A PARAMEDIC has shared an urgent warning to all parents around the dangers of 'milk choking'.
Also known as aspiration, this can happen when something gets into the lungs by accident.
First aid expert and former paramedic Nikki Jurcutz, said this is an incident that commonly happens with liquid, which is why it's referred to as 'milk choking'.
It can also happen with saliva, food and vomit.
She highlighted that recent cases have sparked an interest in the condition, after a four-month-old baby died in India after choking on breast milk.
Nikki, who is also the CEO of Tiny Hearts Education said it's most common in the newborn days, when little ones have tiny airways.
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"They can also have a lot of mucous post-birth," she said.
The expert explained: "Aspiration can cause serious health concerns, such as pneumonia, as the foreign material in the lungs can affect oxygen levels and damage lung tissue."
The NHS states that aspiration pneumonia can develop after accidentally inhaling something, such as a small piece of food.
It's important to note, that aspiration is different to choking, as if a child has something lodged, then an airway can be either partially blocked or completely blocked.
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In comparison, aspiration is when a foreign material in the lungs is affecting oxygen levels and damaging lung tissue, Nikki said.
The former paramedic said milk choking is something many parents ask her about.
Often with aspiration, Nikki said little ones will present with a mild airway obstruction where the child will cough and splutter.
Then the foreign material, such as milk or food, will make its way down to the lungs.
"Silent aspiration is also possible where no signs or symptoms are seen at the time of aspiration," she said.
What are the signs of aspiration you must know?
Nikki explained that there are some things you can look out for when it comes to milk choking.
- weak sucking
- choking or coughing while feeling
- other signs of feeding trouble, like a red face, watery eyes, or facial grimaces
- signs of respiratory disease
- voice or breathing that sounds wet after feeding
- fever after feeding
- wheezing, whistling and other breathing problems
- repeated lung or airway infections
- complaints of food feeling stuck or coming back up
If you little one is in moderate or severe respiratory distress then you should call 999.
This silent type usually appears in children who have recently been unwell with respiratory issues, she added.
"Aspiration should be suspected in a child who has recently eaten or had a drink, which is then followed by respiratory distress," she said.
What you must do
Nikki explained that if you think your child is suffering with a partial obstruction with aspiration, then you should encourage them to cough.
In young children, you should demonstrate coughing to them, to show them what they need to do, she advised.
If they are unable to clear the obstruction you should call 999.
If it's cleared, but your little one is still showing signs then you should call 111 or seek immediate advice from a medical practitioner.
For children who have a severe obstruction with aspiration, you must call 999 immediately.
In order to remove this, Nikki said you need to deliver five back blows, checking the airway after each one.
If the airway is still obstructed, you then need to deliver five chest thrusts, checking the airway after each one.
You should continue this pattern until the obstruction clears.
In the event of your little one becoming unconscious, you should start CPR.
How to perform baby and child CPR
Dr Lynn Thomas, Medical Director for St John Ambulance, said before beginning resuscitation, you should ask a helper to call 999 or 112 for emergency help while you start CPR.
Ask a helper to find and bring a defibrillator if available. If you are on your own, you need to give one minute of CPR before calling on a speaker phone. Do not leave the child to make the call or to look for a defibrillator.
Baby (under one year old)
What to look for:
- The baby isn’t responding
- The baby isn’t breathing normally
How to give CPR to a baby:
- Open their airway and start CPR. Place them on a firm surface and open their airway. To do this, place one hand on their forehead and very gently tilt their head back. With your other hand, use your fingertip and gently lift the chin
- Give five initial puffs. Take a breath and put your mouth around the baby’s mouth and nose to make a seal and blow gently and steadily for up to one second. The chest should rise. Remove your mouth and watch the chest fall. That’s one rescue breath, or puff. Do this five times. If their chest doesn't rise, check the airway is open.
- Give 30 pumps. To do this, put two fingers in the centre of the baby’s chest and push down a third of the depth of the chest. Release the pressure allowing the chest to come back up. Repeat this 30 times at a rate of 100 to 120 pumps per minute. The beat of the song ‘Nellie the Elephant’ can help you keep the right rate.
- Open the airway and give two more puffs. Continue alternating between 30 pumps and two breaths until emergency help arrives and takes over or the baby starts showing signs of life and starts to breathe normally.
- If the baby shows signs of becoming responsive, such as coughing, opening their eyes, making a noise, or starts to breathe normally, put them in the recovery position. Monitor their level of response and prepare to give CPR again if necessary.
Child (over one year old)
What to look for:
- The child isn’t responding
- The child isn’t breathing normally
How to give CPR to a child:
- Open their airway. Do this by placing on hand on their forehead to tilt their head back and use two fingers from the other hand to gently lift their chin.
- Give five rescue breaths. Blow into their mouth gently and steadily for up to one second until the chest rises
- Give 30 chest compressions. Put your hand in the centre of the child’s chest and push down a third of the depth of the chest. Release to allow the chest to rise again. Repeat 30 times at a rate of 100 to 120 compressions per minute.
- Open the airway and give two more breaths
Continue alternating between 30 chest compressions and two breaths until
emergency help arrives and takes over the child starts showing signs of life and starts to breathe normally or a defibrillator is ready to be used
- Use the defibrillator
If the helper returns with a defibrillator, ask them to switch it on and follow the voice prompts while you continue CPR.
- If the child starts becoming responsive such as coughing, opening eyes and starts to breathe normally, put them in the recovery position and monitor their level of response.
In children cardiac arrest is likely to be due to a respiratory cause and so rescue breaths can be critical.
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Doing rescue breaths may increase the risk of transmitting the COVID-19 virus but it is very likely the child will be known to you.
However, this risk is small compared to the risk of taking no action as this will result in certain cardiac arrest and the death of the child.
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