Reduce deadly choking risks in children

David Ma

doi:10.1542/aapnews.2010313-26q

Choking is a leading cause of death among children 3 years old and younger.

While choking usually is associated with curious infants putting marbles, coins and toys into their mouths and swallowing them, food-related risks tend to be overlooked. According to the Centers for Disease Control and Prevention, 60% of nonfatal choking incidents result from food.

“If a toy were too small, it would be pulled off the shelves, but there is no surveillance mechanism to monitor choking hazards in food,” said Gary A. Smith, M.D., Dr.P.H., FAAP, of the American Academy of Pediatrics (AAP) Committee on Injury, Violence, and Poison Prevention.

“Even though kids start to get teeth at an early age, they can’t grind the food,” he said.

What makes certain foods more dangerous is their shape and size. Foods such as hot dogs, carrots and grapes can become lodged inside a child’s airway. In addition, food that can change shape, like peanut butter, can form a plug that becomes difficult for children to cough up, Dr. Smith said.

Parents can reduce the risk of choking by following these recommendations from the AAP and other experts:

Cut foods such as grapes and other fruits, meat, cheese and raw vegetables into small pieces and shapes that won’t block airways. Cut hot dogs lengthwise as well as widthwise.
Cook vegetables so they become softer and easier to chew.
Give only small amounts of peanut butter or other similar foods to prevent them from blocking the airway.
Make sure children are not engaged in high-energy activities when they are eating. If they stumble or get scared, they may gasp and swallow large pieces of food.
Offer plenty of liquids to children when eating, but make sure liquids and solids are not swallowed at the same time.

In addition, parents should keep balloons, coins, marbles, button batteries, medicine syringes, pen or marker caps, and toys with small parts away from children. Manufacturers often indicate the appropriate age range of a toy on the box to convey safety hazards and not the toy’s level of sophistication.

Because it is impossible to prevent all choking episodes, parents can prepare for emergencies by learning CPR and choking first aid.