Baby Led Weaning

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Archive for the ‘The Gagging Thing…’ Category

FYI New Guidelines on Choking and Infant Resus

Thursday, February 20th, 2014

First of all, it goes without saying that if you’re doing BLW this is an area that you will have looked into already. (And if you haven’t… as they say on the adverts… just do it. Crazy not to.)

Personally, I think every parent should try to investigate some basic infant resus, because as those little blighters become more mobile and more curious they have a habit of picking more daft objects up to check if they are food or not. I cannot tell you how high we had to keep our first daughter’s brightly coloured school erasers in order to keep them away from our younger child.

From what I saw on our Facebook page this morning, it seems like this is a technique already advocated in the US and Australia, but for the benefit of the UK and anyone else who is interested, here is the latest video as featured in a Sky news report. 

In fact, it differs only very slightly to the rather brilliant UK National Health Service video ‘How to help a choking child’.  

Can you see, in the NHS video the baby rests on the woman’s arm throughout much of her resus? Whereas St John Ambulance are now saying that there will be better support if the child is on the arm AND thigh? A tiny difference but if it’s best practice, let’s do it! (Might have been better if the St John uniform wasn’t so dark, eh? Can you even see those trousers?)


choking image

As an aside, it is also interesting to query the figures mentioned in the Sky News report, reproduced below. In a survey of parents of 1000 under-fives, 380 said they had seen their child choke, with only 50% knowing what to do in that event. There are two ways of looking at this… one, 190 children choked, and their parents didn’t know what to do but everyone (we assume, for Sky News would have looked for the goriest story possible) was okay. That’s encouraging (but still do your homework).

The other way of looking at it is that parents STILL don’t know the difference between choking and gagging and some of the chokes were mis-represented gags. It is worth knowing the difference as going straight for resus when they’re dealing with a gag can cause babies to aspirate food.

Gagging is actually a safety response to food travelling too far back into the mouth so when we see our babies gagging they are actually handling the problem and it’s best just to keep calm (or at least look calm) and wait until it passes. Choking, you will know about. The baby looks panicked, no or very little sound can come out, and lips may actually start turning blue. Be smart, educate yourself and know how to act quickly. 

So all in all, it’s good news for the BLW crew, in that each and every one of us should already have considered choking, and how we will respond should it happen. (For the record, it happened once with my first child… dratted raw apple, and this below was her a minute later, after she had gotten over it and was onto a rice cake. It just never happened with my second.)


New first aid advice on how to help a choking baby has been issued to parents.

St John Ambulance, the British Red Cross and St Andrew’s First Aid have updated their advice after research suggested that many parents did not know what action to take.

The new advice is to place the baby face down along the thigh while an adult strikes the child’s back.

First aid experts say this gives the baby more support compared with the previous advice, which was to place the baby along the adult’s arm.

A survey of 1,000 parents of under-fives found 38% had seen their child choke.

Half of the parents said they did not know the correct way to help their child or how to clear the obstruction.

Nearly half said they avoided giving their child certain foods in case they choked.

Clive James, training officer at St John Ambulance, said: ‘If an infant is choking then, in the first instance, they should be laid face down along your thigh and supported by your arm, give them five back blows between the shoulder blades with your heel of your hand.

“Previously this was done along the arm but the leg is felt to be more secure and provide more support.

“Check their mouth for any obstruction. If there is still a blockage then turn the infant onto their back and give up to five chest thrusts.

“Use two fingers, push inwards and upwards against their breastbone.

“If the obstruction does not clear after three cycles of back blows and chest thrusts, call for an ambulance and continue until help arrives.”


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Baby Led Weaning Diary.. And it’s goodbye from Siobhan and some stuff about choking.

Friday, March 9th, 2012

Hello all, Siobhan Courtney has finished her diary for us now, having returned from the country and done a bit of practise infant resus… (truth be told she returned some time ago and this got rather lost in my inbox at Christmas. Bad Aitch.) I hope you’ll join me in thanking her for her thoughts and experiences over this exciting developmental (emphasis on ‘mental) stage.

For the record, the first image I have used to illustrate the piece is what one would do for a child of 12 months and over, where you place over your knee and give five blows between the shoulder blades, using the flat of your hand.

With babies, you lie the baby over your forearm so that you know you are giving support to the neck, illustrated further down. If that doesn’t work, it’s onto chest thrusts, which are explained in more detail by the St John Ambulance below*.

“Fellow BLW’ers is sadly the end of our journey. I have really enjoyed sharing it all with you and it’s been wonderful to read all your comments and tips – thank you so much.”

“Back in the country and back in the classroom – (well kind of….)

So I’ve managed to transport a BLW’ing baby back into the country safely and soundly after my very first road trip with Alban. We only went to Wales but what a wonderful adventure it was. I packed a special BLW bag for Alban as I didn’t want to get caught out again. Our ’essential stock’ consisted of breadsticks, apple slices, cheese chunks, red pepper wedges and a banana. Needless to say all very manageable finger foods resulting in a rather varied lunch for the little man at the motorway services!
Our little trip was relatively drama free to be honest. I feel so much more confident about eating out now with him – practice really does make perfect. However, most of the time it’s a real job to get him to eat any of his lunch because he’s just too busy nosing around. I was also very impressed that he had an extremely spicy penne arrabbiata that he ate quicker than me. What a proud parent moment that was – isn’t it funny how you just get so excited over something that must sound so mundane to others?!

One really interesting outcome of our week away is that Alban’s taste buds seem to have totally changed. He’s now not overly fussed about melon, broccoli, carrots and spinach despite not getting enough of them previously. However, I suspect that may have something to do with Mummy serving them to him practically every day. Maybe he’s just decided he’s had enough of those for a while and is enjoying embracing his new found penchant for potatoes, toast, banana and breadsticks. Carb overload anyone? It seems pretty normal though for the fickle little things to love one type of food one week and hate it the next. Anyone else found this?

So, 6 weeks into our BLW journey the subject of choking does tend to linger at the back of my mind. Not in a scary way, but just (god forbid) if anything did happen I wouldn’t have a clue what to do – apart from scream and panic. With that in mind I thought it would be sensible to book onto a first aid course. I’m writing this now after just returning from it proudly brandishing my first aid certificate (my first one ever!) Anyway, I feel so much better after this evening. I really would recommend attending a course – mine was through my children’s centre and they run pretty regularly throughout the year.

Interesting highlights from this evening was the trainer telling the class the two biggest causes of choking in babies is grapes and cherry tomatoes – in that order. There are very few cases of choking though so that should be put into perspective. Our trainer said he’d recently been working with a number of nurseries, who are now cutting the grapes and tomatoes into quarters rather into halves. He said they’re taking the initiative because ‘one can never be too cautious’ and to also soothe parental worries. The advice for parents is to squish them flat before offering them to your child.

We were also told never ever to hold our babies upside down by their feet if they’re choking. Even if you’re so hysterical and think this may be a good idea at the time the baby’s head and neck would be totally unsupported. This dangerous position would also not help at all in dislodging a stuck piece of food.

As I’ve only attended a short course I should state strongly that I am by no means qualified to give medical advice – these are just my experiences from my class tonight. I really do feel the advice we were given tonight though was invaluable. Even if you can’t get a babysitter, take your sleeping baby with you and just park your buggy in a quiet corner of the room – the course is really worth it. There’s also some excellent advice on choking on the St John’s Ambulance website which was recommended as an essential resource. I had a quick look at the site before signing up to the class and was pleased that the trainer made us practice the back blows and abdominal thrusts on plastic dolls until we knew what we were doing.

It was really reassuring to know we were being taught best practice even though I didn’t actually attend a St John’s Ambulance course, but everything we covered was the same as the information on their website and that of the British Red Cross. The trainer also recommended we regularly test our skills online to keep refreshing what we learnt on the course. And finally, apparently this First Aid Manual is an absolute must have for every home with children. It covers how to deal with every emergency and I‘m actually finding that it’s not that bad of a bedtime read.”

Thanks, Siobhan!

*Management of Choking – Children

For all children (above 1 years of age), the management of choking is the same as for an adult:
1. Ask child to cough up obstruction.
2. Give five sharp blows between the shoulder blades
3. Give five chest thrusts.

Management of Choking – Infant (to 1 year)

Lie infant face down on your forearm with head low.
Support infant’s head and shoulders on your hand.
Give 5 sharp blows between shoulders.
Check after each back blow to see if the obstruction has been relieved.
If the blockage is still not cleared, your last resort is ‘chest thrusts’. For infants, this is performed by placing the infant on a firm surface on back. Place two fingers in the CPR compression position and give 5 chest thrusts; slower but sharper than CPR compressions.

Choking Summary
· Encourage the casualty to relax and breathe deeply.
· Ask the casualty to cough to remove the object.
· If unsuccessful, place the casualty with the head low.
· Give 5 sharp blows between the shoulder blades.
· As a last resort, try ‘chest thrusts’.
· While waiting for the ambulance, if the blockage has not cleared, repeat back blows and chest thrusts.
· If the casualty becomes unconscious, remove any visible obstruction from mouth and commence CPR.

There’s a really great summary here as well, from BabyCenter.

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Choking – why we need to stop uselessly fretting about it and instead Learn What To Do If It Happens.

Monday, July 4th, 2011

Have a look at this article from the Daily Mail, it perfectly (and sadly) sums up what we BLWers bang on about constantly. Cut Stuff Up.

We’ve all been through what the poor, poor mother of 18-month-old Toby has, that moment when you are at someone else’s house and they don’t cut up grapes and you have that moment of preciousness thinking ‘oh I really don’t want my kid eating those but am I prepared to make myself look like a prat by going and getting a knife..?’ well, give into it. That’s parental instinct, that’s wot that is.

As for the blueberries… lord I hadn’t even thought about them. Certainly with my two girls I am at pains to get them to cut round things in half with their teeth before they put them into their mouths, but I have never considered blueberries actively dangerous. Maybe our grandmothers knew what they were doing, encouraging us to take dainty mouthfuls? I guess the instinct that I had to squish anything that looked a little too robust (blueberries and clementines in particular if I recall correctly) served me well.

Thankfully (given that it is in the Mail) the main thrust of the article I agree with wholeheartedly – we should all do an infant resus course, something this site has been saying For Ever. What possible harm can it do?

I’ve said it before but the only time I’ve had to pick a kid up, turn them upside down and wallop their back hard was some child in the park, no relation of mine and many, many years beyond the weaning stage. (Incidentally, the descriptions of what a choke looks like in that piece seem to me to be excellent, from what I observed that day. It’s hard to put that look of silent, exponential panic into words). I only thank God I was there that day, for had I not been, that little boy’s story might have been infinitely worse than little Toby’s.

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People around us and their definition of choking

Monday, October 9th, 2006

This post is really more of a rant than a fact or experience or anything useful like that. My current bugbear is the use over-use of the work 'choking'. Relatives are always saying Boomer is 'choking!'.

Choking to me is a severe restriction or blockage of the airways resulting in no air getting in, NOT a slight gulp/sneeze/snivel. She can be quite happily eating bits of food, without even any gagging and people around her are convinced she’s choking. Are there subtleties to the word choking that I am unaware of?

Plus they do that annoying baby ventriloquism to express their views… “Oh she’s saying Mummy, why can’t I have a bit of strawberry tart?”. No, she’s not, she’s trying to eat a paper napkin. And nor would she like a bit of sugar on her fruit to sweeten it up, while we're about it.

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A Gagging Addendum

Wednesday, July 26th, 2006

A nice lady whose name escapes me has just written to me on another website to ask me if Babybear ever vomited after a gagging sesh. And of course she did, but because she hasn't done it in a while I had completely forgotten about it. How remiss of me…

So yes, she did do some puking after a big gag, but I just used to put my hand out to catch it and not make a fuss about it. A bit of 'oh, poor Babybear' and then back to her lunch.

What was peculiar about the vomit was that it seemed very mucus-y as opposed to sicky, almost as if her body had produced some sort of emergency lubricant to help clear her throat. I'd be really interested to know if anyone else had experienced this, so comment please if you can?

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The Gagging Thing v. The Choking Thing

Tuesday, July 25th, 2006

Okay, here goes.
I have no idea why I am largely impervious to the sight of my beloved daughter gagging… perhaps I am just cruel? Other people, such as her Grandma or her Auntie Sharron to name but two, cross the room at the speed of light the minute Babybear starts the tiniest gagging incident and it's all 'ohmygodshe'sCHOKING!' and slaps on the back.

And what does that achieve, ladies and gentlemen? One upset and confused baby, who was in the process of cleverly moving some food round to the front of her mouth with her tongue when some crazy adult swooped in and started battering her.

I do, however, understand why they react in this way – it's not nice when you see someone you love struggle to do something (and if Grandma and Auntie S take a similar approach when she is buying her first flat then all will be well).

What I can tell you is that prior to starting the baby led weaning business I attended an Infant Resuscitation Class at my local maternity hospital. I should have gone while I was pregnant, apparently, but I didn't, so there.

We got Grandma to baby sit while DH and I (and a couple of friends of ours, actually, which was pleasant cos we went for lunch afterwards) headed for the hospital. There was a heavily pregnant woman there who looked about as dazed as I would have been if I had gone at the correct time. She mostly stared at the plastic doll babies, then looked at her stomach, then back again, as if realising for the first time the enormity of what she had done. (Not to mention the enormity of the thing which would soon be emerging from her lady bits… anyway, I digress).

The class was excellent, can't recommend it too highly. I was lucky that my husband (you know the one, Babybear's father) was able to take the morning off so he could come with me because if it had fallen to me to explain how to resuscitate his child when I got home I would have wanted to smother him. Then resuscitate him, presumably.

Basically we all got to practise with the frighteningly realistic dolls, turning them upside down to pop obstructions out of their mouths and watching their little plasticky chests inflate. It really made me feel a great deal more confident about dealing with incidents, should they arise. Which I'm glad to say they haven't.

Gagging, as opposed to choking, is actually a safety response to food travelling too far back into the mouth so when we see our babies gagging they are actually handling the problem and it's best just to keep calm (or at least look calm) and wait until it passes. I give her a wee drink of water immediately afterwards which she seems to like.

I think that this is actually quite a good infant resuscitation website, but it is no substitute for a real class with a real (fake) baby.

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The Gagging Thing…

Tuesday, July 25th, 2006

So sorry about the lack of info on this subject, I'm having a think about how best to write the advice 'Just chill out for god's sake. They gag. It's what they do while they are learning,' in a more supportive way…

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