Normally when eating or drinking, food or fluid is taken into the front of the mouth, moved to the back of the mouth by the tongue, and then is swallowed into the tube leading to the stomach (esophagus). If the fluid or food (or foreign object) enters the airway instead, the person coughs or gags. There are four possibilities for what happens next. 

• Coughing brings the food (object) out of the airway and into the back of the mouth where it is successfully swallowed. 
• The food (object) is coughed or vomited out of the mouth.
• The food (object) is coughed out of the airway, then swallowed and becomes caught in the tube leading to the stomach. 
• The food (object) is inhaled deeper into the airway, making it difficult or impossible to breathe. Difficulty breathing is a life-threatening emergency. Without immediate first aid to clear the airway, the choking victim will die.
  

The Size of the Problem Nationwide

• In 1997, almost 200 children ages 14 and under died from choking. Eighty percent of these deaths occurred in children ages 4 and under.
• In 1998, 10 children died from choking on a toy or toy part.  Balloons caused half of these deaths.
• Every year, approximately 5,000 children ages 14 and under receive emergency care because of an inhaled or swallowed toy or toy part.
• Food items are involved in the majority of childhood choking injuries and deaths.
• Balloon-related deaths are a risk for children ages 3 and older as well as younger children.

Source: National SAFE KIDS Campaign

Useful Info: Choking Hazard Labels 

The Consumer Product Safety Commission protects children from choking as follows:

Children under age 3: The packaging of toys with small parts and loose pieces must display a choking hazard
label with the following warning: “Choking hazard. Small parts. Not for children under 3 years.”
Children ages 3 to 6: The packaging of toys with small parts and loose pieces must display a choking hazard label that warns parents that the toy is a choking risk.
Children under age 8: The packaging for balloons must display a choking hazard label that cautions: “Choking hazard. Children under 8 years can choke or suffocate on uninflated or broken balloons. Adult supervision required.”

Source: National SAFE KIDS Campaign

Health Alert: Choking Risks and Your Child with Special Needs

If your child with special needs has difficulty swallowing, use extra care with feeding and food preparation. Children who continue to “mouth” objects are also at increased risk for choking. All caregivers must be especially careful.

Healthy Habits: Be Ready to Rescue

Be ready for an emergency. You and anyone who cares for your child should be trained in CPR (cardiopulmonary resuscitation). You should also be trained in CPR for infants.

Local hospitals and fire departments offer first-aid and CPR courses approved by the American Heart Association.

Written instructions for CPR and first aid should be immediately available in case of an emergency. Get several copies of CPR and first-aid instructions and place one in your home first-aid kit, the first-aid kit in your car, in your suitcase and in other areas where emergencies are likely to occur. The American Academy of Pediatrics (AAP) offers CPR and first-aid chart. You can order a copy by sending a check for $2.95 to the 

AAP, Attention: Publications
P.O. Box 747
Elk Grove Village, Illinois, 60009-0747.

A list of emergency numbers should be available beside every phone in the house. Children should be taught to dial 911 in an emergency.

When calling 911, speak slowly and clearly and provide the following information:

• Your first and last name and phone number
• Full address including identifying landmarks
• What happened
• What is being done
• How the child is now
• Ask for emergency instructions
• Stay on the line until the 911 dispatcher tells you to hang up

Safety Habits: Choking Alert

Enroll anyone who cares for your child (including babysitters and grandparents) in a CPR course – training must include CPR for infants.

Prevent choking by doing the following:

• Do not allow children younger than 5 to have foods listed in the Choking Hazards Health Alert in the Nutrition section. Nuts should not be given to children until age 7.
• Keep toys with small parts and small household items out of reach of infants and young children. Pay attention to choking hazard warnings on toy packaging.
  
  Dangerous Household Items:
  -latex balloons
  -coins
  -marbles
  -small toy parts
  -pen or marker caps
  -button-type batteries
  -toys that could be squeezed into a child's mouth
  
• Cut food for infants and young children and encourage them to chew well.
• Insist that children eat at the table or sitting down. Do not allow children to walk, run, or play with food in their mouths.
• Supervise mealtime for infants and young children.
• Do not allow children to drink from Styrofoam cups.
• Use only one-piece pacifiers.
• Keep purses and jewelry boxes out of reach.

Source: American Academy of Pediatrics