Choking Causes and Precautions

Choking, strangulation, and suffocation come in at number one for the leading cause of an unintentional death for children under the age of one. For children between one and nine years, these deadly causes rank number four.

When your infant becomes mobile, anything and everything goes in their mouth. After hitting around 9 months, babies will pick up pieces of food inadvertently dropped on the floor, or small toy pieces lingering on the ground. As their age progresses, small toy pieces are joined by coins, nuts and hard candies; foods are the most common reason for choking. As you introduce your child to solid food, the process has to be learned. This requires teeth for grinding and coordination of many mouth muscles, a skill that takes time to develop. Remember, babies are born with a sucking instinct so nursing or bottle feeding is natural for them. They may attempt to ‘suck’ solid foods back and this is where the choking can occur.

Most foods that can be given in pieces, even small pieces, can “go down the wrong way” and cause a choking related problem. What are these foods? First, there is the notorious hot dog; either biting off a small piece, or fed in small pieces directly, it is rarely chewed. Hot dog pieces usually act as a plug in the airway, so make sure to monitor little ones when eating them. Cookies, toast and biscuits crumble when eaten and cause problems. Many choking reports noted in Emergency Room visits include popcorn, carrots, grapes and apple slices, especially with the peel remaining.

To prevent choking or strangulation, monitor your infants and toddlers when eating at all times. Make sure food is fed in small pieces and are properly chewed. Don’t put too much food in the mouth. Watch what your child picks up off the floor and keep all areas clean and free of small, mouth friendly objects. Be alert, be aware and take an infant CPR course. It might mean the difference between life and death.

By Bruce Gach, M.D. 

Bruce is the managing partner of Livermore-Pleasanton-San Ramon Pediatrics Group. He is a Board Certified practicing pediatrician with over 30 years of experience caring for children. He has served on numerous committees dealing with child health and development.