Healthand Safety
E-News for
Caregivers
andTeachers
January 2011
Choking is a top cause of injury
and death among children,
especially children 3 years of age
or younger. The risk for choking
remains significant until the ageof 5. The most common items
that children choke on are food,coins, balloons and other toys.
This is because children put
objects in their mouths as they
explore new environments.
In February of 2010, theAmerican Academy of Pediatrics
published a policy statement that
contains recommendations forparents, teachers, child care
workers and health care
professionals to help prevent
choking among children.
http://pediatrics.aappublications.org/cgi/content/abstract/peds.2009-2862v1
This quarter’s newsletter isdedicated to reducing the risk ofchoking in early childhood
settings.

Reducing Choking Risks:
Tips for Early Education andChild Care Settings
High risk foods and foodcharacteristics
 Hard candy Peanuts/nuts
 Seeds
 Whole grapes Raw carrots
 Apples Popcorn Hot dogs
 Chunks of peanut butter Marshmallows
 Chewing gum Sausages
 Foods that are round andcould conform to a child’s
airwaySince 60% of non-fatal choking
incidents result from food, let’s
examine some ways to reduce therisk of choking while children areeating.

Reducing Food Choking Risks
1.

2.

3.

Children should be seated
when eating—
Caregivers/Teachers should
ensure that children do not
eat when standing, walking,running, playing, lying down,
or riding in vehicles.
Children should not beallowed to continue to feedthemselves or continue to beassisted with feedingthemselves if they begin to fallasleep.
Active supervision is a must—• Watch children for“squirreling” of severalpieces of food in theirmouth. This increases therisk of choking.
• Remember a choking child
may not make any noise,so adults must keep theireyes on children who areeating.
(continued on page 2)

The “Health and Safety E-News for Caregivers and Teachers” is fundedthrough a grant (U46MC04436) from the US Department of Health andHuman Services, Child Care Bureau and the Health Resources andServices Administration, the Maternal and Child Health Bureau to theAAP.

4.

Children at this age require
increased supervision wheneating because they areeasily distracted and maynot pay full attention to thetask of eating.
5. Food should not be used
for children’s games thatinvolve catching the food
item in the mouth or
stuffing large numbers or
amounts of food in themouth.
6. Cut foods such as grapes
and other fruits, meat,cheese, and raw vegetables
into small pieces andshapes that will not block
the airways. Cut hot dogs
lengthwise and well as
widthwise.
7. Cook vegetables so they
become softer and easier toswallow
8. Give only small amounts ofpeanut butter or othersimilar foods to preventthem for blocking thechild’s airway.
9. Offer plenty of liquids tochildren when eating, butmake sure liquids andsolids are not swallowed at
the same time.
10. Remember, foods do notcontain warning labels
about possible choking
hazards.

It is up to the caregiver orteacher to know what steps totake when preparing andserving food to reduce choking
risks.
Non-food choking risks
Because young children put
everything into their mouths,
small non-food items are also
responsible for many choking
incidents. Coins and toys
account for most nonfoodrelated choking events among
young children.
Of all children’s products, latex
balloons are the leading causeof choking death, and most ofthese fatalities are amongchildren younger than 6 yearsof age. Other products such as
safety pins, coins, marbles,
small balls, pen or marker caps,
small button type batteries;
items from the trash such as(page 2)
eggshells, and pop-tops frombeverage cans have been
associated with choking.
Manufacturers often indicate
the appropriate age range of atoy on the box to convey safety
hazards. These are justgeneral guidelines in selecting
toys, it is important to use yourown judgment concerning thechildren in your care.
Before you buy a toy, you need
to be aware that just because a
toy is on the market does notguarantee its safety. Toys soldin retail bins, vending machines,
and on the internet, may not bemarked with appropriate
warning labels.
Finally, it is impossible toprevent all choking episodes
among children. All caregiversof young children should betaught CPR and first aid.

Keep dangerous
toys, foods, andhousehold items
out of reach!!

ResourcesWebsites
Healthy Child Care America
www.healthychildcare.org
Healthy Children
www.healthychildren.org
New AAP Policy on Choking Prevention
http://www.healthychildren.org/English/news/Pages/New-AAP-Policy-on-Choking-Prevention.aspx
Choking Prevention
http://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/Choking-Prevention.aspx
CDC website on choking
http://www.cdc.gov/HomeandRecreationalSafety/Choking/default.html
Publications
http://aappolicy.aappublications.org/cgi/reprint/pediatrics;125/3/601.pdf
AAP Policy Statement: Prevention of Choking Among Children
PEDIATRICS Vol. 125 No. 3 March 2010, pp. 601-607
The Committee on Injury, Violence, and Poison Prevention wrote this policy to illustrate the recurring risks of choking in young
children.
http://aapnews.aappublications.org/cgi/content/full/31/3/26-q
AAP News Vol. 31 No. 3 March 2010, p. 26