Parents often hear “I’m choking” when a child actually means “it hurts to swallow” or “it feels stuck.”

This guide clarifies the three common scenarios:

1) True choking (airway emergency)

Signs:

  • Cannot breathe, speak, or cough effectively
  • Blue color, severe distress
  • Sudden onset while eating

Action:

  • Emergency response and immediate medical care.

2) Food stuck (esophagus: food bolus)

Signs:

  • Child points to middle chest
  • Needs water to push food down
  • Drooling / cannot swallow saliva (severe impaction)

Action:

  • If drooling/can’t swallow saliva: ER now.
  • If mild and passes: arrange evaluation if recurrent.

3) Painful swallowing (odynophagia)

Signs:

  • Swallowing causes pain
  • Child avoids eating due to pain
  • Can occur with throat infections, pill irritation, reflux inflammation

Action:

  • Assess hydration.
  • Seek care if pain is severe, persistent, or associated with weight loss or dysphagia symptoms.

Quick summary

  • Airway choking is the true emergency.
  • Food stuck is an esophagus problem and can be urgent if secretions can’t be handled.
  • Painful swallowing needs evaluation if it persists or limits intake.