Choking Prevention


Article Body

Choking Prevention

Children under age 5 are at greatest risk for choking injury and death.

The size of a young child’s trachea or breathing tube (windpipe or airway) is approximately the size of a drinking straw in width. Imagine a piece of popcorn being lodged in this small area!

Children are most likely to choke on small objects that are round, hard, and/or sticky. Toys, household items, and foods can all be a choking hazard. The most common cause of nonfatal choking in young children is food.

Common Choking Hazards – Foods

Babies 0-6 months

Choking can happen at any age. We often think of choking when a child starts to eat baby food and table foods, however, babies of any age can choke while bottle-feeding.

Babies 6-12 months

Do not feed baby food or table foods before 6 months old.

  • Tough or large chunks of meat
  • Whole hot dogs, meat sticks, or sausages
  • Fish with bones
  • Large chunks of cheese — especially string cheese
  • Peanuts or other nuts and seeds
  • Peanut butter and other nut butter
  • Whole beans
  • Cooked or raw whole-kernel corn
  • Whole uncut cherry or grape tomatoes
  • Raw vegetable pieces (carrots, green peas, celery, etc.)
  • Hard pieces of partially cooked vegetables
  • Whole uncut grapes, berries, cherries or melon balls
  • Hard pieces of raw fruit
  • Whole pieces of canned fruit
  • Fruit pieces with pits or seeds
  • Uncooked raisins and other dried fruit
  • Plain wheat germ
  • Whole grain kernels
  • Popcorn
  • Potato/corn chips and similar snack foods
  • Pretzels
  • Hard candy, jelly beans, caramels, gum drops/ gummy candy
  • Chewing gum
  • Marshmallows

Toddlers and children under the age of 5

  • Hot dogs and sausages
  • Chunks of meat
  • Fish with bones
  • Peanuts and nuts
  • Peanut butter and other nut butter (Do not serve on a spoon. It needs to be spread thinly.)
  • Grapes (whole)
  • Apple chunks
  • Fruit seeds
  • Raw vegetables
  • Popcorn
  • Marshmallows/jelly candy
  • Hard candy
  • Chewing gum

Common Choking Hazards – Household Items – All Ages

  • Coins
  • Toys with small parts
  • Small balls and marbles
  • Balloons
  • Arts & crafts materials
  • Ballpoint pen caps
  • Watch Batteries
  • Jewelry

What Parents Can Do

For babies less than 6 months you can do the following to prevent choking while bottle-feeding:

  • Maintain a calm atmosphere during feeding time.
  • Never prop a bottle in an baby's mouth.
  • Use a nipple with an appropriately sized hole so that the milk does not flow too quickly.
  • Do not feed baby food or table foods until 6 months of age or the child is showing signs of readiness.
  • Never feed a baby who is crying, laughing, walking, talking, or playing.

Avoid feeding your children over 6 months Common Choking Hazard food items listed above, and follow these recommendations:

  • Cut hot dogs in quarters lengthwise and then into small pieces. Cut whole grapes into small pieces. Chop nuts and carrots finely. Spread peanut butter thinly on crackers or bread – do not serve on a spoon. Remove skin and seeds from fruits and mash or cook to soften. Cut fruits and vegetables into cubes then microwave, bake, boil, or steam to make them softer and easy to chew.
  • Pea-size pieces of food are safest for children 12-24 months of age. Make sure foods are a size and texture your child can handle. 
  • Serve at body temperature or cooler, never HOT!
  • Use a highchair or infant seat while feeding your child and never leave it unattended. If a child puts too much food in their mouth, even if the foods are not common choking hazards, a child can still choke.
  • Don’t allow your child to walk or run while eating. Try to avoid eating in the car as well, since it’s hard to supervise.
  • Don’t let your child play with toys that have small parts that could be swallowed.        
  • Keep objects such as safety pins, nails, tacks, screws, jewelry, and coins out of the child’s reach.
  • Check your house routinely for small objects and don’t leave toddlers unattended.

Tips to Remember

  • ALWAYS watch your child while eating. Direct supervision is necessary.
  • NEVER leave your child alone while eating. A choking child may not be able to make any noise.
  • LEARN CPR and the Heimlich maneuver
  • Call 911 if you are unable to get your child to breathe.

Food Safety

Fresh and frozen vegetables and fruits are available to 9-11-month-old babies in the WIC program in place of baby food. WIC families can choose to receive the maximum amount of baby food or combine baby food and fresh or frozen vegetables and fruits. The baby's caregiver needs to be knowledgeable about choking risks and food safety when preparing table food for their baby.

Sources: New York State Department of Health, USDA Infant Nutrition and Feeding – A guide for WIC