Choking, suffocation and swallowed objects

Choking happens when an object or fluid partially or fully blocks the airway and stops the flow of air into the lungs. When this happens, a person is at risk of injury or death from choking or suffocation.

When a child’s airway is partially blocked, they may have noisy breathing and find it harder than normal to breathe. When their airway is fully blocked and they are choking, they may try to breathe but can’t. Choking may result in gagging, coughing and becoming unresponsive.

Children are more at risk of choking because their airway is not yet fully developed, and they are unable to cough up items that are stuck. Children aged up to 4 years are at higher risk than older children. 

Small items such as food, toys and household objects can cause choking. As a general rule, items smaller than a 20-cent coin can choke a child younger than 3 years.

How is gagging different to choking?

Gagging (or the gag reflex) is a normal protective reflex, especially in babies and young children. It happens when food or objects move too far back in the mouth, triggering a response that pushes it forward again. This helps protect the airway and is a normal part of learning to eat and explore new textures. 

How do I tell the difference between gagging and choking?

Gagging is usually noisy and may involve retching or coughing, but the child can still breathe and recovers on their own. Choking is different because the airway is partly or fully blocked. This means the child may not be able to breathe properly, speak or cry. 

Choking is an emergency and requires immediate first aid if the blockage does not clear.

Your response will depend on whether your child can cough and is still able to cry, talk and breathe. Encourage your child to stay calm and cough. This may help the object come out.

Suffocation happens when something blocks the mouth or nose, or compresses the chest. This prevents the person from breathing.

Plastic bags, plastic wrap and dry-cleaning bags are particularly dangerous for children because they can pull them over their heads. Plastic covers for cot and bassinet mattresses need to be removed before use. It's also important to always follow the safe sleeping recommendations to help keep your baby safe.

Immediately remove the object covering their face or head. Check if your baby is breathing normally. 

Babies who have suffocated need to go to hospital so they can be checked and monitored. You will need to check your baby’s environment and remove the object that caused them to stop breathing.

A swallowed object, also called a 'foreign body', is any item that should not have been swallowed.

Examples of typical objects that aren't food include:

• needles, pins or safety pins
• coins, small magnets and small batteries
• buttons, beads, marbles and pen tops
• small plastic toys 
• small stones or pebbles
• pips or seeds from fruit
• teeth that have been knocked out

Once the object has been cleared from the child’s airway, it’s important to check that it looks whole. If small pieces are left, the airway could still be blocked. Small, sharp objects can cause problems in the bowel, even days after being swallowed. This is why it’s important to have the child checked by a doctor.

Objects that are swallowed and go into the oesophagus (food tract) can become stuck. 
Symptoms can include drooling, pain in the chest or neck and trouble swallowing food. 

Your doctor will check what was swallowed and how your child appears. Sometimes an x-ray (Opens in new tab) can help identify where the object is. 

Often, objects are passed in the child’s poo in a day or so. However, if they’re having problems breathing, eating or drinking, the object needs to be removed. 

Button batteries and magnets need to be removed immediately.

Foods that need a lot of chewing and small, hard, solid foods commonly cause choking. These include:

• nuts
• uncooked raw vegetables
• hot dogs or sausages
• lollies and chewing gum
• marshmallows
• stringy food such as celery and pineapple

Household objects that may cause choking include:

• coins
• jewellery
• stationery items — for example paper clips, pen or marker lids, erasers and magnets
• tablets
• stickers from fruit
• garden objects — for example stones and pebbles

Children are naturally curious and place objects in their mouth as a way of exploring the world around them. This is why it’s important to supervise them at all times. It’s also useful to regularly check areas where they play and can get to small objects.

Keep all small objects out of reach. Get into the habit of scanning your child’s environment for small objects. Only buy toys that are suitable for your baby’s age, and check toys regularly to make sure that they’re not broken. 

Learn first aid for young children. 

For more information on product safety and recalls, visit Product Safety Australia (Opens in new tab).

First aid courses

You can learn CPR through a short course. Try St John Ambulance (Opens in new tab), Australian Red Cross (Opens in new tab) or Royal Life Saving Australia (Opens in new tab). Look for a course covering first aid for babies and children.

Information and apps to download

Read the St John Ambulance fact sheet on CPR for infants (Opens in new tab) and fact sheet on CPR for adults or children over 1 year (Opens in new tab).

St John Ambulance Australia has First Aid fact sheets in multiple languages. (Opens in new tab)

Download the free Australian Red Cross First Aid app (Opens in new tab). This resource gives you access to the most up-to-date CPR advice, wherever you are.

Languages other than English

Find choking first aid guides (Opens in new tab) in many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

Find resources for Aboriginal and/or Torres Strait Islander parents about choking and how to keep children safe at home (Opens in new tab).