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5 Foods That Kids Most Often Choke On

Both healthy foods and sweet snacks can be hazardous to young children.
Both healthy foods and sweet snacks can be hazardous to young children.
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Imagine this scene: Typical child comes home from preschool or daycare. Responsible adult has healthful snacks waiting: fresh grapes, cheese cubes and animal crackers. Child munches the wholesome morsels while excitedly relating the events of the day.

What's wrong with that picture? Every detail sets up a choking hazard:

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  • Young children are just acquiring a full set of molars, the teeth that grind food into bits. Their grasp of how and when to use them is still sketchy. Complicating matters, their windpipe is, at its narrowest point, about the diameter of a drinking straw.
  • Eating while talking is a choking risk for anyone. A child's physical and intellectual immaturity compounds the problem.
  • All of the foods listed, due to size, shape and texture, are prone to cause choking.

Added up, these factors can turn healthful and much-loved childhood foods into potential killers. In fact, asphyxiation due to choking is the fourth leading cause of accidental death in children under age 5, and food is often to blame [source: New York Department of Health].

Under the right (or wrong) conditions, almost any solid food can be a choking threat. This article outlines a "Five Most Wanted" list around the five food groups to help you identify and disarm the most dangerous ones. For convenience, we've named each group for its most notorious member, but any food with the same qualities should be suspect.

First, a sweet treat can become a bitter pill.

Pay close attention when children enjoy something tricky and sticky like a lollipop.
Pay close attention when children enjoy something tricky and sticky like a lollipop.
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When kids clamor for something sweet, a hard peppermint or butterscotch candy may seem like one of your better choices. It satisfies the sweet tooth, has no fat, and occupies a youngster for a while, all of which should make for a healthier child and a happier caregiver.

Unfortunately, the candy's hard texture is difficult for young teeth to chomp and chew. The slick surface and rounded shape can send the candy down the throat before the child realizes it.

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Also, children aren't known for self-control. Sucking and savoring a piece of candy isn't nearly as gratifying as gobbling it down. As a result, hard candies are off limits for children aged 4 years and under.

A similar problem follows from the conventional wisdom of cutting raw apples, pears, carrots, and other hard fruits and vegetables into bite-sized pieces. "Bite-size" for an infant is 1/4-inch or smaller (about the size of a pea), 1/2-inch or smaller for toddlers. A safer option may be serious deconstruction: grate, shred or purée the food, or cook it until it's soft.

Next: little green bullets and more.

Despite being sweet and healthy, grapes can be a little too slippery.
Despite being sweet and healthy, grapes can be a little too slippery.
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After a supermarket expedition or during a long road trip, a bunch of grapes might seem like the perfect distraction for a tired child fussing in the car seat. Eating in a moving vehicle, with a driver who's herself distracted, is already a choking hazard. Adding something like grapes to the mix increases the risk.

Foods like grapes, olives, cherry tomatoes and raw peas are softer than candy disks. Yet, they're still too firm for the chomp-and-swallow technique young children employ. Like hard candy, they have a slippery feel and small size that might fool a child into thinking the food can be swallowed whole. Some children even try to, just to see if they can. In reality, they're the right size for lodging in the throat.

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These foods can be made safe. As with bigger fruits and vegetables, cut grapes and other small fruits into halves or quarters. Cook and mash peas. Or let the child smash them: Kids take more interest in foods they help "prepare" themselves.

Our next entry asks the question: Can an all-American sandwich favorite be a health hazard to the schoolkids who made it famous? In a word, yes. And that's not "spreading it on thick." Read on to see what we mean.

Watch out for big globs of peanut butter.
Watch out for big globs of peanut butter.
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If you check your neighbor's kitchen, chances are good (about 3-to-1) that you'll find a jar of peanut butter. If your neighbor has a child, he or she will have downed an average of 1,500 peanut butter sandwiches before graduating high school, most of them without incident.

Most of them. Peanut butter has a track record of causing choking in children, especially when paired with the traditional spongy, sliced white bread. Mouthfuls can form globs that clog the throat. The same is true of other soft, sticky foods, such as cheese cubes and slices, fruit "leathers," and chewy candies like caramels, jelly beans and "gummies."

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To reduce the risk, serve peanut butter thinly smeared between slices of bread, never by the spoonful, and cut the sandwich into 1/4-inch or 1/2-inch pieces. Slice and dice cheese in a similar fashion. Avoid sticky or chewy candy (and chewing gum) altogether until a child is at least 5 years old.

Next: When "buy me some peanuts and Cracker Jack" is a bad idea.

Popcorn: fun movie snack or dangerous choking hazard?
Popcorn: fun movie snack or dangerous choking hazard?
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Nutritionally, popcorn is a healthful alternative to potato chips, cookies and other fried or sugary snacks. But for children younger than 5, and sometimes older, it can be just as harmful.

The problem is popcorn's fluffy consistency and irregular shape. The puffed-up pieces are easily inhaled without chewing, and the rounded and pointed surfaces can wedge in the throat. Heavier, odd-shaped foods pose the same danger, including many snack crackers, animal crackers, pretzels, peanuts, walnuts and raisins.

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These foods present another, treacherous hazard. Small flakes and even whole pieces as big as corn kernels can travel through the airway and settle in the lungs. There, they can trigger pneumonia and other respiratory infections.

For safety's sake, keep young children away from these foods in their original form. Some can be rendered harmless by soaking thoroughly. Soften animal crackers in milk, for example, or raisins in fruit juice.

Finally, what food could be so deadly that one leading pediatrician likened it to "a perfect plug for a child's airway"? Read our last entry to find out.

As a choking hazard, hot dogs are the single most dangerous food in the average American child's diet, responsible for one of every six asphyxiation deaths in children age 10 and younger, according to Businessweek. Hot dogs have three strikes against them: their shape (cylindrical), size (a little less than 1 inch in diameter), and texture (smooth on the outside, compressible inside). In a 2010 policy statement, the American Academy of Pediatrics singled out hot dogs as an example of a food that should be redesigned or carry warning labels due to the high risk of choking. The group might have included sausage links, string cheese and marshmallows, all of which share the treacherous traits.

Meanwhile, caregivers can do their own redesign: Cut hot dogs and other tube-shaped food lengthwise into quarters, then crosswise to make strips. Cut marshmallows down to size likewise, using the 1/4-inch to 1/2-inch guideline.

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The bottom line is: As long as kids will be kids, adults must be adults, so be vigilant about the safety and well-being of the young ones in their care.

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More Great Links

Sources

  • Bren, Linda. ""Prevent Your Child from Choking." (Sept. 14, 2010) http://www.pueblo.gsa.gov/cic_text/family/pre_choking/choking.htm
  • Cornell University. "Top 10 choking foods for children under age 4." (Sept. 9, 2010) http://extendonondaga.org/Cce/choking%20foods.pdf
  • Gardner, Amanda. "Pediatricians Want Redesign of Hot Dogs, Candy to Curb Kids' Choking." Businessweek. Feb. 22, 2010 (Sept. 13, 2010) http://www.businessweek.com/lifestyle/content/healthday/636245.html
  • Keeler, Janet K. "America's Lunch." St. Petersburg Times Online. July 31, 2002. (Sept. 14, 2010) http://www.sptimesonline.com/2002/07/31/Taste/America_s_lunch.shtml
  • New York Department of Health. "Choking Prevention for Children." Jan. 2009 (Sept. 9, 2010) http://www.health.state.ny.us/prevention/injury_prevention/choking_prevention_for_children.htm
  • North Dakota Childcare Resource and Referral. "Preventing Choking in Young Children." (Sept. 14, 2010) http://www.ndchildcare.org/providers/health-safety/docs/Preventing%20Choking.pdf
  • Tarkan, Laurie. "Labels Urged for Foods That Can Choke." New York Times. May 24, 2010. (Sept. 11, 2010) http://www.nytimes.com/2010/05/25/health/25choke.html?_r=1

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