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Reduce choking hazard for your children

Consumer Reports News: August 26, 2011 12:08 PM

You may want to think twice about offering foods like whole hot dogs, hard candy grapes and nuts to children younger than 5. For these young children, who don’t always chew their food properly or completely, choking remains an intractable hazard leading to injury and in some tragic cases, to death. Besides those foods, other choking risks include coins, small flat button batteries, un-inflated or broken latex balloons and other types of toys.

“Choking hazards are not on the radar,” said Dr. David H. Darrow, former chairperson of the American Academy of Pediatrics Section on Otolaryngology-Head and Neck Surgery. While “a lot of kids survive choking events, there’s still pneumonia and other complications.”

To reduce these preventable occurrences, the American Academy of Pediatrics and the American Academy of Otolaryngology—Head and Neck Surgery, have launched a campaign for choking prevention.

“In the U.S., we’ve not changed the incidence of choking hazards over the last 30-40 years,” said Dr. Scott Schoem, current chairperson of the AAP Section on Otolaryngology. “We haven’t made any progress. It’s very disappointing. This is totally preventable. Parents and daycare workers and caregivers are still feeding children foods like peanuts, seeds, large chunks of hot dogs and grapes.”

These particular foods are problematic because of size, shape and texture, said Dr. Darrow, adding that basically anything that “is globular-shaped and has a smooth texture“ are high-risk foods. So, too, are seeds, nuts, chunks of peanut butter, marshmallows, and sausages — any foods that are smooth, round and can block a child’s airway. One of the major problems is that young children, between the ages of 1 and 4, “don’t have all the teeth needed to chew,” said Dr. Darrow. That means that fruits and vegetables like apples and carrots “require a lot of preparation” so they’re safe for children to eat.

And unlike toys, foods don’t contain warning labels about being choking hazards. <5> Chewing gum shouldn’t be given to young children under any circumstances. If you’re unsure about the size of a toy, or type of food, you can gauge it’s size by trying to pass it through a standard small parts cylinder that you can buy at a juvenile products store, a toilet paper roll, which is 1¾ inches in diameter. If the toy or food fits through, it is a choking hazard

The reality, said Dr. Schoem, is that young children, especially in the 1-3 age group, “get into things. You can’t completely child-proof your home.”


Still, with proper care and preparation, even foods like hot dogs, grapes or apples can be safe. When they are “cut appropriately, it’s not a problem,” said Dr. Darrow.

Here are some recommendations from the AAP and AAO-HNS:

• Don’t give young children hard, smooth foods that must be chewed with a grinding motion. Avoid peanuts until your child is 7 or older.
• Don’t give your child round, firm foods like hot dogs and carrot sticks unless they are chopped completely. Cut or break the food into bite-size pieces (no larger than ½ inch) and encourage your child to chew thoroughly.
• If your child is starting to fall asleep, don’t let him continue to feed himself.
• Cut foods, like grapes, other fruits, meat, cheese and raw vegetables into small pieces and shapes that won’t block a child’s airway. Hot dogs should be cut lengthwise and widthwise.
• Supervise your toddler and preschooler during mealtimes. She shouldn’t eat when playing or running. Children should be sitting down when they eat.

See our buying advice and Ratings for food and beverages and for a wide range of products for babies and kids.

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Merri Rosenberg


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