Preventing Choking in Children

Choking can be prevented in children. First, though, it is important to understand how the act happens in the first place. There are three routes through which foreign objects can enter a child’s body:

  • Inhaled. Through the larynx (voice box), trachea (windpipe) and bronchi (main airways to the lungs).
  • Ingested. Through the esophagus (food tube) and stomach.
  • Inserted. Through the nose or ear.

The most serious situation occurs when a child inhales a foreign object. The object can completely block (obstruct) the larynx or trachea, which can lead to choking.

How Common Is Choking?

About 3,000 people die per year from choking. This figure has remained unchanged in the last 20 years. However, there has been a progressive decline in the childhood deaths from choking. In 1968, 650 children died from choking; in 1990, the figure dropped to 261 children.

Why Are Children More Susceptible to Choking?

Children are at higher risk for choking for several reasons:

  • Toddlers have few teeth and cannot chew well.
  • Their swallowing mechanism, which helps them naturally swallow, is not fully mature.
  • Toddlers lack an understanding of what is edible and may mistake foreign objects for foods.
  • They often explore their environment by placing objects in the mouth that can be potential choking hazards.
  • Young children are often easily distracted or playful while eating. This activity can lead to poor chewing or the jarring of food back into the throat.

What Types of Objects Are the Most Hazardous?

Small, globe-shaped objects are particularly hazardous, though any small object can cause choking. Materials that can conform to the shape of the throat, such as plastic bags and balloons also pose a risk. A partial list of potentially dangerous objects includes:

Foods

  • Candies and nuts
  • Grapes
  • Hot dogs (cut into rounds)
  • Peanuts, popcorn, marshmallows
  • Raw peas, beans

Household Items

  • Balloons (broken and uninflated)
  • Beads
  • Buttons
  • "Button" batteries (such as for watches and cameras)
  • Coins, tokens
  • Diaper foam
  • Eraser caps
  • Foam packaging "peanuts"
  • Jewelry
  • Marbles
  • Small game or toy pieces

How Can I Keep My Child Safe From Choking?

The Consumer Product Safety Act (1979) bans objects that pose a choking risk. The small parts test fixture (SPTF) is used to gauge the safety of small objects. Objects that can fit into a cylinder that measures 3 centimeters (cm) in diameter by 2 to 5 cm deep fail this test.

Important ways that we can prevent choking include the following:

  • Educational outreach by physicians to parents, families, communities.
  • Closer observation of infants.
  • Greater attention to our children's eating habits and diet.
  • Improved monitoring of the size, texture and "chewability" of food.

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