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5 Tips to Prevent Your Child from Choking on Food

To make your home a safe space for your young children, you likely went through your house to “baby proof” it – placing child-proof locks on cabinets and drawers, putting up gates to keep children away from stairs, covering electrical outlets and making sure choking hazards were out of reach.

But even though you’ve made your home safe for your child, they are still at risk of choking, especially at mealtime. Here are five things to keep in mind to reduce your child's risk of choking on their food.

1. Some foods pose a bigger risk of choking than others

While it’s possible for a child, or adult for that matter, to choke on anything they’re eating, there are certain foods that seem to pose a bigger risk.

“Hot dogs have always been the most common item children choke on,” said Kathy McCarter, the director of Community Health at Abington - Jefferson Health. “That’s because parents will often cut a hot dog into slices, or pennies, and that’s the worst thing you can do.”

Hot dogs have a firm membrane and a softer inside, so when parents slice them, they become the perfect object to get stuck in a child’s trachea – and the firm membrane can form a sort of seal in the trachea.

“It’s almost like a cork in a bottle – and it’s very hard to dislodge,” she said, adding that grapes tend to pose a very similar choking risk to kids as hot dogs.

Other foods McCarter said tend to be frequent choking hazards for children include raw carrots, popcorn, nuts and hard candies.

2. The size of your child’s food matters

In order to lower the risk of your child choking on a hot dog, McCarter recommends breaking the outer membrane by slicing and then quartering it.

“For similar reasons, grapes need to be halved and then quartered,” she said. “Children can eat [hot dogs and grapes], but they can’t just be sliced.”

For other types of food, if you aren’t sure if the size will pose a choking risk, there are two things you can do.

“Parents should look at food labels – sometimes the food label may have information to help a parent understand whether it could be a choking hazard,” she said.

If the food label doesn’t have this information or the food simply doesn’t have a label, reach for a toilet paper roll.

“If an item can fit inside a toilet paper roll, then the item is too small for a child to handle unsupervised,” McCarter said.

3. Supervision is a must

Although the size and type of food can increase the risk of a child choking, the reality is that a child, just like an adult, can choke on food if they laugh, talk or are startled while eating.

“The epiglottis closes to cover the trachea when you’re eating to prevent food or liquid from getting into the airway," McCarter explained. "If you take a sharp, quick breath, it’s that moment when a person can choke. That’s why we tell children not to talk or run around with food in their mouths.”

4. Coughing can be a good sign

If your child starts choking, the first thing you should do is stand by and observe.

“If your child is doing a lot of coughing, don’t intervene,” she said. “Closely monitor to see if they can move the obstruction on their own.”

Not only is it possible for the child to dislodge the food item on their own, but in some cases, intervening too soon could turn a partial obstruction into a full obstruction.

5. Know what you need to do if they do start choking

If the coughing stops and they start making a squeaky or high-pitched sound or no sound at all, that’s when you need to step in.

“Those sounds tell you that a partial obstruction has become a full obstruction,” McCarter said, noting that someone choking won’t be able to talk or breathe. “People typically grab their throat, which is the universal sign of choking.”

Those are the signs that you need to call 911 and do the Heimlich maneuver.

“If you’re able to remove the object with the Heimlich, it’s recommended to call your child’s primary care provider. If the choking incident was very serious, the child should see their primary care provider or go to the emergency room immediately,” she said.

In the event that the Heimlich doesn’t work, a choking child may become unconscious.

“If you haven’t called 911 already, call now and begin CPR,” McCarter said, adding that the 911 operator will be able to walk you through how to perform CPR if you don’t know how.

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