Children's favorite foods can pose choking hazards

David Geffen School of MedicineJul 30 2014

Most parents never dream that their children's favorite foods can pose choking hazards.

It happened to Landon Jones when he was 15 months old. He was walking around eating a handful of nuts when a cashew became lodged in his bronchi (wind passage to his lung) causing wheezing and coughing.

"At the time, Landon had a cold so it was not obvious if the coughing was related to his illness or choking," recalled his mother, Ula Jones.

Eventually, the nut in his bronchi was detected by his doctor and had to be removed in a delicate surgery under anesthesia. Thankfully, the toddler made a full recovery.

"Landon's situation is surprisingly common," explained Landon's surgeon, Dr. Nina Shapiro, a professor of head and neck surgery at the David Geffen School of Medicine at UCLA. "In many kids, the food object passes down to their bronchi where it gets lodged and they present with coughing, wheezing, or even what might appear to be pneumonia. At first, it is not always clear that the child has had a choking incident."

In fact, it is food—not toys—that is the most common culprit of choking accidents in kids under 5 years of age. More than 10,000 children visit emergency rooms each year due to choking on food. While most of these events are not fatal, one child dies every five days from a food-choking accident. The reasons have a lot to do with a child's anatomy.

"Young children have underdeveloped swallowing mechanisms, immature teeth and narrow airways which put them at a higher risk for choking on food," said Shapiro who is also the director of pediatric ear, nose and throat at Mattel Children's Hospital UCLA. "Plus, the diameter of a child's airway is about the size of their pinky, so high-risk foods can easily block their tiny airways and prevent their ability to breathe."

The list of high-risk foods for children under age 5 years includes many of kids' favorites:
•Cheese sticks
•Chewing gum
•Chunks of meat or cheese
•Chunks of peanut butter
•Chunks of raw vegetables
•Dried fruit
•Grapes
•Hard or sticky candy and lollipops
•Hot dogs
•Nuts
•Popcorn
•Seeds such as pumpkin seeds and sunflower seeds

"The good news is that not all high-risk foods should be completely avoided. Many are healthy for young children — as long as they are served in the right form," added Shapiro.

Here are some tips:
•Vegetables should be cooked and cut into small pieces.
•Hot dogs and cheese sticks should be cut lengthwise, then widthwise, and then into the shape of small moons.
•Grapes should be peeled and cut in half or quarters.
•Nut butters should be spread thinly onto crackers or bread.
•Young children should always be attended to by an adult when they eat and only eat developmentally appropriate foods.
•Children should sit up straight and not play or run while eating.

"We cut all the foods and we are a lot more cautious," said Landon's mother. "We don't feed him in the car and he is not going to have nuts for a really long time."

If a child does choke and is unable to breathe, call 9-1-1 and perform the Heimlich maneuver.

Even if the child seems to choke but then coughs and appears fine, the object may have become lodged and the child should see a doctor.