In the United States, a heartbreaking reality persists: a child loses their life due to choking on food approximately every five days. Shockingly, over 12,000 children require emergency room visits each year due to food-choking incidents, as reported by the New York State Department of Health.
These distressing statistics far surpass those related to tip-over accidents or trampoline injuries, highlighting the severity of the choking hazard. At Safer For Baby, a safety-oriented blog, we are committed to understanding the underlying causes of this alarming issue and equipping parents with the knowledge to protect their little ones.
I have put together this guide to highlight some of the most common choking hazards and provide tips for parents on how to prevent them.
What is choking?
Choking is a potentially life-threatening situation that occurs when an object, such as food or toys, gets stuck in a child’s airway. It is important to understand that babies and young children explore their world by putting things in their mouths. If the obstruction is not cleared by coughing or swallowing, immediate medical intervention may be necessary.
Common choking hazards for children:
- Food: Small, round or hard foods such as nuts, grapes, popcorn and hot dogs can easily get lodged in a child’s throat and cause choking. These should be avoided until children are older.
- Toys: Infants and young children often put toys in their mouths while playing. Be sure to check for small parts that can break off and pose a choking hazard.
- Household items: Items such as coins, buttons, batteries, and small magnets can be tempting for children to put in their mouths but can also cause choking.
How often do babies choke?
According to a survey by St John Ambulance, approximately 34 children are admitted to the hospital daily due to choking incidents with food. It is worth noting that infant fatalities resulting from choking during sleep are exceptionally rare. Additionally, studies indicate that there has been no increase in the number of infant deaths in the United States due to choking since the introduction of back sleeping recommendations in the 1990s.
What can babies choke on: 20 Items
Certainly, here are 20 common items that can pose choking hazards for children:
- Small Toys: Toys with small parts that can detach, such as action figures, dolls, or toy cars.
- Toy Parts: Broken or dismantled toy parts, including wheels, buttons, or beads.
- Balloons: Inflated balloons or balloon fragments that can be accidentally swallowed.
- Coins: Small coins, such as pennies, nickels, dimes, or quarters.
- Marbles: Small glass or plastic marbles used in games or craft projects.
- Buttons: Sewing buttons or decorative buttons that can come loose from clothing or accessories.
- Batteries: Button batteries used in electronic devices, toys, or remote controls.
- Jewelry: Small pieces of jewelry, including earrings, beads, or clasps.
- Nuts and Seeds: Small nuts, seeds, or nut shells, such as peanuts, almonds, or sunflower seeds.
- Hard Candy: Hard candies or lollipops that can break into small pieces.
- Popcorn: Unpopped kernels or partially chewed popcorn.
- Grapes: Whole grapes or grape halves that can block the airway.
- Hot Dogs: Whole hot dogs or hot dog slices that can become lodged in the throat.
- Chunks of Meat: Large chunks of meat or poultry that are difficult to chew.
- Chunks of Cheese: Large pieces of cheese that can be difficult to swallow.
- Vegetable Chunks: Hard or raw vegetables, such as carrots, celery, or broccoli.
- Chewing Gum: Chewing gum or gum wrappers that can be accidentally swallowed.
- Small Parts: Small parts from household items, such as bottle caps, pen caps, or keychains.
- Craft Supplies: Small craft supplies, such as googly eyes, pom-poms, or sequins.
- Kitchen Gadgets: Small kitchen gadgets or utensils, such as bottle openers, corkscrews, or potato peelers.
I have broken down these choking hazards into various categories;
Food that baby can choke on:
A study conducted in 2014 by Sarah Denny et al. from Nationwide Children’s Hospital analyzed the incidence of choking in the pediatric population. The report, titled “Choking in the Pediatric Population,” highlighted findings from the Centers for Disease Control and Prevention (CDC). According to the CDC, out of the 160 US children aged 14 years who died from choking in 2000, 41% choked on food items while 59% choked on non-food items. Furthermore, it is estimated that in the United States, one child dies every 5 days due to food-related choking, with hotdogs being the most commonly associated food with pediatric choking deaths.
Mechanics of Choking Hazard: How it happens:
As per Sarah’s Study, below are the key reasons kids choke:
- Young children have developing teeth, initially lacking the necessary molars for grinding food. Even after molars come in, many children struggle with effective chewing until around the age of 4 or 5.
- In addition to their physical immaturity, toddlers can easily get distracted while eating. Engaging in activities like running, laughing, or talking while eating increases the risk of choking.
- Another choking hazard is well-intentioned older siblings who share toys or food items that may not be suitable for younger children.
- Due to the narrower airways of young children, small objects can easily cause partial or complete obstructions.
- As per Poiseuille’s law, the flow through a tube is inversely proportional to the fourth power of the tube’s radius. Consequently, any blockage in an airway drastically diminishes the airflow.
The report also highlighted that the physical attributes of objects play a significant role in their potential to cause choking incidents. Specifically, foods that have a cylindrical shape, similar diameter to the airway, and are compressible – like hot dogs, grapes, and gel candy – carry the highest risk of completely blocking the upper airway. Moreover, objects that conform to the airway, such as an uninflated latex balloon or its fragment, can be particularly hazardous as they have the potential to completely impede the flow of air.
Although experts have indicated that children aged 3 and below are particularly vulnerable, conservative pediatricians advise exercising utmost caution when it comes to feeding infants under 4 years of age.
Here are some common foods that are choking hazards:
- Whole Grapes: Grapes are one of the most significant choking hazards for young children because their shape and texture can easily block the airway if swallowed whole.
- Hot Dogs: Hot dogs are cylindrical in shape and can easily become lodged in the throat, especially if not cut into small, bite-sized pieces.
- Chunks of Meat: Large chunks of meat, such as steak or chicken breast, can be difficult for young children to chew and swallow, increasing the risk of choking.
- Nuts and Seeds: Hard nuts, such as peanuts, almonds, or walnuts, as well as seeds like sunflower or pumpkin seeds, can pose a choking hazard if not chewed thoroughly.
- Hard Candy: Hard candies, lollipops, or cough drops can easily become lodged in the throat if not dissolved completely before swallowing.
- Popcorn: Unpopped or partially popped popcorn kernels can get stuck in the throat and cause choking, especially for young children.
- Chunks of Cheese: Large pieces of hard cheese, such as cheddar or Swiss cheese, can be difficult for young children to chew and swallow safely.
- Chunks of Vegetables and Fruits: Hard or raw vegetables, such as carrots, celery, or broccoli, as well as fruits with skins or seeds, such as apples, pears, or cherries, can pose a choking hazard if not cut into small, manageable pieces.
- Marshmallows: Large, soft marshmallows can be compressed and become a choking hazard if swallowed whole or if not chewed thoroughly.
Cut the following food items into smaller pieces:
- Hot Dogs
- Chunks of Meat
- Nuts and Seeds such as grapes
- Hard Candy
- Chunks of Cheese
- Chunks of Vegetables and Fruits
Other baby products that can cause choking:
Below are products that CPSC classified as small objects that must meet small object regulations;
- Pacifiers – 16 C.F.R. 1511
- Rattles – 16 C.F.R. 1510
- Cribs – 16 C.F.R. 1508, 1509
- Infant Pillows, Cushions – 16 C.F.R. 1500.18(a)(16)
- Baby Walkers, Bouncers, Jumpers – 16 C.F.R. 1500.18(a)(6)
- Electrically Operated Toys – 16 C.F.R. 1505
- Dolls, Stuffed Toys and Other Products that may cause lacerations or punctures. – 16 C.F.R. 1500.18(a)(1), (2), (3)
- Small Balls – 16 C.F.R. 1500.18(a)(17)
How to help choking kids – First Aid steps:
Step 1: Turn the baby over so they are facing upwards.
Make sure their head is lower than their chest.
Step 2: Place two fingers in the middle of their chest just below the nipples and push sharply downwards up to five times.
If the object does not dislodge, proceed to step 3.
Step 3: Performing chest thrusts can effectively expel air from the lungs and potentially dislodge any obstruction that may be impeding proper breathing.
Step 4: If the initial three steps prove ineffective, gently turn the infant to face upward. Utilize your thigh or lap to provide support, ensuring to cradle and stabilize the head.
Step 5: Position two fingers on the center of the breastbone, slightly below the nipples.
Step 6: Administer up to five rapid downward thrusts, compressing the chest to a depth of approximately one-third to one-half of its total measurement.
Step 7: Continue performing a series of 5 back blows and 5 chest thrusts until the object is successfully dislodged or until the infant becomes unconscious.
Signs of a choking baby:
- Inability to cry or make much sound
- Weak, ineffective coughing
- Soft or high-pitched sounds while inhaling
- Difficulty breathing – ribs and chest retract
- Bluish skin color
- Loss of consciousness if blockage is not cleared
Common Choking Hazards
- Small Foods: Some foods, such as grapes, popcorn, candy, and nuts can easily obstruct a child’s airway. It is important to cut these foods into small pieces or avoid giving them to young children altogether.
- Round Foods: Foods that are round and hard, such as hot dogs, sausages, or carrots, can also pose a choking risk if not cut into smaller pieces.
- Sticky Foods: Chewy or sticky foods like caramel candies or chewing gum can easily become lodged in the throat and cause choking.
- Toys and Household Objects: Small toys, buttons, coins, marbles and
Baby choking and crying: How to help baby
If a baby is crying and struggling to breathe, it is possible that they are choking. In this case, quick action is necessary to help clear the airway and prevent further complications.
Some signs of a choking baby include inability to cry or make much sound, weak or ineffective coughing, difficulty breathing with retractions in the chest and ribs, and bluish skin color.
If you suspect that a baby is choking, follow these steps:
- Check the mouth: If you can see an object blocking the airway, try to remove it with your fingers.
- Give back blows: Lay the infant face down on your forearm, supporting their head and neck with your hand. Use the heel of your other hand to give firm back blows between the shoulder blades. Do this up to five times.
- Give chest thrusts: If the back blows do not clear the obstruction, turn the infant face-up on your arm and place two fingers on their breastbone just below the nipple line. Use quick, firm pressure to give up to five chest thrusts.
- Repeat: Continue alternating between back blows and chest thrusts until the object is dislodged or the infant can breathe again.
- Call for help: If the obstruction does not clear after several attempts, call for emergency medical services and continue with back blows and chest thrusts until help arrives.
Choking vs gagging:
It is important to differentiate between choking and gagging, as the two require different responses. Gagging is a natural reflex that occurs when something touches the back of the throat, while choking means that an object is lodged in the airway and blocking breathing. Babies can gag on their own saliva or even on breastmilk, but it usually resolves quickly without intervention.
Why does my baby choke when lying down?
Babies may choke when lying down due to a variety of reasons, including anatomical factors such as the shape and position of their airway, or developmental factors such as their ability to control their head and neck muscles. It is also common for babies to spit up while lying down, which can lead to choking if they are unable to clear it from their airway. If your baby consistently chokes when lying down, it is important to speak with a healthcare professional for further evaluation and guidance.
Why babies don’t choke on their backs?
Babies are less likely to choke when lying on their backs because this position allows gravity to help keep the airway clear. It also allows for easier breathing and swallowing, as opposed to being on their stomach or side where there is more pressure on the airway. Furthermore, the gag reflex is triggered more easily when a baby is upright or on their stomach, leading to a higher risk of choking. This is why it is recommended for babies to sleep on their backs to reduce the risk of Sudden Infant Death Syndrome (SIDS). However, it is important to always supervise infants while they are lying down to ensure their safety and prevent any potential choking incidents.
What to do when baby chokes on formula/bottle:
If your baby starts to choke on formula or while drinking from a bottle, it is important to stay calm and act quickly. First, try to gently remove the bottle or formula from the baby’s mouth if possible. If this does not work, support their chin with one hand and use the other hand to give five back blows between the shoulder blades. If the choking persists, you can also try giving five chest thrusts by placing two fingers in the center of the baby’s chest and pushing downward. If these methods do not work and the baby is still choking or unable to breathe, call emergency services immediately. It is also recommended to take an infant CPR course to be prepared for any potential choking emergencies.
Precautions for feeding:
To reduce the risk of choking during feeding, it is important to follow certain precautions. These include always making sure the baby is in an upright position while drinking from a bottle or breastfeeding, and ensuring that they are not overly tired or lying down when eating solid foods. It is also important to properly cut up solid foods into small pieces to prevent them from getting stuck in the baby’s throat. Additionally, avoid giving infants foods that are small, hard, or round in shape such as nuts, seeds, popcorn, and grapes as they pose a higher risk of choking.
- About the Author
- Latest Posts
- More info
Sandra W. Bullock is a highly skilled expert in baby safety, specializing in both indoor and outdoor safety. With her previous experience in retail support, she has successfully assisted numerous parents in installing essential safety equipment such as baby gates, cabinet locks, and outlet covers. Additionally, Sandra has collaborated with various child care facilities, providing valuable safety consultations and comprehensive training to caregivers.