Safety & Accidents (choking, safety in the sun etc)

 

Baby safety tips

 

Keeping baby safe

Babies are completely dependent on you for their safety. Here’s what you can do to keep them safe.

 

Preventing falls

Babies soon learn to wriggle and kick. It’s not long before they can roll over, which means that they can roll off beds and changing tables. Once they learn to crawl, babies may try to climb onto things, such as sofas, which increases the risk of falling. Here are some things you can do:

• Change your baby’s nappy on a changing mat on the floor.
• Don’t leave your baby unattended on a bed, sofa or changing table, even for a second, as they could roll off.
• Don’t put your baby in a bouncing cradle or baby car seat on a table or kitchen worktop as their wriggling could tip it over the edge.
• Hold on to the handrail when carrying your baby up and down stairs in case you trip.
• Watch where you’re putting your feet while carrying your baby. It’s easy to trip over something like a toy.
• Use a five-point harness to secure your baby in a highchair.

When your baby can crawl:

• Fit safety gates at the top and bottom of the stairs to stop a baby from climbing stairs or falling down them. Close the gates properly after you go through them.
• If the gaps between banisters or balcony railings are more than 6.5cm (2.5 inches) wide, cover them with boards or safety netting. Small babies may be able to squeeze their bodies through, but not their heads.
• Keep low furniture away from windows. Have windows fitted with locks or safety catches that restrict the opening to less than 6.5cm (2.5 inches), to stop babies climbing out. Make sure adults know where the keys are kept in case of a fire.
• Don't allow your baby to use a baby walker. They're dangerous and can cause serious accidents.
• Remove cot toys and cot bumpers as a baby can climb on them and may fall out of the cot.

 

Preventing burns and scalds

A baby’s skin is much thinner than an adult’s and will burn much more easily. This means you need to take extra care at bath time.

• Babies will grab at brightly coloured objects, such as mugs. If you’re having a hot drink, put it down before you hold your baby.
• After warming a bottle of milk, shake the bottle well and test the temperature of the milk by placing a few drops on the inside of your wrist before feeding. It should feel lukewarm, not hot.

 

Preventing choking and suffocation

Babies can choke very easily, even on their milk. They will be tempted to put small objects in their mouths that could cause choking, even when they’re quite young.

• If you give your baby a bottle, always hold the bottle and your baby while they're feeding.
• Keep your baby out of reach of small objects, such as buttons, coins and small toy parts.
• Once your baby has started on solid food, always cut it up into small pieces. Babies can choke on something as small as a grape.
• Don’t use pillows or duvets with babies under the age of one as they can suffocate if their face gets smothered. They won’t be able to push the duvet away.

 

Preventing strangulation

Don’t tie a dummy to your baby’s clothes as the tie or ribbon could strangle them.

 

Preventing drowning

Babies can drown in as little as 5cm (two inches) of water. Drowning is silent so you won’t necessarily hear any noise or struggle.

• Stay with your baby all the time that they're in the bath. Never leave them for a moment, even if there’s an older brother or sister in the bath with them.
• If you use a bath seat, remember that it’s not a safety device. You still need to stay with your baby all the time.

 

Preventing poisoning

• Keep all medicines locked away or high up out of reach and sight.
• Keep cleaning products high up out of reach. If this isn’t possible, fit safety catches to low cupboard doors. Choose cleaning products that contain a bittering agent. This makes them taste nasty, so children are less likely to swallow them.
• Make sure bottle tops and lids are always firmly closed when not in use.

 

Toddler safety tips

At this stage of their development, children can climb and do simple things like opening containers. They’ll also put things in their mouth to explore taste and texture. This is all perfectly normal, but it can lead to injuries if you don’t take care.

 

Out and about

There will come a time when you'll need to start using a forward-facing child car seat, but carry on using your rear-facing seat for as long as you can as these provide better protection in a crash. Remember, when taking your toddler out of the car or putting them in, do so from the pavement side of the vehicle.

Further tips:

• Use a five-point harness to secure your child in a pushchair.
• Use a harness and reins when out walking, or hold your child’s hand tightly. It only takes a few seconds for them to run into the road.
• Set a good example when crossing the road by choosing a safe place and talking to your child about what you're doing.
• Children under five are too young to play in the street. Find a safe place for them to play outside, such as the garden or a playground.

 

Falls

When babies start to walk, they're unsteady on their feet but can move very quickly. They tend to trip and fall.

• Until your baby is at least two years old, use safety gates at the top and bottom of the stairs to stop them climbing stairs and falling down them. Close the gates properly each time you go through them.
• Teach your child how to climb stairs but never let them go up and down on their own. Even four-year-olds may need some help.
• Don’t let children under five sleep in the top bunk of a bunk bed, as they can easily fall out.
• Keep low furniture away from windows and ensure that windows are fitted with locks or safety catches. Make sure adults know where the keys are kept in case of fire.
• Use a five-point harness when your child is in their highchair.

 

Preventing house fires, burns and scalds

Toddlers will play with anything they can reach.

• Keep matches and lighters out of young children’s sight and reach.
• Use a kettle with a short or curly flex to stop it hanging over the edge of the work surface, where it could be grabbed.
• When cooking, use the rings at the back of the cooker and turn saucepan handles towards the back so they can’t be grabbed by little fingers.
• It’s best to keep your toddler out of the kitchen, well away from kettles, saucepans and hot oven doors. You could put a safety gate across the doorway.
• Keep hot drinks well away from young children. A hot drink can still scald 20 minutes after it was made.
• When you’ve finished using your iron or hair straighteners, put them out of reach while they cool down. Make sure your child can’t grab the flex while you’re using them.

 

Preventing choking and suffocation

Children will put everything and anything they can in their mouths. It’s all part of learning, but even something as small as a grape can choke them.

• Cut food up so that it’s small enough for their mouth. Don’t give young children hard food such as boiled sweets.
• Don’t give whole peanuts or other nuts to children under five years old, as they could choke.
• Don’t leave your children when they're eating. Encourage them to sit still as running around while eating could make them choke.
• Keep small objects such as coins, buttons or small parts from older children’s toys away from toddlers.
• Keep plastic bags of all types out of reach and sight of young children so that they can’t play with them and put them over their head.

 

Preventing strangulation

Toddlers can strangle themselves when playing with cords. They can also get their heads stuck when they squeeze their body through small gaps. This can be particularly dangerous if their feet are off the ground.

• Cut back or tie up curtain or blind cords so that they’re well out of your toddler’s reach.
• Don’t leave any type of rope or cord lying around, including dressing-gown cords.
• Stop toddlers from trying to squeeze through rails or banisters.
• Keep toys and garden play equipment well away from washing lines so that children can't stand on them and reach the line.

 

Preventing drowning

Toddlers can drown in very shallow water, such as in baths or ponds. Drowning is silent so you won’t necessarily hear any noise or struggling.

• Never leave young children alone in the bath, even for a second.
• Empty the bath as soon as you’ve taken your child out.
• If you have a garden pond, fence it off, fill it in or securely cover it.
• Watch toddlers when they're in a paddling pool or playing near water. Empty the paddling pool straight after use.
• Make sure your garden is secure so that your child can’t get into neighbouring gardens, where there may be ponds or other drowning hazards.

 

Preventing poisoning

Toddlers like putting things in their mouths to see what they taste like. They’ll also find all sorts of ways to reach things that look like sweets.

• Keep all medicines locked away or high up out of reach and sight.
• Keep cleaning products high up out of reach. If that’s not possible, fit safety catches to low cupboard doors. Choose cleaning products that contain a bittering agent. This makes them taste nasty, so children are less likely to swallow them.
• Make sure that bottle tops and lids are always firmly closed when not in use.
• Check your garden for poisonous plants. Teach children not to eat anything they pick outdoors until they’ve checked with an adult.

 

Preventing cuts, bumps and bruises

Toddlers don’t understand the concept of danger. While minor cuts, bumps and bruises are part of growing up, there are things you can do to protect them from serious accidents or injuries.

• Use safety glass in low glass doors and windows or cover panes with safety film. Safety film holds the window together if the glass is broken.
• Keep scissors, knives and razors out of children's reach.
• Special devices can stop doors from closing properly, preventing your child’s fingers getting trapped. At night, remember to close doors to stop any potential fires from spreading.
• If furniture has sharp corners, use corner protectors to prevent your child from hurting their head. 

 

Safety for all under-fives

Accidents are one of the main causes of death among children aged between one and five years old.

Every year, about 500,000 children under the age of five go to hospital because of an accident at home.

Exploring and playing are an essential part of learning, and children shouldn’t be over-protected.

Bumps and bruises are inevitable, but you can do some simple things to make sure that your child doesn’t get seriously injured.

 

House fires

If your home catches fire, you and your child could breathe in poisonous smoke. It’s especially dangerous if the fire breaks out at night while you’re all asleep.

• Fit smoke alarms on every level of your home. Test the batteries every week. Change the batteries every year or, even better, get alarms that have 10-year batteries or are wired into the mains or plug into light sockets.
• At night, switch off electrical items wherever possible before going to bed and close all doors to contain a potential fire. If you smoke, put any cigarettes right out.
• Practise how you'll escape if there's a fire so you know what to do if the alarm goes off.

 

In the car

We would advise that all under-fives must ride in proper baby or child car seats when travelling by car, even on short, local journeys.

• Always use a baby or child car seat that’s right for your child’s height and weight.
• When buying a seat, try it in your car before buying it. A badly fitting seat can provide less protection in a crash.
• Make sure the seat is fitted properly in the car and that your baby or toddler is securely strapped in.
• It’s illegal, and very dangerous, to carry a baby in a rear-facing baby seat in a front car seat that has an active airbag. Forward-facing seats in the same position, while not illegal, are not ideal for toddlers. Use the back seat for all under-fives if you can.
• Never leave your baby or toddler alone in the car. It can get very hot in summer. Also, they may play with window and door switches or the cigarette lighter. It’s especially dangerous if you leave the keys in the ignition.

 

Bath water scalds

Bath water scalds can be very serious injuries, needing prolonged treatment and care. They can kill a child. Toddlers may play with the hot tap, scalding themselves and other children sharing the bath with them.

• Never leave a child under five alone in the bath, even for a moment.
• Fit a thermostatic mixing valve to your bath's hot tap to control the temperature and stop your child being badly scalded.
• Put cold water into the bath first, then add the hot water. Always test the temperature of the water, using your elbow, before you put your baby or toddler in the bath. The water should feel neither hot nor cold.

 

Burns and scalds

• Fit fireguards to all fires and heaters. Use a sparkguard if you have a coal or wood fire. Guards can prevent under-fives falling or reaching into fires.
• Don’t leave hot drinks in easy reach of little hands. Babies and toddlers may grab at cups and mugs on low tables or on the floor and pull the contents over themselves.

 

Strangulation

• Make sure any cot toys have very short ribbons, and remove them when your baby goes to sleep.
• Never hang things like bags with cords or strings over the cot.
• Cut or tie up curtain or blind cords well out of your baby’s or toddler’s reach.

 

Poisoning

• Fit carbon monoxide alarms wherever there's a flame-burning appliance (such as a gas boiler) or open fire. Carbon monoxide is poisonous, but you can’t see it, smell it or taste it. Make sure that your appliances are serviced regularly and that ventilation outlets in your home aren’t blocked.
• Remember that child-resistant devices, such as bottle tops, strips of tablets and cigarette lighters, aren’t completely child-proof; some children can operate these products. Store medicines, household chemicals (including cleaning products) and lighters out of sight and out of reach, or locked away safely.

Housing safety

If you live in rented accommodation and are worried that your housing may be unsafe for you and your child, contact your compound manager or landlord.

 

Safety in the sun

Exposing your child to too much sun may increase their risk of skin cancer later in life. Sunburn can also cause considerable pain and discomfort in the short term.

The following tips will help you protect your child:

Encourage your child to play in the shade, for example under trees, especially between 11am and 3pm when the sun is at its strongest.

Keep babies under the age of six months out of direct sunlight, especially around midday.

Cover exposed parts of your child’s skin with a sunscreen, even on cloudy or overcast days. Use one that has a sun protection factor (SPF) of 15 or above and is effective against UVA and UVB. Don’t forget to apply it to their shoulders, nose, ears, cheeks and tops of feet. Re-apply often throughout the day.

Be especially careful to protect your child’s shoulders and the back of their neck when they're playing as these are the most common areas for sunburn.

Cover your child up in loose, baggy cotton clothes, such as an oversized T-shirt with sleeves.

Get your child to wear a floppy hat with a wide brim that shades their face and neck.

Protect your child’s eyes with sunglasses.

If your child is swimming, use a waterproof sunblock of factor 15 or above. Re-apply after towelling

 

Baby accidents:  What to do

Most young children have some injuries and accidents. Most will be minor, but it’s sensible to know what to do if the accident or injury is more serious.

Start by learning some basic first aid or revise what you already know.

 

If an accident happens

It can be difficult to know when to call an ambulance and when to take your child to the Accident and Emergency department (A&E). Use the following as a guide: 

Call an ambulance if your child:

• stops breathing
• is struggling for breath (for example, you may notice sucking in under the ribcage)
• is unconscious or seems unaware of what's going on
• won’t wake up
• has a fit for the first time, even if they seem to recover

Take your child to A&E if they:

• have a fever and are persistently lethargic despite having paracetamol or ibuprofen
• are having difficulty breathing (breathing fast, panting or are very wheezy)
• have severe abdominal pain
• have a cut that won't stop bleeding or is gaping open
• have a leg or arm injury and can’t use the limb
• have swallowed a poison or tablets

If you’re unsure whether you should move your child, make sure they’re warm, then call an ambulance.

 

Objects in the nose or ears

If your child has something lodged firmly in their nose or ear, leave it where it is. If you try to remove it, you may push it further in. Take your child to the nearest accident and emergency department or minor injury unit. If their nose is blocked, show your child how to breathe through their mouth.

Cuts

If there’s a lot of bleeding, press firmly on the wound with a clean cloth, such as a tea towel or flannel. If you don’t have one, use your fingers. Press until the bleeding stops. This may take 10 minutes or more. Don’t use a tourniquet or tie anything so tightly that it stops the circulation.

If possible, raise the injured limb. This will help to stop the bleeding. Don’t do it if you think the limb might be broken. If you can find a clean dressing, cover the wound. If blood soaks through the pad or dressing, leave it there and put another pad or dressing over the top.

It’s very unusual for a wound to bleed so much that there's serious blood loss. An ambulance isn't usually needed, but if the cut keeps bleeding or there’s a gap between the edges of the wound, go to accident and emergency or a minor injury unit. If there is a possibility of a foreign body (e.g. a piece of glass) being in the cut, go to A&E. If your child’s immunisations aren’t up to date, ask your doctor whether they should have a tetanus jab.

 

Burns and scalds

Immediately put the burn or scald under running cold water to reduce the heat in the skin. Don't do this for longer than 10 minutes as babies and toddlers can get too cold. If there’s no running water, immerse the burn or scald in cold water or any other cool fluid, such as milk or another cold drink.

Use something clean and non-fluffy, like a cotton pillowcase, linen tea towel or clingfilm, to cover the burn or scald. This will reduce the danger of infection. If your child’s clothes are stuck to the skin, don’t try to take them off.

Don’t put butter, toothpaste, oil or ointment on a burn or scald as it will have to be cleaned off before the burn or scald can be treated. Depending on the severity of the burn or scald, see your GP or go to a minor injuries unit or accident and emergency department.

Blisters will burst naturally. The raw area underneath them needs a protective dressing. Ask your pharmacist or doctor for advice.

 

Swallowing poisons

If you think your child has swallowed pills or medicines:

• Unless you’re absolutely sure, spend a minute or two looking for the missing pills (have they rolled under a chair?).
• If you still think your child has swallowed something, take them straight away to your GP or hospital, whichever is quickest.
• Take the full set of tablets with you so that the doctors can check the labelling and calculate how much your child may have taken.
• Keep a close watch on your child and be prepared to follow the resuscitation sequence.
• If possible, write down the name of whatever you think your child has swallowed so that you can tell the doctor.
• Don’t give your child salt and water, or do anything else to make them sick.

If you think your child has swallowed household or garden chemicals:

• Calm your child down as much as you can (this will be easier if you stay calm yourself). Act quickly to get your child to hospital.
• If possible, write down the name of whatever you think your child has swallowed so that you can tell the doctor.
• If your child is in pain or there's any staining, soreness or blistering around their mouth, they have probably swallowed something corrosive. Give them milk or water to sip in order to ease the burning and get them to hospital quickly.

 

Shock

If your child looks pale and/or feels unwell after an accident, lie them down. Keep them covered up and warm, but not too hot. If your child feels faint, get them to keep their head down and, ideally, to lie down. The faint feeling will wear off in a minute or two.

 

Fits or convulsions

If your child has a fit, they may suddenly turn blue and become rigid, with staring eyes. Sometimes their eyes will roll and their limbs will twitch and jerk. Or they may suddenly go floppy. The following suggestions will help you deal with the fit:

• Keep calm.
• Lie your child on their side to make sure they don’t vomit or choke. Don’t put anything in their mouth. If you think they’re choking on food or an object, try to remove it.
• Remove your child’s clothing and any coverings and make sure they’re cool but not chilly.
• Most fits will stop within three minutes. When it’s over, reassure your child, make them comfortable and call a doctor.
• If the fit hasn’t stopped within three minutes, call 999. If it stops but it was your child’s first fit, take them to the nearest accident and emergency department to be checked over.
• Don’t panic. Fits need to last longer than 30 minutes for there to be any risk of brain damage.
• Even if it's not the first time and your child recovers quickly, let your doctor know that your child has had a fit.

Although fits may look alarming, they're common in children under the age of three. Although there are other reasons why children have a fit, a high temperature is the most common trigger. 

Fever fits, also known as febrile convulsions, become increasingly less common after the age of three and are almost unknown after the age of five. Febrile convulsions aren't usually connected with epilepsy. 

 

Electrocution

Always turn off the power before approaching your child. If this isn’t possible, push the child away from the source of the shock with a wooden or plastic object, such as a broom handle. Try gently stimulating your child by tapping their feet or stroking their neck and shouting ‘hello’ or ‘wake up’. If you get no response from your child, you must follow the resuscitation sequence.

 

Broken bones

If you think your child’s neck or spine may be injured, call an ambulance. Don’t move them. Unnecessary movement could cause paralysis. A bone in your child’s leg or arm may be broken if they have pain and swelling and the limb seems to be lying at a strange angle.

If you can’t easily move your child without causing pain, call an ambulance. If you have to move your child, be very gentle. Put one hand above the injury and the other below it to steady and support it (use blankets or clothing if necessary). Comfort your child and take them to hospital.

If you think your child is in pain, give them painkillers even if you’re going to accident and emergency. Follow the dosage instructions on the label.

 

Resuscitating a baby

Below is the full, detailed CPR (Cardio-pulmonary Resuscitation) sequence for infants and children. It's highly recommended that every parent goes to a first aid course because it makes this process much easier to understand and remember.

 

1. Ensure the area is safe

• Check for hazards, such as electrical equipment or traffic.

 

2. Check your child’s responsiveness

• Gently stimulate your child and ask loudly, ‘Are you all right?’
• Don’t shake infants or children with suspected neck injuries. 

 

3A. If your child responds by answering or moving

• Leave them in the position in which they were found (provided they're not in danger).
• Check their condition and get help if needed.
• Reassess the situation regularly.

 

3B. If your child doesn’t respond

• Shout for help.

 

If the child is under one year old:

• Ensure that the head is in a neutral position, with the head and neck in line and not tilted.
• At the same time, with your fingertip(s) under the point of your child’s chin, lift the chin. Don't push on the soft tissues under the chin as this may block the airway. 

 

If the child is over one year old:

• Open your child’s airway by tilting the head and lifting the chin.
• To do this, place your hand on their forehead and gently tilt their head back, leaving them in the position in which you found them.
• At the same time, with your fingertip(s) under the point of your child’s chin, lift the chin. Don't push on the soft tissues under the chin as this may block the airway.
• This may be easier if the child is turned carefully on to their back.

If you think there may have been an injury to the neck, tilt the head carefully, a small amount at a time, until the airway is open.

 

4. Keeping the airway open, look, listen and feel for normal breathing by putting your face close to your child’s face and looking along their chest

• Look for chest movements.
• Listen at the child’s nose and mouth for breathing sounds.
• Feel for air movement on your cheek.

Look, listen and feel for no more than 10 seconds before deciding that they're not breathing.

 

5A. If your child is breathing normally

• Turn them onto their side.
• Check for continued breathing.

 

5B. If your child isn't breathing or is breathing infrequently and irregularly:

• Carefully remove any obvious obstruction in the mouth.
• Give five initial rescue breaths (see below).
• While doing this, note any gag or cough response. These responses, or the lack of them, will form part of your assessment of ‘signs of life’ (see below).

 

Rescue breaths (or mouth-to-mouth resuscitation) for a baby under one year:

• Ensure that the head is in a neutral position and lift the chin.
• Take a breath and cover your baby’s mouth and nose with your mouth, making sure it's sealed. If you can’t cover both the mouth and nose at the same time, just seal one with your mouth. If you choose the nose, close the lips to stop air from escaping.
• Blow five breaths steadily into the baby’s mouth and nose over one to 1.5 seconds. It should be sufficient to make the chest visibly rise.
• Keeping their head tilted and chin lifted, take your mouth away and watch for the chest to fall as air comes out.
• Take another breath and repeat this sequence five times.

 

Rescue breaths (or mouth-to-mouth resuscitation) for a child over one year:

• Tilt the head and lift the chin.
• Close the soft part of their nose using the index finger and thumb of the hand that's on their forehead.
• Open their mouth a little but keep the chin pointing upwards.
• Take a breath and place your lips around their mouth, making sure it's sealed.
• Blow five breaths steadily into their mouth over about one to 1.5 seconds watching for the chest to rise.
• Keeping their head tilted and chin lifted, take your mouth away and watch for the chest to fall as air comes out.
• Take another breath and repeat this sequence five times. Check that your child’s chest rises and falls in the same way as if they were breathing normally.  

 

5C. If you have difficulty achieving effective breathing in your child, the airway may be obstructed

• Open the child’s mouth and remove any visible obstruction. Don’t poke your fingers or any object blindly into the mouth.
• Ensure that there's adequate head tilt and chin lift, but that the neck is not over-extended.
• Make up to five attempts to achieve effective breaths (sufficient to make the chest visibly rise). If still unsuccessful, move on to chest compression.

6. Check for signs of life
 
Take no more than 10 seconds to look for signs of any movement, coughing or normal breathing (not just infrequent, gasping breaths).

 

7A. If you’re confident that you have detected signs of life within 10 seconds:

• Continue rescue breathing, if necessary, until your child starts breathing effectively on their own.
• Turn your child on to their side (the recovery position) if they remain unconscious.
• Reassess the situation frequently.

 

7B. If there are no signs of life or you’re not sure

• Start chest compression.
• Combine rescue breathing and chest compression.

 

Chest compressions: general guidance

• To avoid compressing the stomach, find the point where the lowest ribs join in the middle, and then one finger's width above that. Compress the breastbone.
• Push down by roughly one-third of the depth of the chest.
• Release the pressure, then rapidly repeat at a rate of about 100 compressions a minute.
• After 30 compressions, tilt the head, lift the chin and give two effective breaths.
• Continue compressions and breaths in a ratio of two breaths for every 30 compressions. 

 

Although the rate of compressions will be 100 a minute, the actual number delivered will be less than 100 because of pauses to give breaths. The best method for compression varies slightly between infants and children.
 
Chest compression in babies less than one year old:

• Do the compressions on the breastbone with the tips of two fingers, not the whole hand or with two hands.

 

Chest compression in children over one year:

• Place the heel of one hand over the lower third of the breastbone (as described above).
• Lift the fingers to ensure that pressure is not applied over the ribs.
• Position yourself vertically above the chest and, with your arm straight, compress the breastbone so that you push it down by approximately one-third of the depth of the chest.
• In larger children, or if you're small, this may be done more easily by using both hands with the fingers interlocked, avoiding pressure on the ribs.

If no one has responded to your shout for help at the beginning and you're alone, continue resuscitation for about one minute before trying to get help (for example, by dialling 999 on a mobile phone).

 

8. Continue resuscitation until:

• Your child shows signs of life (normal breathing, coughing, movement of arms or legs).
• Further qualified help arrives.
• You become exhausted.

 

Helping a choking baby

Children, particularly those between the ages of one and five, often put objects in their mouth. This is a normal part of how they explore the world. Some small objects, such as marbles and beads, are just the right size to get stuck in a child’s airway and cause choking.

The best way to avoid this is to make sure that small objects like these are kept out of your child’s reach.

No matter how careful you are, your child may choke on something. In most cases, you or someone else will see your child swallow the object that causes choking. There can be other reasons why your child starts coughing. However, if your child suddenly starts coughing, is not ill and has a habit of putting small objects in their mouth, there's a good chance that they're choking.

Try these suggestions:

• If you can see the object, try to remove it. Don’t poke blindly with your fingers. You could make things worse by pushing the object in further.
• If your child is coughing loudly, there’s no need to do anything. Encourage them to carry on coughing and don’t leave them.
• If your child’s coughing is not effective (it’s silent or they can’t breathe in properly), shout for help immediately and decide whether they’re still conscious.
• If your child is still conscious but they’re either not coughing or their coughing is not effective, use back blows (see below).

Back blows for children under one year:

• Support the child in a head-downwards position. Gravity can help dislodge the object. It’s easiest to do this if you sit or kneel and support the child on your lap.
• Don’t compress the soft tissues under the jaw as this will make the obstruction worse.
• Give up to five sharp back blows with the heel of one hand in the middle of the back between the shoulder blades.

Back blows for children over one year:

• Back blows are more effective if the child is positioned head down.
• Put a small child across your lap as you would a baby.
• If this isn’t possible, support your child in a forward-leaning position and give the back blows from behind.

If back blows don’t relieve the choking and your child is still conscious, give chest thrusts (see below) to infants under one year or abdominal thrusts (see below) to children over one year. This will create an artificial cough, increasing pressure in the chest and helping to dislodge the object.

 

Chest thrusts for children under one year:           

• Support the baby on your arm, which is placed down (or across) your thigh as you sit or kneel.
• Find the breastbone, and place two fingers in the middle.
• Give five sharp chest thrusts (pushes), compressing the chest by about a third.

 

Abdominal thrusts for children over one year:

• Stand or kneel behind your child. Place your arms under the child’s arms and around their upper abdomen.
• Clench your fist and place it between the navel and ribs.
• Grasp this hand with your other hand and pull sharply inwards and upwards.
• Repeat up to five times.
• Make sure you don’t apply pressure to the lower ribcage as this may cause damage.

 

Following chest or abdominal thrusts, reassess your child as follows:

• If the object is still not dislodged and your child is still conscious, continue the sequence of back blows and either chest or abdominal thrusts.
• Call out or send for help if you’re still on your own.
• Don’t leave the child.

Even if the object is expelled, get medical help. Part of the object might have been left behind or your child might have been hurt by the procedure.

 

Unconscious child with choking:

• If a choking child is, or becomes, unconscious, put them on a firm, flat surface.
• Call out loudly or send for help if you’re on your own.
• Don’t leave the child at any stage.
• Open the child’s mouth. If the object is clearly visible and you can grasp it easily, then remove it.
• Start CPR

Don’t poke blindly or repeatedly with your fingers to try to get the object out. This can push the object further in, making it harder to remove and causing more injury to the child.

 

Teaching your child to stay safe

Children under three can’t always understand or remember safety advice, so they need to have an adult nearby at all times.

From the age of three, children can start learning how to do things safely but will sometimes forget, especially if they’re excited or distracted. Even if they repeat your instructions back to you, they may not have understood them or be able to follow the instructions all the time.

Children copy other people. If you, your family or their friends do risky things, they'll think it’s acceptable and normal. Tell your child that if they feel uncomfortable and are being told to do something silly or dangerous, it’s fine to say no. Encourage them to talk to you if this happens.

There are a few basic things you can teach even young children to help keep them safe:

• Teach your child their surname as early as you can.
• Teach them their address as soon as they're old enough to remember it.
• Once they’re old enough to understand danger, teach them what 999 means and how to call it, especially if you're epileptic, diabetic, blind or have any condition that means they may need to call for help. Young children may need to be taught what a ‘9’ looks like.
• Teach them to stay where they are if they get lost (for example, when you’re out shopping) and to tell a mummy who has other little girls or boys with them. This is safer than telling them not to talk to adults at all and risking them wandering off.