I n t e rv i e w Preventing Choking on Food in Young Children Every five days, a child in the United States dies from choking on food, and each year 10,000 -to-20,000 children are treated in emergency rooms for food-choking accidents. Nina Shapiro, MD, a UCLA pediatric otolaryngologist, explains which foods should be avoided for children under 5. Why are young children at particular risk for choking on food? Before the age of 5, children may not have molars to help them chew. Their swallowing coordination and reflexes are immature. For infants and toddlers, the airway is small — about the size of their pinky finger — and high in the neck, which gives direct access for high- risk foods to go into the windpipe. And a lot of young children are running around, playing or jumping in their chairs when they eat. What are some of the most dangerous foods? Foods tend to be dangerous either because of their shape or because of the way they’re served. A hot dog generally is fine, but its cylindrical shape poses a very high risk for small children. To be safe, it should be cut length-wise and width-wise, into the shape of a half or quarter moon. Grapes are also high-risk choking foods. They need to be peeled and cut into halves or quarters. Peanut butter and other nut butters should be spread thinly on crackers or bread. Vegetables should be cooked and cut into small pieces. Dried fruit, raw vegetables and chunks of meat or cheese can be dangerous. Any nuts or seeds, popcorn, hard or sticky candy, lollipops and chewing gum should be avoided for children under the age of 5. What other measures should parents and/or caregivers take to prevent choking incidents? An adult always should attend to a young child when the child eats. A high percentage of UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631)