A leading cause of injury among children, choking can sometimes be fatal – especially in children ages 4 and younger.
“The number of children who choke on food is particularly high, especially because the size, shape and consistency of certain foods make them more likely to be a choking hazard,” according to the American Academy of Pediatrics about a study released earlier this year, “Nonfatal Choking on Food Among Children 14 Years or Younger in the United States, 2001-2009.”
Stephen Teach, MD, MPH, Chair of the Department of Pediatrics at George Washington University School of Medicine and Health Sciences and Director and Principal Investigator of IMPACT DC (Improving Pediatric Asthma Care in the District of Columbia), said most of the choking episodes he and his colleagues see are food-related, particularly among infants and developmentally challenged youngsters who may have swallowing difficulties. Teach said high-risk foods include grapes, raisins, certain nuts and seeds, as well as cut-up carrots and celery, popcorn, and hard candy.
“Hot dogs are a choking hazard because they’re so commonly cooked and perfectly shaped,” Dr. Teach said, adding that they pose a threat especially to toddlers, children under 4 years old, and should be cut into non-round pieces.
Tips to reduce the risk of choking for toddlers:
- Create a safe eating environment and avoid certain foods until your child is 4 years old
- Supervise your child, making sure they are not alone while eating
- Sit your child upright in a high chair
- Discourage talking and eating at the same time
- Cut your child's food into small pieces until their molars come in
- Don’t allow your children to run with food in their mouth
Airway obstructions in young children occurred less often than other injuries, but the mortality rate was higher, according to research conducted by Children’s National pediatric otolaryngologists Sukgi Choi, MD, and Rahul Shah, MD. The study found that “alternative education measures should be considered to train physicians in the management of this infrequent, potentially lethal condition.”
Choking is a major cause of toy-related deaths and injuries.
“Between 2001 and 2012, more than 90 children died from choking incidents,” according to the U.S. Public Interest Research Group, a watchdog organization, which published “Trouble in Toyland,” a survey of hazardous toys.
Common objects children swallow include toys with small parts or toy foods that “look to small children like something that should be eaten,” according to the report, which was published in late November.
Often, when choking, adults will cross their hands over their throats to show they need help. When asked what signs of choking parents should be aware of, Dr. Teach said, “Coughing, gagging, struggling to breath, turning bright red and ultimately blue, and passing out.”
As for toys, be aware of small, round objects that “could easily get stuck in the airway,” Dr. Teach said, such as marbles, coins, and small blocks or anything else that may pose a choking hazard to children. The Consumer Products Safety Commission requires labels on toys that pose a choking hazard to children younger than 3 (Read a copy of the CPSC’s small-parts regulation).
Nonfood items that can be choking hazards:
- Balloons (inflated and deflated)
- Small game parts
- Safety pins
- Pen caps
- Small button-like batteries such as kind used in watches
“This is one of those things where common sense and vigilance are important,” Dr. Teach said. “If it’s too small to give to a child then it’s probably too small to give it to them because it could pose a threat of choking. Be aware that young children can be very aggressive into getting into things so it’s important to keep an eye out, making sure they don’t put anything in their mouth that they shouldn’t. Or that they thoroughly chew their food. Cut up their food, but make sure the pieces are not so small that they can obstruct their airway.
If your child cannot cough out the item themselves, Dr. Teach advises parents to inspect the child’s mouth to look for the object and pull it out, if you can. If your child can not make a sound, call 911 and do the Heimlich maneuver or a series of back blows. If your child swallows something, and their airway is now clear, but there’s concern that a piece may have entered a lung, consult a doctor.