When children begin crawling or eating table foods, parents must be aware of the dangers and risks of choking. Children younger than 5 years can easily choke on food and small objects.

Choking occurs when food or small objects get caught in the throat and block the airway. This can prevent oxygen from getting to the lungs and the brain. When the brain goes without oxygen for more than 4 minutes, brain damage or even death may occur.

Many children die from choking each year, and some children who survive a severe choking episode have permanent, life-changing brain injuries. Most children who choke to death are younger than 5 years. Two-thirds of choking victims are infants younger than 1 year. Balloons, balls, marbles, pieces of toys, and foods cause the most choking deaths.

Read more about choking prevention and first aid.

Dangerous Foods

Keep dangerous foods from children until 4 years of age or older, depending on each child’s development and maturity level. However, round, firm foods, such as hot dogs or grapes, can be served if completely chopped into tiny pieces. When infants and young children do not grind or chew their food well, they may try to swallow it whole. Peanut butter and other nut butters should be spread thinly.

Here are foods that can be choking hazards:

• Hot dogs
• Hard, gooey, or sticky candy
• Chewing gum
• Nuts and seeds
• Whole grapes
• Raw vegetables, such as carrot sticks
• Raw fruit chunks, such as apple chunks
• Popcorn
• Chunks of peanut butter or other nut butters
• Marshmallows
• Meat sticks/sausages
• Chunks of meat
• Chunks of cheese or string cheese

Dangerous Household Items

Keep the following household items away from infants and children:

• Balloons
• Coins
• Marbles
• Toys with small parts
• Toys that can be squeezed to fit entirely into a child’s mouth
• Small balls
• Pen or marker caps
• Small button-type batteries
• Medicine syringes

What You Can Do To Prevent Choking

• Learn CPR (cardiopulmonary resuscitation) (basic life support).
• Be aware that balloons pose a choking risk to children up to 8 years of age.
• Keep dangerous foods from children until 4 years of age or older, depending on each child’s development and maturity level.
• Insist that children eat at the table or sit down when they eat. They should never run, walk, play, or lie down with food in their mouths.
• Cut food for infants and young children into pieces no larger than one-half inch, and teach them to chew their food well.
• Supervise mealtime for infants and young children.
• Be aware of older children’s actions. Many choking incidents occur when older brothers or sisters give dangerous foods, toys, or small objects to a younger child.
• Avoid toys with small parts, and keep other small household items out of the reach of infants and young children.
• Follow the age recommendations on toy packages. Age guidelines reflect the safety of a toy, which is based on any possible choking hazard, as well as the child’s physical and mental abilities at various ages.
• Check under furniture and between cushions for small items that children could find and put in their mouths.
• Do not let infants and young children play with coins.

First Aid for the Child Who Is Choking

Make it a point to learn the instructions on pages 2 and 3 of the handout. Post the chart in your home. However, these instructions should not take the place of an approved class in basic first aid, CPR, or emergency prevention. Contact your local American Red Cross (www.redcross.org) or the American Heart Association (www.heart.org) to find out about classes offered in your area. Most of the classes teach basic first aid, CPR, and emergency prevention, along with what to do for a choking infant or child. Your child’s doctor also can help you understand these steps and talk with you about the importance of supervising mealtime and identifying dangerous foods and objects.

Disclaimer

Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication. The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

© 2018 American Academy of Pediatrics. All rights reserved.