Kids and Killer Hot Dogs? 3 Tips to Prevent Choking on Food

You don’t have to wait until foods are “re-engineered.” Easy precautions you can take now.

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It's easy to giggle over the killer-hot-dog headlines that have been sparked by the American Academy of Pediatrics' new recommendation that, to prevent choking, hot dogs should come with a warning label. What would it say—"Choking on this hot dog may be hazardous to your child's health"?

But I'd bet that most parents have had the awful experience of seeing a child's face suddenly turn red when a piece of food "went down the wrong pipe." I'll never forget the instructor in a baby CPR class who showed us how to whack a choking toddler between the shoulder blades and said: "You WILL have to do this." She was right.

Fortunately, all it took in my daughter's case was a good thwack on the back to knock loose the food. Not all parents are that lucky. Choking is a leading cause of injury and death in young children, and food is one of the main culprits, causing 60 percent of the 17,000 choking cases that land kids in the emergency room each year. Between 66 and 77 children under age 10 die from choking on food each year. And because of the cylindrical shape that seems custom-made to lodge in a kid's throat, hot dogs are the food most commonly associated with fatal choking among children.

Toys have been regulated since 1960 to reduce the risk of choking hazards. That's why the pediatricians are calling for the Food and Drug Administration to consider warning labels or recalls of foods that pose a choking hazard, and the doctors also have suggested re-engineering hot dogs and other problem foods. (Packages of Orville Redenbacher popcorn already have a safety warning that popcorn isn't appropriate for infants or toddlers because of the choking risk.)

Of course, parents don't need to wait for the federal hot dog re-engineering panel to convene to reduce the odds that kids will choke on food. Some of the advice commonly offered, like "Never leave a child alone while eating," was clearly written by someone who was never a parent. Are we doomed to follow a grape-eating toddler around the house? Then there's the classic "Don't let children eat in the car." Not likely. OK, how about "Don't let children eat hot dogs and grapes in the car"?

Here are three practical ways to reduce choking risk for children: 

*Re-engineer children's food yourself to reduce choking hazards. For children under age 4, cut foods into chunks that are a half-inch or less. Cut hot dogs and grapes in halves or quarters. 

*Cook foods intended for small children until soft. That includes pasta, beans, and vegetables. 

*Keep high-risk foods like peanuts, peanut butter, marshmallows, chewing gum, meat sticks, and round candy away from children. Hard candies are notorious choking hazards, because kids hold them in their mouths, and they are slippery. A big glob of peanut butter can be hard to dislodge from the throat. The pediatricians note that most of the high-risk foods are man-made and could be reconfigured to be less risky. 

Here's one more simple way to reduce choking risks for your family: Be careful of balloons. Latex balloons are the leading cause of children's choking deaths. I'll never forget a local pediatrician telling me how he struggled, and failed, to remove a bit of balloon from a child's throat. That child died. No one is seeking to ban balloons, but if all of us parents realized that popped balloons are risky, then our own vigilance would go a long way toward reducing the risk.