DEAR DOCTOR K:
I have two young children. I know not to buy toys with small parts or keep coins within their reach. What other choking hazards should I be aware of?
Your question is timely, because a large study on this topic was recently published. It provides answers that surprised me and may surprise you. I think this is information that every parent with young children needs to know.
You’re absolutely right that toys, coins and other small solid objects are a threat. But what the new study pointed out is that food may be an even bigger threat.
The study included more than 100,000 children coming to emergency rooms in U.S. hospitals from 2001 to 2009. The kids in the study ranged from newborns to age 14. As you might expect, a lot of the kids (nearly 40 percent) were less than 1 year old. The top foods associated with choking were:
- Hard candy
- Other candy
- Fruits and vegetables
- Formula/breast milk
- Seeds, nuts and shells
- Chips, pretzels and popcorn
- Biscuits, cookies and crackers
- “Multiple unspecified foods”
A child’s age, of course, makes a difference. There aren’t many school-age children choking on breast milk. And on the unusual occasions when babies choke on milk or other liquids, it’s rarely serious.
To prevent choking, it’s important to know what children of each age can handle.
Infants are just figuring out how to coordinate their swallowing. By 4 to 6 months, infants will reach for foods and show interest in what their parents and others are eating. This doesn’t mean they are ready to eat those foods.
After 6 months, you can slowly work up to small pieces of soft solid foods. But make the pieces very small and soft (easily broken by a child’s mouth into smaller pieces). While it’s OK to give toddlers harder foods, you still need to be careful, especially with raw food, nuts and candy.
It’s best to stay vigilant no matter how old your children are. The following tips can help prevent choking:
- Encourage children to chew their food well.
- Sit down together for meals.
- Insist that kids sit down when they eat. (No snacks while climbing on the jungle gym or heading out to sports practice.)
- Don’t let children run, play or lie down with food in their mouths.
It’s also a good idea to learn the Heimlich maneuver. You can use this emergency technique to help a child who is choking on food or another object. Ask your pediatrician how you can learn to do the Heimlich maneuver and other lifesaving skills.