Choking Prevention

According to the Centers for Disease Control and Prevention (CDC), choking rates are highest for babies under one year old.  The majority of kids’ choking injuries are caused by food.  There are three basic steps in keeping kids safe from choking:

  • Keep a watchful eye on children when eating and playing.
  • Keep dangerous toys, foods, and household items out of reach.
  • Learn how to provide early treatment for children who are choking.

Tips to prevent choking among babies

  • Your baby should sit up while eating, and be supervised at all times.
  • Teach babies from an early age to “chew” (or gum) food well.
  • Don’t hurry your child when eating—allow plenty of time for meals.
  • Only put a small amount of food on the tray at a time.
  • Avoid round, firm foods and chunks (hot dogs, nuts, whole grapes, hard or sticky candy, popcorn, raw carrots, other firm, raw fruit or vegetable chunks).
  • Hot dogs are not safe for babies.  If your toddler likes hot dogs, cut it in long, noodle-like strips.
  • Avoid stringy foods like string beans and celery.
  • Avoid commercial white bread products—they can form pasty globs in your baby’s mouth.
  • Offer only a few pieces of food at a time.
  • Cut meat and poultry across the grain, and into tiny fingertip-sized pieces.
  • Food pieces should be no larger than one-half inch in any direction.  If in doubt, cut food into smaller pieces. 

Suggestions for safe and healthy finger foods

  • O-shaped cereals
  • Well-cooked carrots sticks
  • Whole-wheat toast
  • Scrambled eggs
  • French toast
  • Cooked peas (no pod)
  • Very ripe pear slices
  • Well-cooked apple slices
  • Cooked pasta pieces (consider using whole-grain pasta)
  • Tofu chunks
  • Deli meat or string cheese cut into small pieces (again no larger than one-half inch in any direction)
  • Avocado chunks
  • Soft-cooked peas and beans

Find out more about feeding babies and feeding kids.

Tips to prevent choking among children

Kids under age five can choke on food and small objects.  Believe it or not, a lot of the choking prevention advice for babies still holds for children up to 4 to 7 years old!

The American Academy of Pediatrics says that the following foods are highest risk. (Children under 4 years old should not eat them.):

  • hot dogs or sausage
  • hard, gooey or sticky candy
  • peanuts, nuts and seeds
  • whole grapes
  • chunks of meat or cheese
  • marshmallows
  • chunks of peanut butter
  • popcorn
  • chunks of raw fruits or vegetables (such as carrots or apples)
  • chewing gum

Additional tips to prevent choking include:

  • Children under age 7 should not be given nuts, because they are still at risk for choking.
  • Make sure your kids eat at the table, or at least while sitting down.  No running, walking or lying down while eating.
  • Mealtime needs to be supervised by adults.  Older brothers and sisters are often not aware of what foods may cause a younger sibling to choke.  Many choking accidents happen when older siblings give dangerous foods to younger children.
  • Learn CPR and first aid for choking. 

Non-food choking hazards

  • Latex balloons:  Believe it or not, balloons cause more childhood deaths than any other toy.  Any substance that can take the shape of a child’s windpipe or airway (like balloons or disposable diaper stuffing) is a more dangerous choking hazard than a hard, solid object.  Children ages 3-8 are still at risk for choking on balloons.  Keep uninflated or broken balloons out of kids’ reach, and supervise children under age eight when they are around balloons. 
  • Small, loose, or broken toys and parts.  A small toy or part can easily become lodged in a child's ear, nose or throat. Children can be seriously injured or killed from inhaling, swallowing or choking on objects such as marbles, small balls, toys, or parts of toys that can be compressed to fit completely into a child’s mouth.
  • Other hazardous items:  Round, oval, cylinder or ball-shaped toys, toy parts or other objects. These are the biggest risk when they are the size of the child's windpipe. Some examples are coins, magnets, rubber balls, pen or marker caps, and small button-type batteries (like watch batteries).

How do I childproof my house to prevent choking?

Each time before you set your crawler or toddler loose, get down on the ground and look for dangerous items.  Remember to check under furniture and between cushions.  If you have older kids, make sure your younger child can’t get to the toys with small parts. 

While you are preparing your home for a new baby, start training older children to keep dangerous toys in the designated “small parts” area.  Supervise kids when they are playing.  Make sure your older kids don’t give dangerous toys or objects to your younger kids.  Follow age recommendations on toy packages—they often are based on possible choking hazards.

Be aware also of other kinds of airway obstruction injuries such as suffocation, strangulation and entrapment and how to prevent them and other injuries. 

Additional resources:

Reviewed by Sara Laule, MD  

Updated March 2017