof mattress protectors.
• Do not give uninflated balloons to young children. Long strings on balloons are also dangerous.

Pillows and mattresses

These are another potential hazard for suffocation in young children.

• Pillows and cot bumper pads should not be used for children under two years of age.
• Choose a firm, close fitting mattress and do not put infants and young children to sleep on soft surfaces such as beanbags or waterbeds.
• Infants should not be put to sleep on sofas or in adult beds.

Prams

Do not use the pram for a sleeping baby if it will be unsupervised. Infants can become trapped and suffocate.

Clothing

• When choosing clothing avoid ties, ribbons or crocheted jackets that may pull tight.
• Always remove a baby’s bib before putting them down to sleep.
• Avoid necklaces and other jewellery that can get caught.
• Be aware that cords and drawstrings on clothing such as parkas and hooded windcheaters can catch on play equipment.

Small articles

Any object smaller than a D-size battery can choke children under three years.

Make sure that young children cannot reach or play with:

• Needles, pins and safety pins.
• Coins and small button batteries including spare batteries and toys containing small button batteries.
• Buttons, beads, marbles, the tops of ballpoint pens and polystyrene beads (found in stuffed toys and bean bags) are all easily inhaled.
• Watermelon seeds, dried peas, toys with small parts that can be removed.

When a small button battery is swallowed it can burn through tissue in just two hours, causing severe injury or death.  If a child swallows a button battery, go to your nearest hospital emergency department immediately and do not induce vomiting