Colin Snow
Many parents worry about their newborn choking on their spit-up or vomit while sleeping. While this is a valid concern, it is important to note that placing your baby on their back to sleep is generally recommended and provides them with airway protection. Sleeping on the back allows gravity to act so that any vomit or spit-up will flow back down the oesophagus, reducing the risk of choking. On the other hand, sleeping on the stomach increases the risk of choking as the oesophagus sits above the upper airways, causing vomit to pool at the trachea opening. Therefore, it is advised to place newborns on their backs to sleep, reducing the likelihood of choking and lowering the risk of Sudden Infant Death Syndrome (SIDS).
| Characteristics | Values |
|---|---|
| Can newborns choke in their sleep? | It is unlikely for a newborn to choke in their sleep if they are placed on their back. |
| Safe sleeping position for newborns | It is recommended to place newborns on their back while sleeping to reduce the risk of choking and sudden infant death syndrome (SIDS). |
| Risk factors for choking | Risk factors for choking in newborns include sleeping on the stomach, vomiting, spit-up, and certain physical conditions that affect airway clearance. |
| Preventative measures | To prevent choking, avoid using pillows, positioners, bumpers, or devices that restrict movement. Ensure the sleeping surface is firm and flat, and always supervise newborns while eating. |
| Choking response | If a newborn is coughing, encourage them to keep coughing. If they are unable to breathe or make noise, call for emergency help and perform first aid interventions such as back slaps and chest thrusts to dislodge any obstructions. |
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What You'll Learn
Newborns sleeping on their backs are less likely to choke
It is understandable for new parents to worry about their newborn choking in their sleep. However, according to medical professionals, newborns sleeping on their backs are less likely to choke. In fact, the American Academy of Pediatrics (AAP) recommends that all healthy infants under the age of one sleep on their backs.
Sleeping on the back is the safest position for newborns, including those born prematurely or with reflux, until they are one year old. This is because the back sleeping position reduces the risk of sudden infant death syndrome (SIDS) and other sleep-related deaths. SIDS is the sudden and unexplained death of a baby younger than one year old and is the leading cause of death among infants one month to one year old.
When a baby sleeps on their back, the upper respiratory airways are positioned above the oesophagus, which is the tube that carries food and fluids from the mouth to the stomach. This means that if a baby spits up or vomits while sleeping on their back, gravity will pull the fluids back down into the oesophagus and stomach, reducing the risk of choking. On the other hand, when a baby sleeps on their tummy, the oesophagus sits above the airways, causing vomit to pool at the opening of the trachea (windpipe), increasing the risk of choking.
While it is rare, choking can occur in newborns while they sleep. If a baby is coughing, you should encourage them to keep coughing to clear the obstruction. If the baby is unable to breathe or make any noise, indicating a complete blockage of the airway, immediate action is necessary. Call emergency services and follow their instructions while tending to the baby. Place the baby face down on your non-dominant arm with their head lower than their body and use the heel of your hand to give five firm slaps between the shoulder blades to dislodge the object. If the object does not move, place two fingers at heart level on the baby's breastbone and thrust down rapidly and forcefully five times to help supply the body with oxygen. Continue alternating between back slaps and chest thrusts until help arrives.
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Choking hazards to avoid
It is extremely unlikely for a newborn to choke on their back while sleeping. Research shows that otherwise healthy babies can sleep safely on their backs, even if they have been throwing up. This is because an infant's body has reflexes (head turning, coughing, and swallowing) that prevent fluids from entering the airway. In fact, babies who sleep on their backs are less likely to choke than babies who sleep on their stomachs.
However, choking hazards for newborns do exist in other forms, and it is important to be aware of them to ensure your baby's safety. Here are some choking hazards to avoid:
Foods:
- Always supervise your child during mealtimes and ensure they are sitting down.
- Avoid giving your baby a bottle in bed.
- Cut solid foods into small pieces, no larger than your fingertip or a pea.
- Avoid giving your baby foods that are choking hazards, such as whole corn kernels, uncut grapes or cherry tomatoes, hard raw vegetables or fruits, whole nuts and seeds, dried fruits, large chunks of meat, and hot dogs.
Objects:
- Keep small objects out of your baby's reach. Objects smaller than 1 1/4 inches in diameter or 2 1/4 inches in length can pose a choking hazard.
- Avoid buying toys with button batteries and keep loose batteries out of reach.
- Keep older siblings' toys, such as Lego, doll clothes, beads, and car parts, separate and out of reach.
Remember, it is always a good idea to talk to your child's doctor or nurse to learn more about choking hazards and how to respond in an emergency.
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What to do if a newborn chokes
It is understandable for new parents to worry about their newborn choking in their sleep. However, it is important to note that newborns have reflexes that help prevent choking, such as head turning, coughing, and swallowing, which keep their airway clear. In fact, studies have shown that sleeping on their backs reduces the risk of choking and sudden infant death syndrome (SIDS).
Nevertheless, it is crucial to be aware of the signs and know what to do in case your newborn chokes. Here are some steps you can take:
- Check the Scene and Assess the Situation: Before taking any action, ensure you are in a safe position and quickly assess the situation. Check if there is any visible obstruction in the baby's mouth and if the baby is conscious.
- Encourage Coughing: If the baby is conscious and coughing forcefully or has a strong cry, do not interfere. Encourage the baby to keep coughing and be prepared to act if their condition deteriorates. A strong cough can help dislodge the obstruction.
- Back Blows: If the baby is not coughing forcefully or is unable to clear the obstruction, you can try delivering back blows. Sit, kneel, or stand, supporting the baby's back along your forearm, with your thigh providing additional support. Ensure the baby's head is lower than their body. Use the heel of your hand to deliver 5 quick, firm back blows between the baby's shoulder blades.
- Chest Thrusts: If the back blows do not dislodge the object, turn the baby face-up while continuing to support their head and neck, keeping their head lower than their chest. Place the baby on your thigh or lap. Use two fingers to deliver 5 quick chest compressions just below the nipple line, compressing the chest by one-third to one-half of its depth.
- Alternate Between Back Blows and Chest Thrusts: Continue alternating between 5 back blows and 5 chest thrusts until the obstruction is cleared or the baby loses consciousness.
- Call for Help and CPR: If the baby loses alertness, shout for help and begin CPR immediately. Call 911 or your local emergency number after one minute of CPR.
- Remove Visible Objects: If you can see the object blocking the airway, try to remove it with your finger, but only if you can easily do so without causing further obstruction.
- Seek Medical Attention: Even if you successfully dislodge the object and the baby seems fine, always call your doctor after a choking incident as a precautionary measure.
Remember, the best way to prevent choking and reduce the risk of SIDS is to place your baby on their back when sleeping, both for naps and at night. This sleeping position ensures that even if your baby spits up or vomits, the fluids will flow out of their mouth due to gravity, reducing the risk of choking.
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Safe sleeping positions to avoid choking
It is understandable for parents to worry about their newborn choking in their sleep. However, it is important to note that newborns have reflexes, such as head turning, coughing, and swallowing, that help prevent fluids from entering the airway and causing choking. These reflexes help keep the airway clear even if the baby spits up or vomits while sleeping.
The safest sleeping position for a baby is to lie on their back on a flat, firm, and waterproof mattress. This position reduces the risk of sudden infant death syndrome (SIDS) and other sleep-related deaths. Research has shown that babies who sleep on their backs have a lower risk of choking compared to those who sleep on their stomachs or sides. Sleeping on the back also allows any spit-up or vomit to flow out of the baby's mouth, reducing the risk of choking.
It is recommended to place your baby on their back for every sleep, including naps and at night, until they are one year old. Once babies can roll over on their own, you can leave them in the position they choose as long as they start sleeping on their back. It is also important to keep the baby's sleeping space clear of any items, such as toys, that could cover their face and obstruct their airways.
Additionally, it is recommended to keep the baby in the same room as the parents or caregivers for the first six months. This allows for close monitoring and provides added safety. It is also important to note that side sleeping is not recommended as it is unstable, and babies may roll onto their stomachs, increasing the risk of SIDS.
By following these safe sleeping positions and recommendations, parents and caregivers can help reduce the risk of choking and create a safer sleeping environment for their newborns.
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Co-sleeping and choking
Co-sleeping, or bed-sharing, is a common practice where parents or caregivers sleep in close proximity to their baby. While co-sleeping can have benefits, such as facilitating breastfeeding and enhancing the bond between the baby and the parents, it also raises concerns about the risk of choking and other sleep-related hazards.
It is important to distinguish between choking and other sleep-related hazards, such as Sudden Infant Death Syndrome (SIDS). Choking refers to the obstruction of the airway by a foreign object, such as vomit, food, or saliva. On the other hand, SIDS is the sudden and unexpected death of an infant that remains unexplained after a thorough investigation.
Research suggests that the risk of choking during sleep is influenced by the sleeping position of the baby. Sleeping on the back is generally recommended for newborns and infants up to one year old as it reduces the risk of SIDS and other sleep-related deaths. Sleeping on the back also minimizes the risk of choking on vomit or spit-up. This is because, in the back-sleeping position, gravity helps to direct any fluids towards the oesophagus and stomach, preventing them from entering the trachea (windpipe). Additionally, babies sleeping on their backs can easily turn their heads, cough, or swallow, further reducing the risk of choking.
On the other hand, sleeping on the stomach or side increases the risk of choking. When a baby sleeps on their tummy, vomit or spit-up can pool at the opening of the trachea, making it easier for these fluids to enter the airway and cause choking. Side sleeping is also unstable, as babies can easily roll onto their stomachs, which is the position associated with the highest risk of SIDS.
Co-sleeping itself does not directly increase the risk of choking. However, certain factors related to co-sleeping may influence the likelihood of choking or other sleep-related hazards:
- Sleeping position: In a co-sleeping arrangement, it is important to maintain the recommended sleeping position for the baby, which is usually on their back. Placing the baby on their stomach or side to sleep increases the risk of choking and SIDS.
- Bedding and sleep environment: Soft bedding, pillows, or other sleep positioners in the co-sleeping environment can pose a risk of suffocation, strangulation, or entrapment. It is recommended to keep the baby's sleeping space clear of any objects that could obstruct the airway or restrict movement.
- Alcohol and sedative consumption: If a breastfeeding mother consumes alcohol or sedatives before bedtime, it can increase the risk of choking during sleep for the baby. These substances can relax the throat muscles and suppress protective reflexes, making it easier for aspiration (inhaling foreign substances into the airway) to occur.
- Smoking: Exposure to secondhand smoke is a risk factor for choking and other respiratory issues in newborns and infants.
- Health conditions: Certain health conditions in the baby, such as gastroesophageal reflux disease (GERD) or a history of birth defects like cleft palate, may increase the risk of choking during sleep. It is important to follow the recommendations of the baby's paediatrician regarding sleeping positions and other precautions.
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Frequently asked questions
It is extremely unlikely that a newborn will choke in their sleep if they are placed on their back. This is because an infant's body has reflexes, such as head turning, coughing, and swallowing, that prevent fluids from entering the airway.
Placing a newborn on their stomach to sleep is associated with the highest risk of Sudden Infant Death Syndrome (SIDS). Sleeping on the stomach may block the airway and increase "rebreathing", which is when babies breathe in their own exhaled air.
Signs that a newborn is choking include the baby stopping breathing in their sleep, turning blue, or not waking up. If the baby is coughing, encourage them to keep coughing. If the baby cannot breathe or make noise, this means that something has completely blocked their airway, and immediate action is necessary.
If the baby is under 1 year old, place the baby face down on the adult’s non-dominant arm with their head lower than their body. Using the heel of the hand, give five firm slaps in between the shoulder blades. If the object does not move, place two fingers at about heart level and thrust down five times at a rapid but forceful rate to help supply the body with oxygen. Continue alternating between back slaps and chest thrusts until help arrives.
