As children begin to move from baby food to table food, the possibility of choking is something parents need to be aware of. Having teeth doesn’t mean children can handle all foods. The grinding action of a child’s teeth is not very effective until at least 3 to 4 years of age. Children have small upper airways, inexperience with chewing and a natural tendency to put objects in their mouths. Choking occurs when food or small objects get caught in the throat and block the airway. According to the National Safety Council’s Injury Facts 2017, choking was the fourth leading cause of unintentional injury deaths.
Food choices, monitoring where and when kids are eating, and good mealtime behavior can help to reduce the risk of choking on food. Provide foods that are soft, moist and cut into bite-size pieces.
Some general guidelines are:
• Avoid foods that clump, are sticky, stringy or slippery, or dry and hard-textured.
• Pay attention to food size and shape, especially a shape such as round, that could conform to the shape and size of the trachea (windpipe).
• Combinations of food size, texture, and shape can pose a threat. For example, a slippery hard candy with a round shape about the size of a drinking straw could block a windpipe.
Following are examples of foods to avoid offering to children younger than 3 to 4 years of age:
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• Nuts, seeds, popcorn, chips, raw carrots, raisins, hard candy, jellybeans, gum, and foods with pits, like olives and cherries.
• Whole grapes, hot dogs, and string cheese. Grapes can be cut into quarters, hot dogs and string cheese can be quartered lengthwise and cut into pieces.
• Peanut butter, especially in spoonfuls or on soft white bread. Add a little jelly or applesauce to peanut butter to make it easier to swallow.
Just as important as what a child is eating, is how a child is eating. Insist that children sit down to eat or drink. Learning to sit up straight, eat at a table or high chair, take small bites, chew food completely, and take time to eat vs. rushing through a meal are important for food safety. They should not eat when they are walking, riding in a car, lying down or playing. Always watch young children while they eat. Older brothers and sisters may offer inappropriate foods or distract their younger sibling while eating.
Coughing is a sign that the child is removing an obstacle naturally. Before intervening, give the child the chance to cough out the food.
A child who is choking cannot make noise to attract your attention. If your child cannot breathe, cough, talk or cry, be prepared to use the Heimlich Maneuver quickly to dislodge solid foods that are blocking the airway. The technique for infants and toddlers differs somewhat from that for adults. The American Academy of Pediatrics recommends that parents participate in either the American Heart Association’s Pediatric Basic Life Support Course, or the American Red Cross’s Infant and Child CPR Course. For more information, call the Safe Kids Coalition at 410-876-4448.
Lauren Harrison is a community health educator with the Carroll County Health Department.