Prevention of Choking Among Children

Abstract

Choking is a leading cause of morbidity and mortality among children, especially those aged 3 years or younger. Food, coins, and toys are the primary causes of choking-related injury and death. Certain characteristics, including shape, size, and consistency, of certain toys and foods increase their potential to cause choking among children. Childhood choking hazards should be addressed through comprehensive and coordinated prevention activities. The US Consumer Product Safety Commission (CPSC) should increase efforts to ensure that toys that are sold in retail store bins, vending machines, or on the Internet have appropriate choking-hazard warnings; work with manufacturers to improve the effectiveness of recalls of products that pose a choking risk to children; and increase efforts to prevent the resale of these recalled products via online auction sites. Current gaps in choking-prevention standards for children's toys should be reevaluated and addressed, as appropriate, via revisions to the standards established under the Child Safety Protection Act, the Consumer Product Safety Improvement Act, or regulation by the CPSC. Prevention of food-related choking among children in the United States has been inadequately addressed at the federal level. The US Food and Drug Administration should establish a systematic, institutionalized process for examining and addressing the hazards of food-related choking. This process should include the establishment of the necessary surveillance, hazard evaluation, enforcement, and public education activities to prevent food-related choking among children. While maintaining its highly cooperative arrangements with the CPSC and the US Department of Agriculture, the Food and Drug Administration should have the authority to address choking-related risks of all food products, including meat products that fall under the jurisdiction of the US Department of Agriculture. The existing National Electronic Injury Surveillance System–All Injury Program of the CPSC should be modified to conduct more-detailed surveillance of choking on food among children. Food manufacturers should design new foods and redesign existing foods to avoid shapes, sizes, textures, and other characteristics that increase choking risk to children, to the extent possible. Pediatricians, dentists, and other infant and child health care providers should provide choking-prevention counseling to parents as an integral part of anticipatory guidance activities.

Impact of peanut consumption in the LEAP Study: Feasibility, growth, and nutrition

“…However, clinicians should still emphasize that whole peanuts and chunks of peanut butter are a choking hazard in young children and should not be consumed before 5 years of age. (6-8,13)…”

“…Smooth peanut butter (Sunpat® and Duerr's® brands) was also provided by the study center; for safety, it was advised that this be loosened using warm (cooled, boiled) water prior to feeding infants. (13) Due to choking risk, it was also recommended that whole peanuts be avoided during early childhood. (13) Participants randomized to avoidance (and participants who were diagnosed with peanut allergy) were given detailed dietary advice on how to avoid exposure to peanut during study participation.…”

“…(13) Due to choking risk, it was also recommended that whole peanuts be avoided during early childhood. (13) Participants randomized to avoidance (and participants who were diagnosed with peanut allergy) were given detailed dietary advice on how to avoid exposure to peanut during study participation. They were advised that avoidance of products with peanut precautionary allergen labelling (where peanut was not a listed ingredient) was unnecessary unless diagnosed peanut allergic.…”

Compliance of Parenting Magazines Advertisements with American Academy of Pediatrics Recommendations

“…As such, the AAP has age-specific choking recommendations minimize exposure to choking hazards (i.e., no peanuts, popcorn, hard or gummy candy under age four; no latex balloons under age eight) [18,19]. The second largest share of advertisements which contained messages inconsistent with AAP guidelines were for those regarding these age-specific choking hazards.…”

“…The majority of the advertisements which violated choking guidelines were for gummy vitamins ( n = 50; 84.7%) which the advertisers indicated as intended for ages two and up. The shape and consistency of these vitamins is the same as gummy candy which the AAP does not recommend children consume until at least age four [18]. Several advertisements also depicted young children with latex balloons, which the AAP recommends avoiding until age eight, as they contribute to 29% of choking deaths [18].…”