Choking on food and non-food items has long been a worry of parents, especially those with young children.  Numerous safety recalls and regulations have been issued by the Consumer Product Safety Commission (CPSC), mostly involving toys that kids put into their mouths.  Coins are notorious choking hazards in children as well.  The Child Safety Protection Act requires choking warning labels on products such as balloons, marbles, small balls, and toys and games that contain small individual pieces.

However, a majority of choking episodes in children occur from choking on food rather than non-food items.  A new study published this week in Pediatrics looked at emergency room records in the United States from 2001-2009 and found:


  • 12,435 children 14 years old and younger were treated each year in emergency departments for non-fatal choking on food.
  • Most of the episodes (62%) involved children 0-4 years old.
  • Of all food types, hard candy (15%) was most often responsible for a choking episode, followed by other candy (13%), meat (other than hot dogs) 12%, and bone (12%).  Formula/breast milk/milk accounted for 7% of food-related choking episodes and hot dogs accounted for 3%.  Raw fruits and vegetables and chewing gum also caused significant choking events in this study.
  • Choking requiring hospitalization occurred most commonly with hot dogs and seeds/nuts/shells.


The authors explain why certain foods are especially dangerous in children 0-4:

Compared with older children, those [less than] 4 years of age are at greater risk of food-related choking. Before molars erupt (age 2 years and older), children are able to bite off a piece of food with their incisors but lack the ability to grind it adequately. By 3 to 4 years of age, children have developed molars but are still learning to chew and swallow effectively. Children in this age range also may be easily distracted and not focused on the task of eating. In addition, behavioral factors, such as high activity levels while eating, as well as developmental disabilities and neurologic conditions may increase choking risk among young children.


This study reminds us that choking is still a common worry among parents and pediatricians.  Awareness and common sense should help parents prevent a lot of these episodes from occurring.