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This week's guest columnist is Dr. Kevin Morris, a family practice resident at the University Hospital and Clinics here in Lafayette. My wife and I sit down to enjoy dinner with our boys- the three year-old in a booster and the 8 month-old in a high chair. We are chatting and relaxed when the baby quits making sounds. He had inhaled to cough and sucked in a piece of teething biscuit, completely blocking his airway! I pulled him out of his high chair and used three quick back blows taught in basic rescue classes. The piece popped out and tragedy was averted. Most people understand the danger of non-food items causing choking, like coins or rocks, but any object in the mouth is a hazard. This is especially true for infants and children, who explore with their mouths and aren't careful about chewing. The National Safety Council Injury Facts 2016 reports that choking is the fourth leading cause of unintentional death. What to do? First and foremost every adult, parents or not, should take a Basic First Aid/CPR course. In these you're taught important life-saving maneuvers, including the Heimlich maneuver. There are different techniques to use depending on the child's age, and you practice hands-on. Call the American Red Cross, American Heart Association, or your local Fire/EMS for a class, or navigate their websites. The most obvious way to avoid a choking episode is to make sure there aren't small, non-food items within the child's reach. This includes marbles, rocks, small toys like lego pieces, button batteries, etc. "Within reach" is a big place for a toddler- they explore by crawling and walking wherever they can. Since their mouths are one of the most sensitive parts of their bodies, they lick and taste new things they find, and pop them inside for a really good going-over. Thus to keep children safe from choking, parents, grandparents, and other sitters need to be diligent. Caregivers should periodically get on their hands and knees and explore the house and yard like a toddler would- finding and cleaning up all small things that the child might ingest. You can look on-line for all sorts of other ways to "toddler-proof" their world. Keeping non-food items out of your child's mouth is one thing; but food is also a choking hazard. My boy, who choked on the teething biscuit as a baby, had a second episode when he was 5 years. When we were leaving a restaurant he grabbed a peppermint from the bowl on the counter. Once in the car I was backing out of the parking space, looked over my shoulder, and saw a scared look on my son's face. His hands flew to his throat, the classic sign of choking. Since he was older, the back blows I used when he was a baby were no longer appropriate. I jumped out, grabbed him from his seat, and administered the Heimlich maneuver. After five abdominal thrusts the peppermint was expelled and my son was breathing again. Like we said above, prevention is the best medicine for choking. The American Academy of Pediatrics recommends avoiding these foods for young children: hard candies like that peppermint, un-cut hot dogs, nuts, peanut butter chunks, popcorn, seeds, whole grapes. You get the idea: any firm object large enough to block your child's airway. Grapes are good for kids, they just need to be cut into halves or quarters. Hot dogs need to be sliced. Children don't always chew food thoroughly, and aren't yet able to reliably keep food from falling to the back of their throats. Another important rule is never let toddlers and small children walk and eat. It's hard for a kid to do both when they're still new to those activities. When kids walk, they breathe harder, chew less, and thus increase choking risk. And when they're walking, they can walk out of your sight and choke to death without you even knowing it! Therefore, all kids from infancy to elementary school should sit while eating, where they can be monitored by adults. And as I have repeated, we highly recommend that every parent, caregiver, and babysitter take a BLS/First Aid course to have the skills to save a choking child. Like I did twice with my son, you may save a life very important to you!