It’s more common than you probably think. On average over 12,000 children a year, under the age of 14, are treated in hospital emergency rooms for food-related choking. That’s about 34 kids a day according to a new study.

The most common choking hazards appear to be hard candy, followed by other types of candy, then meat and bones. The study noted that most of the young patients were treated and released, but around 10 per cent were hospitalized.

"These numbers are high," said Dr. Gary Smith, who worked on the study at Nationwide Children's Hospital in Columbus, Ohio.

What's more, he added, "This is an underestimate. This doesn't include children who were treated in urgent care, by a primary care physician or who had a serious choking incident and were able to expel the food and never sought care."

The estimated 12,435 children ages 14 and younger that were treated for choking on food each year also doesn't include the average 57 pediatric food-choking deaths reported by the U.S. Centers for Disease Control and Prevention annually, the researchers noted.

Smith and his colleagues analyzed injury surveillance data covering 2001 through 2009.

They found that babies one year old and younger accounted for about 38 percent of all childhood ER visits for choking on food. Many of those infants choked on formula or breast milk.

Children who choked on hotdogs, nuts and seeds were the most likely to be hospitalized.

"We know that because hot dogs are the shape and size of a child's airway that they can completely block a child's airway," Smith told Reuters Health, noting that seeds and nuts are also difficult to swallow when children put a lot in their mouths at once.

Supervision is the most important choking prevention. Parents or guardians should make sure that a small child’s food is cut up into manageable bites that can be easily chewed and swallowed. An example might be grapes and raisins. A whole raisin is probably okay to be given to a toddler, but a grape should be sliced.

What should you do if your child is choking?

For children ages 1 to 12:

1. Assess the situation quickly.

If a child is suddenly unable to cry, cough, or speak, something is probably blocking her airway, and you'll need to help her get it out. She may make odd noises or no sound at all while opening her mouth. Her skin may turn bright red or blue.

If she's coughing or gagging, it means her airway is only partially blocked. If that's the case, encourage her to cough. Coughing is the most effective way to dislodge a blockage. If the child isn't able to cough up the object, ask someone to call 911 or the local emergency number as you begin back blows and chest thrusts. If you're alone with the child, give two minutes of care, then call 911.

On the other hand, if you suspect that the child's airway is closed because her throat has swollen shut, call 911 immediately. She may be having an allergic reaction to the food.

Call 911 immediately is your child is turning blue, unconscious or appears to be in severe distress.

2. Try to dislodge the object with back blows and abdominal thrusts.

If a child is conscious but can't cough, talk, or breathe, or is beginning to turn blue, stand or kneel slightly behind him. Provide support by placing one arm diagonally across his chest and lean him forward.
Firmly strike the child between the shoulder blades with the heel of your other hand. Each back blow should be a separate and distinct attempt to dislodge the obstruction.

Give five of these back blows.

Then do abdominal thrusts

Stand or kneel behind the child and wrap your arms around his waist.

Locate his belly button with one or two fingers. Make a fist with the other hand and place the thumb side against the middle of the child's abdomen, just above the navel and well below the lower tip of his breastbone.
Grab your fist with your other hand and give five quick, upward thrusts into the abdomen. Each abdominal thrust should be a separate and distinct attempt to dislodge the obstruction.

Repeat back blows and abdominal thrusts Continue alternating five back blows and five abdominal thrusts until the object is forced out or the child starts to cough forcefully. If he's coughing, encourage him to cough up the object.

If the child becomes unconscious If a child who is choking on something becomes unconscious, you'll need to do what's called modified CPR. Here's how to do modified CPR on a child:

Place the child on his back on a firm, flat surface. Kneel beside his upper chest. Place the heel of one hand on his sternum (breastbone), at the center of his chest. Place your other hand directly on top of the first hand. Try to keep your fingers off the chest by interlacing them or holding them upward.

Perform 30 compressions by pushing the child's sternum down about 2 inches. Allow the chest to return to its normal position before starting the next compression.

Open the child's mouth and look for an object. If you see something, remove it with your fingers. Next, give him two rescue breaths. If the breaths don't go in (you don't see his chest rise), repeat the cycle of giving 30 compressions, checking for the object, and trying to give two rescue breaths until the object is removed, the child starts to breathe on his own, or help arrives.

A good rule of thumb for parents and guardians is to take a CPR class. Many hospitals and clinics also offer classes on what to do if your child is choking.

Sources: Genevra Pittman, http://www.reuters.com/article/2013/07/29/us-choking-food-idUSBRE96S04K20130729

http://www.babycenter.com/0_first-aid-for-choking-and-cpr-an-illustrated-guide-for-child_11241.bc