When a child is choking, it means that an object — usually food or a toy — is stuck in the trachea (the airway). When this happens, air can't flow normally into or out of the lungs, so the child can't breathe properly.
The trachea is usually protected by a small flap of tissue called the epiglottis. The trachea and the esophagus share an opening at the back of the throat. The epiglottis acts like a lid, snapping shut over the trachea each time a person swallows. It allows food to pass down the esophagus and prevents it from going down the trachea.
But every once in a while, the epiglottis doesn't close fast enough and an object can slip into the trachea. This is what happens when something "goes down the wrong pipe."
Most of the time, the food or object only partially blocks the trachea, is coughed up, and breathing returns to normal quickly. Kids who seem to be choking and coughing but still can breathe and talk usually recover without help. It can be uncomfortable and upsetting for them, but they're generally fine after a few seconds.
Sometimes, an object can get into the trachea and completely block the airway. If airflow into and out of the lungs is blocked and the brain is deprived of oxygen, choking can become a life-threatening emergency.
A child may be choking and need help right away if they:
In these cases, if you've been trained, immediately start abdominal thrusts (also known as the Heimlich maneuver), the standard rescue procedure for choking.
If you have kids, it's important to get trained in both CPR and the technique of abdominal thrusts (the Heimlich maneuver). Even if you don't have kids, knowing how to do these first-aid procedures will let you help if someone is choking.
When a person does abdominal thrusts, a sudden burst of air is forced upward through the trachea from the diaphragm and will dislodge a foreign object and send it flying up into (or even out of) the mouth.
Though the technique is pretty simple, abdominal thrusts must be done with caution, especially on young children. They are safest when done by someone trained to do them. If done the wrong way, the choking person — especially a baby or child — could be hurt. There's a special version of abdominal thrusts just for infants that is designed to lower the risk of injury to their small bodies.
The technique of abdominal thrusts and CPR are usually taught as part of basic first-aid courses, which are offered by YMCAs, hospitals, and local chapters of the American Heart Association (AHA) and the American Red Cross.
Call 911 for any serious choking situation.
Here are several possible situations you might face and tips on how to handle them:
If a child is choking and coughing but can breathe and talk:
If a child is conscious but can't breathe, talk, or make noise, or is turning blue:
If the child was choking and is now unconscious and no longer breathing:
After any major choking episode, a child needs to go to the ER.
Get emergency medical care for a child if:
If a child had an episode that seemed like choking but fully recovered after a coughing spell, there is no need to get emergency medical care, but you should call your doctor.
All kids are at risk for choking, but those younger than 3 are especially at risk. Young kids tend to put things in their mouths, have smaller airways that are easily blocked, and don't have a lot of experience chewing, so they might swallow things whole.
To help protect kids:
Take the time now to become prepared. CPR and first-aid courses are a must for parents, other caregivers, and babysitters. To find one in your area, contact your local American Red Cross, YMCA, or American Heart Association chapter, or check with hospitals and health departments in your community.
Reviewed by: Yamini Durani, MD
Date Reviewed: Apr 20, 2023