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Simple Ways to Prevent Life-Threatening Choking Episodes in Children

By Sandra Banas, MD



Food is the most common cause of choking in children. To swallow solid food carefully, it must be mashed into small pieces by the teeth and pushed safely into the esophagus by the muscles of the throat, or pharynx. During this process, a child’s airway is more vulnerable to blockage compared to an adult’s due to its smaller size. Infants first learn to chew using an inefficient up-down motion. Chewing in a rotary manner, which is necessary to grind food, is not well developed until age four. Strength and control of chewing continues to improve until at least age seven. Remember that children with special health care needs or developmental delays may not master chewing until an older age. You can promote a safe eating environment with the following tips:

  • Never leave a child unattended while eating.
  • Children’s meal and snack times should be unhurried.
  • Children should always be seated when eating, not walking, running, or playing.
  • Avoid distractions during meal or snack time so children can focus on eating.
  • Always offer liquids to children when eating.
  • Model safe eating habits and chew food thoroughly.


Hot dogs are the food most commonly associated with fatal choking in children. Other high-risk foods include hard candy, peanuts and other nuts, whole grapes, raw carrots, popcorn, and chunks of peanut butter. To reduce risk of choking:

  • Cut foods into small pieces no larger than ½ inch, removing seeds and pits.
  • Hot dogs should be cut lengthwise and widthwise.
  • Cook or steam vegetables to soften their texture.
  • Do not give children food that is round and firm, such as peanuts and hard candy, until at least age seven.
  • Use only a small amount of peanut butter when the child is ready, offered on bread or mixed with other softer foods to prevent it from sticking in the child’s throat.

Because infants and toddlers use their mouth to interpret and interact with their environment, small non-food objects are also responsible for many choking incidents. Latex balloons are the leading cause of choking death. Other objects that pose a significant risk include marbles, coins, safety pins, small magnets, small balls, pen caps, tacks, and button-type batteries. Button-type batteries, such as those used for hearing aids and watches, are especially dangerous because chemicals leached from the battery’s pole can damage and liquefy the lining of the esophagus in as little as two hours. If you suspect your child has ingested a battery, call 911 and contact the 24-hour National Battery Ingestion Hotline at 800-498-8666.

To reduce your child’s risk of choking on an object:

  • Before your child begins to crawl, get down to your child’s level and look for things within reach, even under furniture cushions, and remove them or place them out of reach.
  • Look for age-appropriate guidelines in selecting toys, but use your own judgment concerning your child.
  • Store toys for younger children separately from those for older children.
  • Use a toilet paper roll to evaluate potential choking hazards. If an object can fit inside the roll, which has a diameter of approximately 1¾ inches, keep it out of reach of young children.
  • Never allow a young child to play with an uninflated balloon or attempt to inflate it. If a balloon pops, remove all pieces out of a child’s reach immediately.
  • Always secure the battery compartment of every product. Store all batteries in a secure location out of a child’s reach.

 

Because it is impossible to prevent all choking episodes, parents and child care providers should learn CPR and choking first aid for children. Contact your local fire or police department for information on classes that may be available in your area.

If you suspect that your child has issues swallowing or is at a higher risk for choking, please visit www.dupagemedicalgroup.com to learn more about our Otolaryngology (ENT) services.    



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