Choking Prevention for Children

Choking Injuries and Deaths are Preventable!

Vacations should be a time for fun. Unfortunately this was not the case for one New York family. "J.T." died after choking on a hot dog while on vacation. In response to this preventable death, New York State enacted legislation to help parents, caregivers and providers recognize common choking hazards for children and prevention tips. The choking prevention legislation is known as " J.T.'s Law". The following information is provided to help educate parents, caregivers, and providers about how to prevent choking incidents and possible deaths.

  • Choking is the fourth leading cause of unintentional death in children under the age of 5.
  • Children under age 5 are at greatest risk for choking injury and death.
  • Toys, household items and foods can all be a choking hazard.
  • The most common cause of nonfatal choking in young children is food.
  • At least one child dies from choking on food every five days in the U.S., and more than 10,000 children are taken to a hospital emergency room each year for food-choking injuries.
  • Toy manufacturers label toys for choking hazards and some food manufacturers voluntarily label food products as posing a potential choking risk; however, any food can present a choking risk.
  • Education regarding choking risks, precautions to take in avoiding these risks, and known life saving procedures are necessary to eliminate senseless and tragic injuries and deaths caused by choking.
  • Pediatricians, family practice physicians, health care workers, parents, grandparents, day care workers, school personnel, older children, siblings, babysitters and communities as a whole play a key role in the prevention of injuries and need to share information with caregivers to identify potential choking hazards.
  • The size of a young child's trachea (windpipe) or breathing tube is approximately the size of a drinking straw in diameter. Imagine a piece of popcorn being lodged in this small area!

Precautions and Prevention

  • Never leave a small child unattended while eating. Direct supervision is necessary.
  • Children should sit up straight when eating, should have sufficient number of teeth, and the muscular and developmental ability needed to chew and swallow the foods chosen. Remember, not all children will be at the same developmental level. Children with special health care needs are especially vulnerable to choking risks.
  • Children should have a calm, unhurried meal and snack time.
  • Children should not eat when walking, riding in a car or playing.
  • Cut foods into small pieces, removing seeds and pits. Cook or steam vegetables to soften their texture. Cut hot dogs lengthwise and widthwise.
  • Model safe eating habits and chew food thoroughly.
  • Offer plenty of liquids to children when eating, but solids and liquids should not be swallowed at the same time. Offer liquids between mouthfuls.
  • Use only a small amount of peanut butter when the child is ready and use with jelly, or cream cheese on whole grain breads (Remember peanut butter can stick to the roof of a child's mouth and form a glob.)
  • Think of shape, size, consistency and combinations of these when choosing foods.
  • Pay particular attention to those foods, toys and household hazards mentioned that pose choking hazards to ensure child safety.
  • Educate caregivers and the community about choking hazards and precautions to take to prevent choking. Identify emergency resources and contacts.
  • Become familiar with life-saving techniques such as child cardiopulmonary resuscitation, abdominal thrusts (Heimlich Maneuver), Automated External Defibrillators (AED) or calling 911.

Choking Hazards

Foods:

  • Hot dogs (especially cut into a coin shape), meats, sausages, and fish with bones
  • Popcorn, chips, pretzel nuggets, and snack foods
  • Candy (especially hard or sticky candy), cough drops, gum, lollipops, marshmallows, caramels, hard candies, and jelly beans
  • Whole grapes, raw vegetables, raw peas, fruits, fruits with skins, seeds, carrots, celery, and cherries
  • Dried fruits, sunflower seeds, all nuts, including peanuts
  • Peanut butter, (especially in spoonfuls or with soft white bread)
  • Ice cubes and cheese cubes
  • Foods that clump, are sticky or slippery, or dry and hard textured
  • Food size and shape, especially round or a shape that could conform to the shape and size of the trachea (windpipe). The size of a young child's trachea (windpipe) or breathing tube is approximately the size of a drinking straw in diameter.
  • 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 an airway (windpipe)

Household Items/Toys:

  • Latex balloons, coins, marbles, toys with small parts, small balls, pen or marker caps, button type batteries, medicine syringes, screws, stuffing from a bean bag chair, rings, earrings, crayons, erasers, staples, safety pins, small stones, tiny figures, and holiday decorations including tinsel, or ornaments and lights
  • Any toy or other object that is labeled as a potential choking hazard

Remember: Choking Injuries and Deaths are Preventable!

Helpful Resources/Websites

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