BLW and choking...reassurance please

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My 7.5 month DS is doing brilliantly with BLW. Loves exploring, loves swallowing. I'm with him all the time and haven't been worried about choking (though aware obviously) until I read an article in the Daily Mail about a grape, a baby choking and brain damage...

...it totally freaked me out. I know what to do if he does choke, but any thoughts on how to reassure me and any preventions (apart from the obvious cutting up of round things especially) that I should think about that I might not be...?

He does like to stuff a lot in, not obviously aware of what he's got in his mouth. Bits then fall out...

You are doing everything right already. Cut up anything hard that might block his windpipe, make sure you know how to flip him over and pat his back to help him if anything does go down the wrong way, and stay with him whilst he eats.

If stuff is falling out that is absolutely fine. He is still little and his gag mechanism will be quite pronounced so he'll spit stuff rather than let it reach the back of his mouth where he might accidentally inhale it. By the time his gag reflex recedes a bit he will already have lots of practice at using his tongue to move things round his mouth so he'll be able to spit stuff out without difficult.

Maybe don't read the Daily Mail either! I just googled to find the story you mention and bloody hell they love their scary childcare stories.

I don't read the DM! But it was linked as part of a choking story on the BLW forum. I hate the DM. But once they get in your head...

Thanks for the response

That story you found was brilliant in its scaremongering though. It starts with a truly harrowing tale of a child who suffered brain damage. Then it suggests that this could happen to just about anyone with the story of the blueberries.

No incidence figures for choking are given, although later on it does state that around 24 children a year under 5 die as a result of choking. There are around 4million under 5s in the UK so that is a total annual mortality rate of approx 1 in 170000. Which is awful assuming that some of those deaths are preventable, but also indicates just how safe British children are if that is the third most common cause of death.

The only thing that I found a bit odd is that it didn't mention how much the journalist's house was worth. I mean without that vital bit of context I'm not sure if I know quite what to do...

I recently went a weaning workshop and the nurse that run it singled out grapes as a very serious chocking hazard. It's their shape and hardness that can lead to them getting stuck in a child's windpipe and not being able to move one way or the other. The advice was not to give whole grapes for under-5s and to cut them in half. Anyway, grapes are so full of sugar I would forgo them for 5 years with no regrets. Nuts were mentioned too.

The other major prevention that I'm sure you are doing anyway, is to make sure he is upright when he eats. I HATE seeing babies eating in carseats / buggies / bouncy chairs as they are too reclined and they haven't the strength to pull themselves into an upright position.

Keep chopping up grapes and cherry toms, keep him upright, let him decide what goes in his mouth (don't break bits off and pop them in for him) nad I'm sure he'll be just fine.

The Red Cross have some very helpful videos showing first asid for babies and children, including choking:

childrenfirstaid.redcross.org.uk/

it was me who linked to the story on the blw site, sorry for worrying you. i thought it was a good description of choking, as opposed to gagging.

didn't you notice that the kids were all older than weaning age, though? and that BLW wasn't mentioned, so that guarantees that none of them were BLWed. because believe me, if the DM could have got a 'new weaning trend kills babies' story out of that, they would have done so with great gusto.

there was a thread a couple of days ago where a child had choked, properly seriously choked, on a bit of scrambled egg (the poor mum had been out of the room for a short, short time but in those minutes...) again, that baby was 11 months old, well past 'weaning'. again, no mention of BLW.

the fact is, kids can choke, and the smart thing to do is take measures to prevent it and know what to do if it happens.

keep an eye on them when eating, cut little round things up (or smush them, basically stop them from being little round things...) and educate yourself on what you would do if the worst happens.

i've said it before, but the only time i've had to do a proper 'turn them upside down and SLAP' thing was on a toddler in the park. no-one else knew what to do, or if they did, they didn't do it. i was just glad i was there as god knows what would have happened if i hadn't been.

for anyone interested in reading the DM article

Hi Aitch - no, I think it was right to link to the article and to raise awareness; for some reason it just made me anxious and I thought I'd ask around...

But having spent some time today thinking rationally (i.e not in Daily Mail style) and reading up on stats, I feel much better. And I love BLW, and I don't want to cast a cloud over it.

I've also decided to do a Baby first aid course and roped in enough friends with babies that we have the minimum required for a course run in our home. I think this will be really useful. It might not prevent hazards such as a choking experience, but I think, even in a panicked situation, I'll be better off drawing on learned knowledge than anything else.

good plan, i think. if it's any consolation i have a pal who is a paediatric A&E consultant, i asked him about choking incidents and he said that he has seen kids coming in who have choked on something and whose parents have brought them in, but he couldn't recall in a twenty something year career across the country, a single fatality. likewise the nurse who did our infant resus course, not a one in her career either.

no reason to get cocky, of course, but it helps to keep things in perspective i think.

I read the article in the paper and didn't see it as scaremongering as such - just mums trying to raise awareness. Made me think about being careful when round someone else's house with ds, and older children and/or adults are eating.

I think of it as scaremongering because of the tone rather than the content. It exploits two rules-of-thumb which social psychologists (and journalists) know heavily influence the ways in which people estimate the likelihood of a risk occurring.

The 'affect heuristic' makes us over-estimate the risk of events occurring that trigger strong emotions in us. The article is written to emphasise how horrific and frightening choking incidents may be. It also highlights how powerless they make parents feel. After reading it most of us will have made a strong emotional connection between choking and fear and horror and impotence.

The 'availability heuristic' makes us more likely to over-estimate risks which call to mind vivid mental images - the child turning red, the eerie silence because they can't breathe, their fearful eyes. All of these things are mentioned more than once to reinforce this vivid picture of the choking scene.

This is fine if all you want to do is highlight how dangerous choking can be to small children. But there are two problems with this. The first is that over-estimating the likelihood of an adverse event occurring may make us unnecessarily fearful and anxious and just make us feel miserable. So rather than enjoy mealtimes with our babies we are fearful instead. Context is important here. The risk is still very small. They don't actually cite a source for the figure of 24 children dying by choking a year (and it must be a generous estimate because last year only 17 children aged 0-18 died in housefires in England and Wales and they say that death by fire is more common than death by choking), but as I point out above that is still a risk of 1 in 170000 per year.

The other problem is that when we modify our behaviour to avoid the risks we are really scared of we sometimes incur other much greater risks. Sometimes this risk substitution is very direct. The American academic Cass Sunstein points out that during the Washington sniper attacks of 2002 when a sniper was deliberately targeting victims who had pulled up at petrol stations people changed their behaviour by driving further afield to refuel. As a result more people died on the roads in Washington and Virginia in that period than were killed by the sniper.

But in this instance the more likely effect is that parents will make small low-key decisions which have subtle and hard to quantify knock-on effects. If we drive our children to school because we are scared to let them walk there and risk abduction (incredibly unlikely) or being knocked down by a car (about as likely as their dying in an accident whilst we are driving) we also reduce the exercise they take, and increase their risk of obesity (very high, 1 in 3 children) and lifelong risk of heart disease, stroke and premature death. But those hard-to-imagine long term consequences which are actually frightening seem less scary than the short term fear of crime or an accident.

There is nothing wrong with pointing out that choking is a particular hazard to small children and simple measures can dramatically improve their safety. But this article is written in a way which deliberately attempts to distort rather than reinforce rational reasoning about risk.

brilliant post, veronica. you know, it's funny that you mentioned the lack of a source for that 24 figure, because it didn't sound right to me... i wonder where they got it.
i phoned ROSPA a few years ago (i have searched on my blog for the post but cannot find it anywhere, suspect it got deleted when my server went kaput) to find out the scale of things and the guy said that they didn't quite collect figures the same way any more so the last figures they had were for fatality by choking from something like 2004 for England and Wales and i am pretty sure that the number was something like four children under seven had died that year, or seven children under four... something like that, certainly no way was it over ten, and i distinctly recall that the age banding was useless in terms of a 'weaning' question.

these are some choking stats from the BBC, from 1999 though. is it possible that the DM has simply divided these up to come up with theirs? mental maths is not my thing but it seems to tally, except in the crucial aspect that you can't just divvy up death rates and ascribe them to age groups, as the over 75 group demonstrates.

"UK choking statistics
About 16,000 cases of choking are treated in UK hospitals each year
In 1999, a total of 218 people choked to death on food. A further 55 died after choking on non-edible objects
About half the choking fatalities in 1999 were men and women aged 75 and over
About 2,600 choking accidents in the UK each year involve children under four years of age."

AitchTwoOh, how did you arrange the first aid course? Just starting BLW and I really want to do one - and reckon my NCT group would too....

Thanks

they do them as part of the ante natal classes at my local hosp, so i just tagged along there when it was time to wean dd1. me, dh, my pal, her dh AND A FREAKING TERRIFIED PREGNANT WOMAN lol. she was so not ready to think about that child actually being BORN and then choking...

The Red Cross do sessions in first aid and emergency life support for babies and infants. And they will do private sessions too if you can get a group together.

www.redcrossfirstaidtraining.co.uk/