Feel confident about food safety in your setting with this advice on gagging and choking on food from Edwina Revel at Early Start Nutrition…
Tragically, a child dies in the UK every month from choking. Each day around 40 under-fives are rushed to hospital after choking or swallowing something dangerous.
It can happen quickly and it can happen to anyone. It is reported that choking on food is the most likely cause, but small objects such as toys can be risky for young children too.
We know that many early years staff and families worry about children choking on food, particularly when introducing new textures and finger foods.
Parents are sometimes unsure if their little one is gagging or choking. Let’s look at the steps you can take in your setting to support children at mealtimes and consider the information you can share with families.
The EYFS Statutory Framework requires early years providers to take all necessary steps to keep children safe and well. They state that your setting must be confident that those responsible for preparing and handling food are competent to do so. You can take the following steps to meet these requirements.
Gagging is completely normal and can happen often during weaning. Children’s gag reflexes are much more sensitive than adults, as they are further forward on their tongue.
Gagging is a safety mechanism to reduce the risk of choking because it helps to bring the food back to the front of the mouth. Babies grow, learn and develop at different rates so some babies will naturally gag more than others.
During the initial stages of weaning, babies need to be supported to learn to bite, chew and move food around in their mouth. Encourage babies to move on to thicker, lumpier textures and finger foods so they become more confident to bite, chew and swallow.
As baby grows, the gag reflex moves further back in the mouth and becomes less sensitive and as they get older, they will gag less.
Gagging is usually loud with coughing and/or spluttering. You may notice that their eyes water and their face may go red. They may bring the food forward in their mouth and make a retching movement and may even vomit.
Staff and parents often wonder if they should intervene when a child is gagging. If a baby does cough or gag when eating, it’s important to stay calm and reassure them.
Often they will carry on eating. But if they become upset don’t force them to carry on. You can simply try again at the next mealtime. Afterwards, give them a smile, some reassurance and a sip of water, if needed. Remember to always stay with babies and children while they’re eating.
It’s reassuring to know that choking is very uncommon. For babies and young children, food can be a choking hazard, especially if they don’t chew their food well or try to swallow it whole. Choking can happen with any foods. However firm foods, food containing bones and small round foods present a higher risk.
Choking is when an object has either partially blocked or completely blocked the airway. You’re likely to notice the child is having difficulty breathing, speaking or coughing with a red puffy face.
They may also show signs of distress and may point to their throat or grasp their neck. If a child is quiet and blue they need your help.
Follow the guidance from your paediatric first aid course, depending on the age of the child. For further information, read guidance from the NHS and St John’s Ambulance.
There’s lots we can do to reduce the risk of choking at mealtimes. Firstly, it’s important to stay with babies and toddlers while they’re eating or drinking. Support children to stay in a sitting position to allow them to swallow the food safely or spit it out, if required.
It’s best to avoid distractions at mealtimes to support little ones to focus on the texture of the food and to co-ordinate putting it to their mouth to bite or chew and swallow safely.
It is also important to think about how foods are prepared. Choking can be a cause of injury in young children, mainly because their small airways are more easily obstructed. Follow these tips to reduce the risk of choking:
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