As anyone who takes care of young children can tell you, kids can get into things in the blink of an eye. Installing "baby"-gates, electrical socket plugs, cabinet locks and bed rails, and consistently using car seats and bicycle helmets are safety measures that most parents and child caregivers routinely employ. Keeping kids safe from choking hazards is critical too-and not just at mealtime.
While anyone can choke, it's more common in children. "Children 4 years old and under are at the highest risk for choking," says Ronald Kleinman, MD, chief of pediatric gastroenterology and nutrition at Massachusetts General Hospital. According to Kleinman, young children have small airways, making them vulnerable to choking in two ways. "At this age, if a large, hard object is swallowed it can compress the small airway, as well as lodge in the airway itself," explains Kleinman.
Choking is not only frightening for both the child and the parent or caregiver, but it can also be life threatening. Like many health threats, prevention is the best medicine. Here are a few suggestions for keeping children safe from choking.
"Babyproofing" and Supervision
Infants and young children (sometimes up to 4 years old) explore their world by putting things in their mouths—a normal, but potentially dangerous practice. Prevention helps but since it's impossible to prevent infants from mouthing toys and other objects—and not recommended because it's a primary way they learn about their environment—it's essential that the house and childcare setting be "babyproofed" by the time a child reaches about 4 months of age.
"Babyproofing" is equally important for older children. The greater mobility and independence of older children makes babyproofing just as important, if not more so. The toddler-to-preschool-age group: has an extremely limited understanding of consequences or danger. According to Kleinman, toddlers are especially at risk for dangerous misjudgments. "The 1- to 2 1/2-year olds often put large things in their mouths without thinking about how difficult it might be for them to swallow the object," notes Kleinman.
Older children, age 4 to 7 years, are not immune to choking risks. Children this age are often daring and frequently over-confident about their physical abilities—a potentially hazardous combination. Swallowing coins or other non-food items, and accidentally getting clothing or ties wrapped too tight around their necks or stuck in playground equipment may be more of a hazard for kids in this age group, who often play in less supervised settings.
Minimize household risks
According to the U.S. Consumer Product Safety Commission (CPSC), between 1980 and 1989 146 children died from choking on toys or other children's objects. About 70 percent of those incidents involved balloons, small balls, or marbles.
Keeping inappropriate toys away from young children is imperative for preventing choking. Before purchasing a toy, check the recommended age listed on the package—and abide by it. Also, CPSC recommends immediately disposing of deflated or broken balloons, as even a piece of a balloon can choke a child. Also, all children should be cautioned not to put balloon pieces in their mouths. Alternatively, parents may want to purchase Mylar balloons, which aren't choking hazards, instead of latex ones.
Aside from toys, everyday objects found around the house can pose a choking risk to children. Keeping the house tidy and free of clutter, sweeping and vacuuming the floor frequently, and storing potentially hazardous items way out of a child's reach are easy steps that should be taken to minimize choking risks.
Mealtime safety
According to the American Academy of Pediatrics, children don't learn to chew with a grinding motion until about age 4. Until then, they simply don't have the ability to chew firm, smooth foods or large chunks of food very well. Certain foods present more of a choking risk than others do. Foods which commonly cause choking in young children are generally firm and smooth (grapes, nuts, candies, etc.) or are served in chunks (meats, cheese, vegetables, etc.) Meat can be particularly difficult for a child to chew unless it's cut into very small pieces.
It's not just what the child is eating that causes choking; it's how the child eats. For example, a child who likes the taste of something or is particularly hungry, will often eat in a rush or try to stuff the whole portion of food into his or her mouth instead of taking normal-sized bites. In these situations, chewing food adequately becomes difficult, and choking can result. For this reason, it's important to serve food in small portions (giving another portion if the child desires it) and to continue to cut up food until the child is old enough to properly cut up his or her own food.
Another common habit of toddlers is sometimes called "pouching," in which the child keeps food in his or her cheeks instead of swallowing it. If the wad of food becomes dislodged, it can pose a choking risk.
Keeping mealtime pleasant, nourishing and safe for kids is an achievable goal. Getting into the habit of preparing and serving safe, age-appropriate foods will go a long way toward keeping children healthy and happy.
