It has been a difficult week for my group practice as we have had a small child sustain a terrible accident after choking on an apple. As a pediatrician, I talk about choking with parents beginning at the first visit, and encourage all new parents to take a CPR course. When you discuss this with young parents you never dream that they will actually ever have to perform CPR.
Choking hazards in young children are very real. A toddler’s airway is about the size of their “pinky” finger and there are many ominous objects just waiting for an active toddler to put into their mouths.
Children like to explore with their mouths, so nothing is off limits! With that being said, child proofing the house from choking hazards such as small toys, and objects is imperative.
It is also important that when beginning to offer a toddler table foods that parents and caregivers think about choking hazards. Parents worry about a child choking if they are beginning table food and don’t have teeth.
It is not commonly known that teeth really have nothing to do with a toddler eating table foods, as even toddlers with a full mouth of teeth do not know to chew. They just take big bites and swallow. So, think about foods being mushy and well cooked, in order that chewing is not necessary. It is like older folks, who often do not have a lot of teeth to chew with, so their food is all well cooked and cut into small pieces, which does not necessitate chewing.
Every food that is offered to a toddler needs to be well cooked and think about being able to mush it up with a fork or between your fingers.
The concerns about food allergies and the risks of giving a child a food “too soon” are no longer thought to be valid. The biggest concern about new foods for toddlers and children is really more about choking risks.
With that being said, think about some of these foods. Peanut butter is fine, but never a peanut or other nut that could easily cause airway obstruction.
Melons that are mushy and given in small pieces would be fine too, but never a melon ball.
Chips, popcorn, hard candies and hot dogs are a no-no too.
So are uncooked carrots, celery sticks, apple slices, and chunks of meat like steak or pork. Remember, can you mush it between your fingers?
Well cooked peas, carrots, squash, eggplant, this list goes on and on and well cooked food are usually okay.
So too are ground meats, shredded lunch meats and flaky fish. It is important for toddlers to have a well balanced diet, while at the same time being aware of the risks of choking.
Grapes should be cut into pieces, strawberries too. Don’t let a toddler take a “bite” out of a hard fruit, rather cut it all up and give them small mushy pieces, several at a time.
Lastly, remember to have your child sitting at a table for meals and snacks and do not allow them to walk around the house carrying food that might cause choking.
It may be something that takes a little thought and reminding in the beginning, but your child will quickly learn that they eat at a table, rather than while “cruising”. It’s a really a good rule for all of us!
So if you have a young child, and do not know CPR, call and sign up now! At the same time be aware of choking hazards and the rare but deadly accidents that may occur.
That's your daily dose for today. We'll chat again tomorrow.