7.5.4  Choking after a vitamin A dose

If an infant or child starts choking when you administer the vitamin A dose you should do the following:

For infants:

  • Lay the infant on your arm or thigh in a head down position
  • Give five blows to the infant's back with heel of hand
  • If obstruction persists, turn the infant over and give five chest thrusts with two fingers, one fingerbreadth below nipple level in midline (see Figure 7.3).
Resuscitation method to overcome choking for infants
Figure 7.3  Resuscitation method to overcome choking for infants.(Source: Federal Ministry of Health, March 2006, Guidelines for the enhanced outreach strategy (EOS) for child survival interventions)

For children:

  • Give five blows to the child's back with heel of hand with child sitting, kneeling or lying
  • If the obstruction persists, go behind the child and pass your arms around the child’s body; form a fist with one hand immediately below the child’s breast bone (sternum); place the other hand over the fist and pull upwards into the abdomen; repeat this Heimlich manoeuvre five times (see Figure 7.4)
  • If the obstruction persists, check the child’s mouth for any obstruction, which can be removed
  • If necessary, repeat this sequence with backslaps again.
Resuscitation method to overcome choking in children
Figure 7.4  Resuscitation method to overcome choking in children. (Source: Federal Ministry of Health, March 2006, Guidelines for the enhanced outreach strategy (EOS) for child survival interventions)

Table 7.4 below is a summary of the different symptoms you might observe as side effects of vitamin A administration, which include overdose and accidental choking. It also describes how you can prevent these from happening and what actions you need to take to overcome these problems if they occur.

Table 7.4  Potential problems of vitamin A administration.
SymptomsPreventable?Action required
Side-effectHeadache, loss of appetite, vomiting or a bulging fontanel (in infants)NO, it happens with approx. 5% of childrenAdvise the parent that this is normal, symptoms will pass and no medical treatment is necessary
Not harmful
OverdoseVomiting and lethargy/listlessnessYES, if protocol is followedRefer for medical treatment
Only occurs if child takes multiple doses togetherReport
ChokingAccidental blocking of tracheaYES, if proper administration of the vitamin A dose is carried outResuscitation
Report

7.5.3  Administering vitamin A supplements safely using a capsule

7.5.5  Dietary diversification and modification for Vitamin A