Choking on Food Is a Preventable Danger for Children


The American Academy of Pediatrics estimates that at least one child in the United States dies every five days from choking on food – about 100 a year. Toddlers and preschool children aged four and younger are at the greatest risk. However, the risk is preventable and the AAP is calling for warning labels on high-risk foods to alert parents of the dangers.

"This is a call to action," said Dr. Gary Smith, a pediatrician and immediate past chairman of the Committee on Injury, Violence and Poison Prevention of the AAP. "For many years, the U.S. has protected children from choking on toys. We have legislation (and regulation). But we don't have a consistent set of measures that have been put together for prevention of choking on food."

The group is asking the U.S. Food and Drug Administration to establish a choking-incidence surveillance database and reporting system, in addition to warning labels on foods. The policy would also give the FDA the authority to recall foods that pose a “significant and unacceptable choking hazard.”

Certain types of foods have high-risk characteristics that make choking more likely. Round or cylindrical foods such as hot dogs, grapes, marshmallows, raw baby carrots, hard round candies, popcorn, and peanuts are of highest concern. Young children without molars can bite foods with their front teeth, but may not chew them well enough to safely swallow them.


Smith says, “If I took the best engineers in the world and asked them to design a perfect plug for a child’s airway, they couldn’t do much better than a hotdog. It is exactly the right size and shape to wedge itself down into the back of a child’s throat. It’s compressible so it fits in very snugly, and it’s almost impossible to dislodge.” In one analysis of about 450 choking fatalities among children, 17% were caused by hot dogs.

The National Hot Dog and Sausage Council supports the Academy’s call to action, particularly in educating parents about choking prevention. “Ensuring the safety of foods we service to children is critically important for us,” says Janet Riley, President.

If the airway becomes obstructed by a food or other object and not removed within a short amount of time, death can occur from lack of oxygen. Even a few minutes without oxygen can result in brain damage.

Parents can prevent choking in children by following these guidelines from the American Academy of Pediatrics:
· Cut hot dogs lengthwise and grapes into quarters, changing the round shape of the food.
· Avoid giving toddlers high risk foods.
· Make sure your child eats slowly and chews foods thoroughly before swallowing.
· Never let small children run, play or lie down while eating.
· Parents and caregivers of small children are also urged to learn CPR and first aid for choking.

The AAP policy statement appears in the March issue of Pediatrics.