home Pulmonology

Airway Obstruction: Prevention

Since most accidental child strangulations, chokings, and suffocations happen in the home, parents are well-advised to carefully childproof their homes. Another preventive step to take is to learn infant and child CPR (cardiopulmonary resuscitation) and first-aid before an accident happens. Other prevention tips include:

  • Always supervise young children when they are eating. Make sure they sit down when they have food in their mouths. Don't allow them to run or walk while eating.

  • Keep small items that are a choking hazard out of children's reach. Check under your furniture and between seat cushions for choking hazards. These include coins, marbles, watch batteries, buttons, and pen or marker caps.

  • Consider buying a small parts tester to help determine which items are choking hazards.

  • Make sure your child plays with age-appropriate toys.

  • Check toys regularly for damage.

  • Be aware that foods account for more than half of airways obstructions. Keep the following foods away from children younger than 4 years:

    • Hot dogs

    • Nuts and seeds

    • Chunks of meat or cheese

    • Whole grapes

    • Hard or sticky candy

    • Popcorn

    • Chunks of peanut butter

    • Chunks of raw vegetables

    • Chewing gum

  • Remove hood and neck drawstrings from young children's outerwear.

  • Don't allow children to wear necklaces, purses, scarves, or clothing with drawstrings on playground equipment.

  • Tie up or cut all window blind and drapery cords.

  • Don't hang anything over the crib that has cords or ribbons longer than 7 inches.

  • Don't let children under age 6 sleep on the top bunk of bunk beds. They may strangle or suffocate themselves if they fall.

  • Don't let your child play on bean bag chairs that contain small foam pellets. If the bean bag chair rips, your child can inhale and choke on the pellets.

  • Don't let young children play with shooting toys. An arrow, dart, or pellet can be a choking hazard if shot into a child's mouth.

  • Remember to discard any plastic wrapping the toy came in. Plastic wrapping can suffocate a small child.

Babies and sleeping

Babies should be placed on their backs in their cribs to reduce the risk of SIDS (sudden infant death syndrome). Placing babies on their back may also reduce the chance of choking. This is because babies may have a hard time lifting their head at first, if they are face down. The crib should be made according to national safety standards, with a firm, flat mattress. Don't put soft bedding, toys, or other soft products, pillows, and comforters in the crib with a baby.

Reducing the risk for SIDS (sudden infant death syndrome) and other sleep-related deaths

Here are recommendations from the American Academy of Pediatrics (AAP) on how to reduce the risk for SIDS and sleep-related deaths from birth to age 1: 

  • Make sure your baby is immunized. A baby who is fully immunized can reduce the risk for SIDS.

  • Breastfeed your baby. The AAP recommends giving a baby only breast milk  for at least 6 months.

  • Place your baby on their back for all sleep or naps until they are 1 year old. This can decrease the risk for SIDS, aspiration, and choking. Never place your baby on their side or stomach for sleep or naps. If your baby is awake, allow your child time on their tummy as long as you are supervising, to decrease the chances that your child will develop a flat head.

  • Always talk with your baby's healthcare provider before raising the head of their crib if your baby has been diagnosed with gastroesophageal reflux (GERD or heartburn).

  • Offer your baby a pacifier for sleeping or naps, if not breastfed. If breastfeeding, delay introducing a pacifier until breastfeeding has been firmly established.

  • Use a firm mattress (covered by a tightly fitted sheet) to prevent gaps between the mattress and the sides of a crib, a play yard, or a bassinet. This can decrease the risk for entrapment, suffocation, and SIDS.

  • Share your room instead of your bed with your baby. Putting your baby in bed with you raises the risk for strangulation, suffocation, entrapment, and SIDS. Bed sharing is not recommended for twins or other multiples. The AAP recommends that babies sleep in the same room as their parents, close to their parent's bed but in a separate bed or crib appropriate for babies. This sleeping arrangement is recommended ideally for the baby's first year, but should at least be maintained for the first 6 months.

  • Don't use infant seats, car seats, strollers, infant carriers, and infant swings for routine sleep and daily naps. These may block a baby's airway or cause suffocation.

  • Don't place babies on a couch or armchair for sleep. Sleeping on a couch or armchair puts the baby at a much higher risk for death, including SIDS.

  • Don't use illicit drugs and alcohol, and don't smoke during pregnancy or after birth. Keep your baby away from others who are smoking and areas where others smoke.

  • Don't over bundle, overdress, or cover a baby's face or head. This will prevent your baby from getting overheated, reducing the risk for SIDS.

  • Be sure the slats of your baby's crib are no more than 2-3/8 inches apart so the baby can't fit through the slats.

  • Don't use loose bedding or soft objects—bumper pads, pillows, comforters, blankets—in a baby's crib or bassinet to help prevent suffocation, strangulation, entrapment, or SIDS.

  • Don't use home cardiorespiratory monitors and commercial devices —wedges, positioners, and special mattresses—to help decrease the risk for SIDS and sleep-related infant deaths.

  • Always place cribs, bassinets, and play yards in hazard-free areas —those with no dangling cords, wires, or window coverings—to reduce the risk for strangulation.