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 cardiopulmonary resuscitation (CPR) and first-aid before an accident happens. Other prevention tips include the following:

  • Always supervise young children when they are eating. Make sure they sit down when they have food in their mouths.

  • 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.

  • You may want to purchase 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.

  • Foods account for 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.

Infants and sleeping

The medical community recommends placing infants on their backs in their cribs to reduce the risk of sudden infant death syndrome (SIDS). Placing infants on their backs may also reduce the chance of choking, as infants may have a hard time lifting their heads 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, and other soft products, pillows, and comforters in the crib with an infant.

Reducing the risk for sudden infant death syndrome (SIDS) 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. An infant who is fully immunized can reduce his or her risk for SIDS.

  • Breastfeed your infant. The AAP recommends breast milk only for at least 6 months.

  • Place your infant on his or her back for all sleep or naps until he or she is 1-year-old. This can decrease the risk for SIDS, aspiration, and choking. Never place your baby on his or her side or stomach for sleep or naps. If your baby is awake, allow your child time on his or her 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 he or she has been diagnosed with gastroesophageal reflux (GERD or heartburn).

  • Offer your baby a pacifier for sleeping or naps, if he or she isn't 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 infants sleep in the same room as their parents, close to their parent's bed, but in a separate bed or crib appropriate for infants. 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 lead to obstruction of an infant's airway or suffocation.

  • Don't place infants on a couch or armchair for sleep. Sleeping on a couch or armchair puts the infant at a much higher risk of 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 an infant's face or head. This will prevent him or her from getting overheated, reducing the risk for SIDS.

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

  • Don't use loose bedding or soft objects—bumper pads, pillows, comforters, blankets—in an infant'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.