Most parents are pretty savvy when it comes to knowing about choking in young children. Even so, at least one child dies every five days in the U.S. from choking on food, and another ten thousand children are seen in an emergency room each year for choking. Choking is the fourth leading cause of accidental death in children one to nine years of age (surpassed by motor vehicle injuries, drowning, and fires/burns).
While food is the most common cause of choking, toys and small household items also present a choking hazard. Manufacturers must label small toys as being unsuitable for infants and toddlers, but food, of course, carries no warning.
The American Academy of Pediatrics and the American Academy of Otolaryngology joined forces in a campaign to help parents recognize common choking hazards in young children and how to prevent them. A study of data from nearly fifty children’s hospitals around the world found the ten foods most commonly associated with fatal airway obstruction are: hot dogs, hard candy, nuts, grapes, meat, cookies and biscuits, carrots, apples, popcorn and peanut butter.
Other high-risk foods for choking include sticky candy, cheese cubes (and other cubed food), seeds, whole grapes, cherries, chewing gum, marshmallows, pretzel nuggets, small sausages and other round foods that could occlude a child’s small airway.
Choking from food is largely preventable with appropriate supervision and food preparation. Supervision means that you should never leave a small child unattended while eating. A choking child cannot call out for you if you’re in the next room. Children should sit up straight when eating, should have a sufficient number of teeth for the intended food, and the muscular and developmental ability needed to chew and swallow chosen foods. Children with certain neurological or developmental problems may be unable to safely eat foods that children without such conditions can eat.
Young children should eat while sitting in a quiet calm environment with continual supervision. They should not eat while standing, walking, running, playing, lying down, or when they are sleepy. They should refrain from eating while riding on a bike or as a passenger in a vehicle. They should not play games such as catching thrown food in the mouth or stuffing the mouth full of food. Young children are easily distracted and may not pay full attention while they are eating.
Food preparation means cutting foods into age appropriate sizes, especially round foods that could easily occlude the child’s airway (especially grapes and hot dogs). Remove seeds or pits from fruits. It is safer for young children to eat their fruit and vegetables cooked rather than raw. Peanut butter should be thinly spread on bread so it doesn’t form a glob that cannot be swallowed. Offer fluids with meals, but be sure the child has completely chewed and swallowed any food before drinking.
Certain toys and household items pose a special risk of choking. Latex balloons are extremely dangerous to young children. If inhaled, the latex can form an airtight seal over the child’s airway. Other problematic items include coins, marbles, toys with small parts, small balls, pen or marker caps, tiny button-type batteries, magnets, screws, stuffing from a bean bag toy, and jewelry such as rings and earrings. Make sure children cannot get into trash cans that may hold a variety of small objects of interest to a curious toddler.
Be sure other caregivers such as sitters, older siblings, and grandparents know about choking hazards. Ideally, parents and anyone who cares for young children should know child CPR and the Heimlich maneuver.
Read instructions from the Mayo Clinic at: www.mayoclinic.com/health/first-aid-choking/FA00025
or view a video in which a first responder demonstrates the Heimlich at: www.youtube.com/watch?v=LrPfzux2rI4&feature=related.
When it comes to childhood choking, nothing beats supervision and knowledge.
References: “Choking Hazards Campaign,” American Academy of Otolaryngology, at: www.entnet.org/HealthInformation/Choking-Campaign.cfm; “Prevention of Choking among Children,”
American Academy of Pediatrics, at: http://aappolicy.aappublications.org/cgi/content/full/pediatrics;125/3/601; and “Preventing Choking in Children,” American Academy of Pediatrics at: www.entnet.org/HealthInformation/upload/Preventing-Choking-in-Children-News-Article.pdf. Read More