Choking, suffocation and strangulation

Children under five are at significant risk of death, disability and serious injury from unintentional injury. Public Health England makes a strong argument to focus on tackling the leading, preventable causes of death and serious long-term harm. 

Choking, suffocation and strangulation is one of five principal causes of serious injuries for the under-fives in England. Here we look in more detail at the issue and the steps local authorities and their partners can take.

The scale and nature of the problem

These injuries lead to the highest number of deaths for the under-fives – 28 each year – though hospital admissions are low. There are three main causes:

  • Inhalation of food and vomit – over eight under-fives die in England each year. There are low numbers of emergency hospital admissions but stays in hospital are much longer than average. The injuries primarily affect children under the age of two.
  • Hanging and strangulation – results in low numbers of hospital admissions but on average six under-fives in England die each year. Blind cords are a major hazard.
  • Suffocation in bed – over seven under-fives die in England each year.

The links with child development

Food is the most common cause of choking. Babies and young children are learning how to chew, swallow and breathe in the right order and sometimes get them mixed up, causing choking. Babies and small children explore by putting things into their mouths, so small objects and toys can also be risky.

Young children are at risk of strangulation if they catch themselves on looped blind cords or chains, often when exploring or climbing. Also, some children have died from strangulation in cots or beds (including bunk and cabin beds), where straps, cords and ribbons from bags or toys are a hazard. 

The economic case for prevention

Injury prevention can be low cost and there is a tremendous return for young children in terms of preventable years of life lost. Choking, suffocation and strangulation lead to the highest number of deaths for the under-fives.

Action by local authorities and their partners

PHE shows that injury prevention does not require major new investment – much can be achieved by co-ordinating existing services and programmes, building on strengths and developing capacity. Support and training for the early years workforce is key. 

Injury prevention initiatives can include home safety equipment schemes that supply and fit blind cord cleats, and educational campaigns and resources on threats to breathing.

Support from CAPT

CAPT worked closely with PHE to develop the resources and is now offering local authorities evidence-based support for effective action. This includes an opportunity to talk through the PHE guidance and explore local prevention opportunities. To find out more, contact Kevin Lowe on 020 7608 7363.

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Updated September 2014