Choking Hazards for Toddlers

Choking is the fourth leading cause of accidental death in children under the age of 5. Choking occurs when children swallow something large enough to block their airways. When a child’s airways are blocked, the child will either find it difficult or impossible to breathe.

Choking may seem a simple problem for parents to understand and deal with. Parents know, for instance, that hotdogs pose a choking hazard to children. But how many parents think they solve the problem by slicing a hotdog into thin rounds?

The diameter of a child’s airway is around the same size as the child’s pinky finger. A thin round of hotdog could most definitely block that child’s airway, if swallowed whole. That is because the shape and texture of that slice of hotdog can make it act like a cork in a bottle, closing the child’s airway completely.

Cutting a hotdog can make it safe. But you have to understand the shape and size of your child’s airway to understand how to cut that hotdog. The smart way to do it is to slice the hotdog into four, lengthwise, and then into shorter pieces crosswise. These chunkier pieces, angled at the top, will make it past a child’s airway, even if the child doesn’t properly chew his food.

Food isn’t the only choking hazard for a young child, but it is a big one. That’s because most small children don’t do a good job of chewing their food. This means that any round, firm food is going to pose a choking hazard.

A parent might think that a grape, for instance, is a soft fun fruit that perfectly fits a child’s small hand and mouth. Grapes are so easy to pop into the mouth! But grapes are actually the perfect size and texture to block a child’s airway, if swallowed whole. An x-ray posted to Facebook by an Australian blogger illustrated this point better than any words might do.

Another food that could prove deadly to small children is nut butter. We all know how peanut butter sticks in our throats. A child’s throat is so slender that eating a spoonful of nut butter could seal it shut. For this reason, it is recommended to spread a thin layer of nut butter on a slice of bread or a cracker for the child, rather than offer up a spoonful of the stuff.

Foods to Avoid

Here is a list of foods that can be dangerous for children under the age of 4 years:

  • Thin, circular slices of hotdog
  • Whole grapes
  • Popcorn
  • A gob of peanut butter, for instance on a spoon
  • Hard candy
  • Gooey candy
  • Sticky candy
  • Marshmallows
  • Chewing gum
  • Nuts
  • Seeds (these can pass through the airway and into the lungs)
  • Raisins
  • Hunks of meat or cheese
  • Raw vegetables

Cutting Food

Because children tend not to chew their food very well, it’s important to cut food down to a size that won’t block their airways if swallowed whole. Pieces of food should be cut no larger than one half inch. Conversely, seeds and other very small items also pose a danger. “If the food item is small enough, and passes through the windpipe, it can settle in the lung, leading to lung collapse and pneumonia,” says Akram Alashari, a trauma surgeon and critical care physician.

If your child is teething and you use a topical anesthetic to numb the gums, don’t give food or drink for an hour or so. The numbing effect can interfere with the child’s ability to swallow and present a choking hazard.

Choking: Location, Location, Location

It’s tempting to let children walk around with food in their hands. It’s best, however, to make sure your child eats only at the table. When your child eats at table, she’s in an upright position. She’s also focused solely on the twin tasks of chewing and swallowing.

Another tempting place to give kids snacks is in the car. The problem with this is that if you are the driver, you may not notice if your child chokes while noshing on a snack in the backseat of the car.

Parents should always watch their small children when they are eating. A piece of food could block the child’s airway and you might not know about it if you’re in the next room, for instance. A child who is choking may not be able to speak or call out. Here it’s important to note that choking means that less oxygen is getting to the brain. It only takes four minutes of serious choking to cause permanent brain damage or even death.

Choking and Crawling

When babies begin to crawl, it’s time for parents to baby proof the home. Baby proofing is about seeing things from the baby’s perspective. Parents should be on the watch for small objects a baby might find while crawling and attempt to put in the mouth (and babies try to put everything into their mouths—it’s how they explore the world). Such objects should be placed far out of reach of babies since they pose a choking hazard.

Examples of small objects that pose a choking hazard include:

  • Toys with small parts that can break off or come apart
  • Toys that can be compacted to fit inside the child’s mouth whole
  • Coins
  • Marbles
  • Latex balloons
  • Caps from pens or markers
  • Small balls
  • Small, round batteries
  • Hair clips and barrettes
  • Beads and strings of beads
  • Medicine syringes
  • Buttons

Choking and Latex Balloons

It seems like the most natural thing in the world to give a child a balloon. That is until you learn that latex balloons are the leading cause of death by choking in children 8 years and under. Children have been known to inhale balloons while trying to inflate them. Children have also choked on pieces of broken balloons.

A child may chew on a balloon, causing it to burst, and pieces of latex might then be inhaled by the child. Because latex has a smooth surface, it can mold itself to a child’s throat, blocking the child’s airway so completely that the child cannot breathe.

The worst part about latex balloons and choking is that a Heimlich Maneuver won’t help the child in such a case and may even make the problem worse. That’s because any air that comes through is going to expand the pieces of latex so that they further cover the throat and airway. And of course, if you try to stick your fingers into the child’s throat to get that piece of latex out of there, you can end up pushing it farther in, still.

Now that you know how dangerous latex balloons can be for small children, be smart and buy Mylar balloons, the ones made out of shiny foil, instead. They’re easier to inflate and just as fun. The main difference is that the foil balloons aren’t dangerous to small children.

Toy Safety and Choking

Always make sure your child plays with toys that are appropriate for his age. Most parents read the package before buying a toy. But parents may not take into account age warnings when receiving hand-me-down toys. Secondhand toys may have been deemed safe for young children when they were first manufactured, but safety standards may have been changed or upgraded. Older toys may be damaged with pieces that can break off and pose a choking hazard.

If you have more than one child, it’s important to make sure that young children don’t have access to the older child’s toys. These may not be age appropriate and may pose a choking hazard to your younger child. A Lego piece, for instance, can be deadly to a small child, if a single piece is left on the floor or under a sofa cushion for the smaller child to find and swallow.

Toys that are small or have small parts can be tested with a small parts tester for suitability. A small parts tester is a tube. If the toy fits into the tube, the toy is too small to give to a small child and presents a choking hazard. Most fine toy stores carry small parts testers. Also watch recall lists to make sure that your child’s toys haven’t been deemed choking hazards since they were manufactured and purchased.

Parents and prospective parents would be wise to learn how to perform child CPR in case of emergency. It’s something you hope you’ll never need to use. But CPR can save lives, if not your child’s life, perhaps the life of a neighbor’s child.

Keep emergency numbers posted where you can easily find them. In case of choking, make sure to call 911 right away. Don’t wait for the situation to resolve on its own.

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Varda Meyers Epstein is a mother of 12, communications writer, and education blogger at the Kars4Kids blog.