Common Choking Hazards and How to Prevent Them


To learn what to do in a choking emergency, join our webinar on Infant & Child CPR presented by Ashley Meves, RN.


Few things are scarier than seeing your child struggle to breathe. As a parent, you'd never want to imagine a scenario in which your child chokes on something, but it's vitally important to prepare for this possibility. According to the American Academy of Pediatrics, choking is a leading cause of death among children, especially those under three years of age. Once an object gets stuck in a child's throat, it prevents oxygen from reaching the brain, which can lead to brain damage or death within four minutes.


Food only accounts for 50% of choking episodes. Both edible and non-edible items are to blame - to a baby or toddler, they are one and the same. From foods that are too large to swallow to household items that are too small to notice, here are the most common choking hazards.



Common Foods


To a baby, the act of chewing is a novel skill, and any food that could be caught in his or her throat (making it difficult or impossible to breathe) can be very dangerous if swallowed whole. But choking concerns are not reserved for just parents and caregivers of infants. Any child under the age of five is at risk for choking injury or death. Generally, babies and toddlers should be served soft, forgiving foods smaller than a thumb's width (the size of their airway). Take extra safety measures when preparing the following foods, or else avoid them entirely until your child is over the age of four.


Fruits: Fruit is often a baby's first food, but any firm fruit with skin that can separate from the flesh, such as apples and pears, can cause choking. Remove the skin and seeds of fruit before feeding it to your baby, and if your baby does not yet have a full set of teeth, serve fruit cooked or steamed. Whole grapes are the worst choking hazard of all fresh fruits, followed by cherries, berries and melon balls. These fruits should be sliced lengthwise and quartered for little ones under four years of age.

Hot Dogs: The tube-like shape and compressibility of a hot dog make it a perfect fit for a child's windpipe. When preparing a hot dog for a young child, cut it lengthwise and chop it into small pieces instead of a coin shape. Likewise, cut up other proteins into manageable bites smaller than one-half inch so that if something gets swallowed whole, it won't get stuck. That includes steak, turkey, chicken, fish, and string cheese!


Peanut Butter: Globs of peanut butter can conform to a child's airway and block the ability to breathe. To make peanut butter safer for your little one to swallow, spread it in a very thin layer, serve it with a drink, or dilute it with a little water. Avoid putting peanut butter on soft white bread, which when mixed with saliva, can become pasty and adhere to the back of your child's throat.


Small Vegetables: Most vegetables should be cooked to soften them before feeding to a baby. However, even cooked vegetables can pose a danger to tiny airways. Peas and corn can be easily inhaled and lodged in an airway if your child eats quickly or distractedly. Cook these veggies to a mushy consistency or puree them before serving. A teething baby might love to gnaw on a raw carrot, but it's all too easy for a piece to break off and become a choking hazard. Unless you're going to watch your baby like a hawk, prepare raw, hard produce like carrots and cucumbers by shredding them or slicing them super thin.


Foods to Avoid Before Age 4: Popcorn, pretzel nuggets, nuts, dried fruit, marshmallows, hard or chewy candies, and gum should all be reserved until your child has a full set of molars and can be trusted to thoroughly grind his or her food. Any of these foods can be easily inhaled if your little one tries to swallow it whole, takes a deep breath, or laughs while eating.


Try to encourage your child to sit still in an upright position while eating and focus on chewing his or her food. Wiggling, walking, playing, or talking while eating are activities that dramatically increase the risk of choking. Always supervise meal times, and never feed your child any unsafe snacks in the car. If you're considering Baby-Led Weaning (in which your baby skips over purees straight to finger foods starting at 6 months), don't let the fear of choking stop you. Under proper supervision, this method is safe and actually strengthens a child's gag reflex, making choking less likely in the long run.



Common Household Items


Infants are notorious for putting anything and everything in their mouths. Starting at about 5 months of age, every body part and object within reach seems to make a beeline for a baby's mouth. This oral exploration is a normal stage of early childhood development, enabling babies to first learn about the world around them, practice self-soothing, and exercise their mouth muscles in preparation for eating and speaking. Though you should not discourage mouthing, you need to be vigilant so that nothing dangerous enters your baby's mouth. Here are the most common non-food items that can lead to choking emergencies.


Latex Balloons: The most popular item at a birthday party is also the most hazardous for little ones. Latex balloons are a leading cause of choking deaths in children under the age of 8. Children can accidentally inhale a latex balloon while trying to blow it up by mouth, and babies can choke on broken balloon pieces. Latex is a particularly dangerous material because it can conform to a child's throat, blocking the airway completely. Don't allow little ones to play with deflated latex balloons, and if a latex balloon pops, be sure to clean up all of its pieces.


Coins, Coin Batteries, and Magnets: When a baby begins to crawl, previously harmless objects lying around the house can suddenly become deadly targets. Coins, coin/disc batteries, and magnets look like bite-sized treats to a baby or toddler. Though swallowing one of these small objects can be benign if it gets shuttled through the digestive tract, it can also get lodged in the esophagus and require an emergency room visit to remove it by endoscopy. To ensure that your home environment is safe for a mobile baby, get down on the floor and look for things that could be picked up. Don't forget to check under furniture and cushions, where little hands might wander. Watch out for loose change that might fall to the floor off a table or out of a pocket in the laundry room, and check that any remotes or toys containing coin batteries are tightly screwed shut.


Small Toys: Toys have labels with an age recommendation for a reason. If a toy is labeled "not for children 3 and under," chances are it is a choking hazard or has little parts that could get stuck in an ear, nose, or throat. Small bouncy balls and marbles are the biggest offenders. Babies love the rubbery or cold sensation of these round treasures and can't resist popping them in their mouths. Only offer your little one toys that have parts larger than his or her mouth. If you have older children, make sure their toys are safely stored (away from your baby's toys) when you're not present.


Other items to keep an eye out for are pen or marker caps, hair barrettes or ties, rubber bands, buttons, beads, jewelry, erasers, and dog food. With the holidays around the corner, beware of putting holiday decorations (e.g. lights, ornaments, figurines, tinsel) within your baby's reach.



Choking is preventable. By knowing when and how to safely feed your little one foods that fall in the choking hazard category, you can avoid a terrifying emergency. Keeping your home clear of objects that a baby or toddler might ingest will give you peace of mind...and could save a life!



With Warmth and Wellness,

Your EmmaWell Team

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