Originally published in the the Wisconsin State Journal, February 7, 2013.
Dear Reader: Choking is a leading cause of death and injury in children, especially those 3 and under. The risk of choking increases as infants begin eating more solid foods.
While we as parents want to decrease this risk, we can’t keep them on a fully liquid diet forever. Infants at this age also explore the world around them with their mouths. Anything that is in their hands is likely to end up in the mouth. Their feet even are a chew toy from time to time.
There are definite steps you can take to decrease the risk of choking hazards. When it comes to food, start out with pureed foods. Slowly increase the consistency as your infant tolerates and is able to handle the thicker consistency. The first finger foods should be safe to be swallowed whole and dissolve in the mouth. This is why Cheerio type cereals and puffs are ideal.
Even when infants have a few teeth, they are able to bite but not grind their food. The ability to grind food does not come until about age 4. For this reason, smooth, hard foods should be avoided until a child can grind food. Some of these foods include hard candy, grapes, raw carrots, hot dogs, peanuts, etc. If these foods are given, they should be cut into pieces less than ½ inch.
Infants and children should always be supervised when eating. They should be discouraged from running, playing or talking with food in their mouths, as these all increase the risk of choking. Chewing gum should not be given to small children.
I recommend parents become aware of what is within their child’s reach, as it is likely to end up in the mouth. Toys with small parts, especially older siblings’ toys, are a risk. Other common choking hazards are loose pieces on stuffed animals, including plastic eyes. Even household items that can easily end up on the floor can be big risks, such as safety pins, screws, magnets and coins.
I also strongly encourage everyone to take a CPR (cardiopulmonary resuscitation) class. I believe this is especially important for parents and other caregivers of small children. As health care providers, we have to renew our certification every two years. I also recommend parents renew their skills with a class every couple of years. Recommendations change with time, and we forget details.
While I hope you never have to use these skills, they can be life-saving needed. They teach you to handle choking situations as well as other cardiac and respiratory events.
Most of the health care associations in town, including Meriter, as well as other organizations offer these classes for a small fee. A link to area classes can also be found at www.heart.org. If attending a class is just not possible, there are kits called “Infant CPR Anytime” and “Family and Friends CPR Anytime” that can be purchased. These include a DVD and practice manikin.
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Johnson to people submitting questions.
Dr. Dana Johnson is a pediatrician at the Meriter McKee clinic.
Click here to learn more about Meriter’s Infant CPR for Family & Friends course.