What To Do If A Child Swallows An Object?

A child swallowing a foreign object that blocks their airway is every parent or caregiver's greatest fear. In such cases, timing is crucial, but panicking and using improper methods often causes more harm to the child than the problem itself.

Pediatrician and emergency care specialist for children and adolescents, Nano Shvangiradze, shares important recommendations on what to do (and what not to do) in these emergencies.

Common Mistakes: What Should You Never Do?

In Georgia, many methods passed down through generations are not only medically unfounded but also dangerous. The specialist emphasizes that the following actions are strictly prohibited:

• Suspending a child by the legs - This increases the risk of injury and is ineffective at removing the object;
• Slapping the child on the back (while upright) - This can inadvertently push the foreign object deeper into the airway;
• Reaching into the mouth - If the object isn't clearly visible and easy to grab, searching with your fingers often pushes it further down.

Instead, the "sandwich maneuver" is the gold standard for safety.

For children under one year old, traditional methods like the Heimlich maneuver (abdominal compressions) are dangerous due to the sensitivity of their internal organs. The effectiveness of the sandwich maneuver comes from properly holding the child and allowing gravity to do the work.

How to perform the maneuver step-by-step:

1. Proper fixation (The "Sandwich") - Immobilize the child's lower jaw with one hand (avoiding the throat) and support the back of the head with the other. Position the child between your forearms like a sandwich;
2. The Reclined Position - Turn the child over onto your arm so their head is lower than their body. This ensures gravity helps the object exit rather than letting it slip into the lungs;
3. Directed Blows - Deliver 5 sharp blows with the palm of your hand between the shoulder blades. The force should be directed forward and downward;
4. Repositioning - If the object remains, turn the child onto their back (still head-down) and apply 5 chest compressions using two fingers.

Unlike random back blows, the "sandwich" maneuver keeps the child secure so they don't slip. This method creates an "artificial cough"—a flow of air from within that mechanically pushes the object out. During the maneuver, keep the child’s mouth open and pointing toward the floor.

What if the child loses consciousness?

If the maneuver is unsuccessful and the child loses consciousness, the approach changes immediately. Dr. Shvangiradze recommends these steps:

• Place on a hard surfacen- Lay the child on their back on a flat, firm surface;
• Open the airway - Gently tilt the head back;
• Create a seal - Cover the child’s nose and mouth with your own mouth to create a vacuum;
• Rescue breaths & Compressions - Give two rescue breaths followed by 30 chest compressions. Repeat this cycle.

Will the object penetrate deeper?

Many parents worry that breathing might push an object from the upper airway into the lungs. Dr. Shvangiradze explains this is "a choice between bad and worse."

An upper airway obstruction is an immediate threat to life because air cannot enter the body at all. If the object moves into a lung instead, it is not immediately life-threatening. The child can continue to breathe with the other lung, giving you the precious time needed to get to a clinic where doctors can safely remove the object with specialized equipment.

Knowledge is your most important weapon. Don't rely on old myths—learn the sandwich maneuver and the basics of CPR. These skills could one day save a life.