What Foods Are Potential Choking Hazards for Young Children

Two toddlers eating a snack together. Notice how the food is cut into little pieces. Source: dcdp - Canva Pro/Getty Images

On average, every five days a child under 5-years-old dies unintentionally due to choking. Food items account for more than half of those deaths.

Additionally, thousands of other, non-fatal injuries occur from choking episodes in young children. For example, tiny food fragments that get into the lungs can cause pneumonia. Also, if a child is deprived of oxygen for as little as four minutes, brain damage occurs.

Why Are Kids Under Five At High Risk For Choking?

The rate of natural growth and development is the primary culprit.

Let's talk about their teeth. Infants typically begin teething between five and eight months, with the front ones arriving first. The very back teeth (called molars) are designed for grinding food – all the others are for biting and tearing. The molars start arriving around 12 to 16 months. They don’t completely push through the gumline until 20 to 30 months.

Chewing food effectively is a learned skill. As the old saying goes, practice makes perfect. It can’t magically happen in a few days.

Consider how much keeps changing. For months, they can only mash food with their gums. Their world changes as the first couple of teeth appear – something dramatically new and different. Gradually, over many months, new teeth show up. Each time it happens, their body must figure things out anew.

Piling on even more work, they must develop ample techniques to move food around in the mouth using their tongue and jaw position. Instinct automatically tells the mouth to move food pieces. Skill allows you to do it well without choking on it.

Growing up is challenging. It takes time.

There’s another critical physical aspect that comes into play. The opening of the windpipe (also referred to as the throat or trachea) of a 4 to 5-year-old is approximately 9mm (equal to less than half an inch) in width. That’s relatively tiny – about the diameter of a straw. It doesn’t take much to get something stuck in it.

Lastly, kids tend to be impulsive, fidgety, and easily distracted. That’s a recipe for potential problems around food.

A young child obviously enjoying meal time. Source - Nazar Nazaruk - Canva Pro/Getty Images

What Is It About Certain Foods That Creates Problems For Young Children?

Obviously, anyone can choke on any food under the right circumstances. And the older a child gets, the greater the variety of foods she can manage. Yet certain foods are persistent hazards for young children under five, with an exceedingly long history of harming them. Why?

There are four main aspects of food you need to consider:

1. Size

Remember that a child's windpipe is approximately as wide as a straw. Anything a young child can't easily and consistently break apart within their mouth will always be a hazard.

Examine the size of the individual pieces of food. They should be no larger than a quarter of an inch so that a child can readily chew them into manageable bits.

Foods that are long or big enough to require taking multiple bites out of them – such as celery, a string of cheese, or a potato chip – are problematic. It’s simple (and quite likely) for a child to inadvertently take too big a bite, putting more food in their mouth than they reasonably manage.

2. Shape

The windpipe opening is round-ish. Round (or even oval) things may accidentally slide into round openings more easily than other shapes could. Ball-shaped foods, such as cherry tomatoes and grapes, fit that description. So do flatter foods that are still round or oval in some aspect – for example, M&M’s and pumpkin seeds.

3. Texture

Slippery foods (such as grapes) can slide uncontrolled to the back of the mouth quickly. Sticky and gooey foods (such as gum and caramel), as well as any food that can quickly form into a thick glob in the mouth, can become an effective plug blocking the airway. The outer skin of some fruits comes off, which is often difficult to chew.

4. Firmness

Solid and firm foods are problematic for a young child to chew adequately. Hard candies are an obvious issue. Lollipops are meant for licking up until you bite off a piece or it slides off the stick entirely. Compare the firmness of raw vegetables versus cooked ones. When raw, many can be difficult to manage. Once cooked, those challenging foods become soft, readily breaking apart in the mouth.

Which Foods Can Be Modified, Making Them More Appropriate For Young Children?

Hotdogs are the biggest food-related choking hazard for young children. Let’s examine why.

Hotdogs are common, popular, and relatively inexpensive compared to other options. They’re frequently available at restaurants and numerous food vendors encountered on outings or vacations. The texture of the outer skin is different than the rest. Being long, you must bite off one piece at a time, the size of which can vary. If you slice it along its length, the smaller pieces are flat and round. All this fits several of the issues we discussed earlier.

Yet, with some modifications, hotdogs and many other foods can be altered from hazardous to manageable.

• Cut all foods into pieces approximately half an inch in size.

• Any food or slice of food (such as from a hotdog or carrot stick) that is round or oval should be cut in half and then in half again, resulting in four triangle-shaped pieces.

• Remove all seeds, nuts, pits, and bones (from certain meats).

• Remove the outer skins from foods if they may be problematic.

• Choose cooked vegetables over raw ones.

• Peanut butter, cheese, and similar foods (depending on their consistency) that could form into a thick glob in the mouth should be eaten with care in tiny amounts at one time.

• Whole-kernel corn and peas may need to be cooked and mashed.

What Foods Should Young Children Avoid?

Certain foods shouldn’t be given to children under five years old. They’re often too much of a choking hazard to risk feeding to young children.

These foods include – but are by no means limited to – the following:

• Gum, taffy, caramel, marshmallows, or any other sticky type of food

• Any kind of nuts, seeds, or pitted fruits – whole or in pieces

• Popcorn, due to the kernels found within it

• Hard candy, including lollipops

While the veggies are fine for the doll, they may be a bit too big for her toddler owner to eat safely. Source: Jaspe - Canva Pro

Are There Other Meal Considerations That May Create Choking Hazards For Young Children?

Absolutely.

Your child needs to remain sitting or standing in place while eating anything. Walking and playing means not paying attention to the food in his mouth.

Frequently encourage and reinforce good eating habits. These include taking only small bites from bigger food, chewing food thoroughly, not putting too much food in their mouth at once, and never talking or laughing while chewing.

Observe your child while he eats. Don’t leave the room or get distracted doing other tasks. Children may cough, gag, or spit out food they're having difficulty managing. But if the situation progresses to choking, things become quiet and quick. If you're not watching him the entire time while eating, tragedy could happen.

Never give your young child food while in the car. There's no way to supervise him appropriately while not crashing the car. Also, the instability created by car movement complicates matters when eating.

Lastly, older siblings may unknowingly attempt to give the younger child food that isn't yet appropriate for them. Be aware that some adults may be unaware of what foods your child can manage. Teach them all which foods are best.

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Understand that the information presented here can never be specific enough or all-inclusive. Four to five years is a long span of time, in which many things change as your child grows.

Every two to five months, your child's chewing and swallowing abilities tend to improve. However, certain kinds of food may persistently be problematic in some manner. Therefore, you and your pediatrician should frequently discuss your child’s development, including the best time to introduce different foods.