A Dr. Momma Minute
Toddlers shovel food into their mouths. Eating food takes time and toddlers seem to always be in a hurry. Parents must be aware of common food choking hazards in kids. Even though these are foods that are often eaten every day, caution must be used when these foods are given to young kids.
First and foremost, according to the American Academy of Pediatrics, choking is a leading cause of injury in kids under age 4. There are many things besides food that kids choke on, and I address how to prevent the most dangerous non-food choking hazards in kids in a separate post.
And although I am specifically talking about toddlers today, just wanted to share that thousands of adults over age 70 die from choking each year. So keep in mind that choking severe impacts the very young and the very old. Watch that food!
As a Pediatric ENT physician, one of the things I really spent time learning during my fellowship was how to treat airway problems. Choking and inhaling foreign objects is a big part of that. In toddlers, it is often food that has been poorly chewed.
Do you remember hearing that it is bad to talk with food in your mouth? Well, you might have thought it was just for good manners since no one needs to see your half-chewed food! But the other thing that is important is that if you have food in your mouth and suck in air, like screaming toddlers often do, food shoots into the airway. Not a good thing.
This takes me to share another reason chronic mouth breathing is bad! I have had more than my fair share of parents complain about their chronic mouth breathing kids who have poor table manners, smacking food and choking while eating. Closing the mouth to chew and swallow is the best way to eat. Sucking in air while eating, well that is asking the food to go into your voice box instead of down into your stomach.
How common is choking on food?
I always knew toddlers choke frequently on food; however, I did not know how common it actually was. Recently, I learned that over 30 kids are seen in the emergency room every day due to choking on food. And sadly, a child dies from choking on food at least once every week. These facts help to understand why choking is the fourth leading cause of unintentional death in children under the age of 5
Of course, the numbers I just described are the most severe episodes. How many of us have seen a child choke but the food was able to be removed? Emergency avoided! So, please understand that life-threatening choking can occur at any moment in a young child’s life but is more of the exception and not the rule. Awareness and prevention are key.
12 common food choking hazards, especially in toddlers
Let’s just go ahead and list the foods that kids commonly choke on. As you can see, these are foods eaten on a regular basis.
- Hot dogs
- Hard candy
- Nuts and seeds
- Meat chunks
- Grapes / Raisins
- Marshmallows (Nerd grammar tip: it is not Marshmellow)
- Carrots, chunks of raw veggies
- Apples, chunks of hard fruit
- Chunks of cheese (including string cheese)
- Popcorn / Skittles / M&Ms (Basically foods kids tend to cram into the mouth by the handful!)
- Peanut butter / Caramels (and other ooey-gooey sticky substances)
- Gum
Honorable mention goes to fish bones. These are small and do not block the airway, but they stick into the lining of the esophagus and breathing tube. They can be extremely difficult to swallow and often need surgical removal. So…fish bones in kids? No.
How do physicians diagnose these problems?
Most of the time, an adult is nearby and reports that choking occurred while eating. Sometimes the adult has recently left the room and returns to a choking child. If one of the classic food choking hazards was being eaten, this will be extremely helpful information to share with physicians.
When seen in the emergency room, kids are immediately checked to be sure they are able to breathe well. If not, kids are taken directly to the operating room where telescopes are used to find and remove the foreign object.
Sometimes a chest x-ray is obtained. This may not show the food since it usually does not show up well of this type of study; however, they could show the degree of blockage or any complications.
Some kids had coughing while eating a meal, and then coughing went away. This does NOT mean the food particles came out. Food that does not cause an immediate blockage may cause swelling or blockage later on.
If trouble breathing occurs, with recurrent cough, xrays can show pneumonia that can happen behind a food blockage. Or it can show air that stays trapped in the lungs because it cannot escape past the food blockage.
Prevention tips for food choking hazards
Parents can help prevent toddlers from choking. Some basic concepts include:
- Adult supervision while eating, at all times
- Cut firm or round food into thin strips or small pieces (1/2 inch or less)
- Kids must sit up while eating (no lying down).
- Best to sit in a chair with a straight back instead of a soft lounge chair.
- Avoid eating in the car or stroller.
- Do not allow older siblings to feed toddlers
Additionally, educating kids is important. They should be taught to:
- Always stay seated until finished eating
- Chew food slowly and thoroughly
- Don’t talk or laugh with a mouth full of food
- Put only as much food into their mouths as they can comfortably chew
What should you do if a child is choking?
As I already said, the best thing to do is prevent it from happening. But if does happen, the most important thing any adult can do is help the child breath immediately. This means that all parents and adults need to learn infant and child CPR. This is very different than traditional adult CPR.
The Heimlich maneuver is a way to help remove a trapped foreign body. I recommend all parents become familiar with this maneuver. A reference guide with the basics for life-saving infant and toddler measures is included in the resource section, but many classes are available in the community and online.
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