Preventing choking in young kids

My son is 3 years old, and he is a little rambunctious. He runs around, touches everything, and, more often than not, everything winds up in his mouth. I am constantly worried about the potential choking dangers buI don’t want to be too over protective. What can I do to make sure my son stays safe while becoming more mobile and playful?

You are right to want to be careful, as children under the age of 5 are at the highest risk for choking on small objects. Your son’s trachea (the “windpipe” that connects the throat to the lungs) is much smaller than that of an adult or older child, with a diameter approximately the same size as that of a drinking straw. However, by knowing the risks and the precautions you can take, you and your son can be happy and carefree.

Toys are an integral part of children’s play. However, they can pose a significant risk of choking, especially for children ages 3 and under. It is best to avoid toys that have loose parts that are smaller than one and quarter inch in diameter and shorter than two and a quarter inches long. Legos, dolls, or figurines with small attachments that break off; marbles; pen and marker caps; crayons; erasers; and toy cars with wheels that come off can all pose a risk of choking. Broken latex balloons and the beads often used as filler in stuffed animals can also lead to suffocation if inhaled. Pay attention to toy labeling, especially the suitable age range. If a toy is meant for an older child, it can wait for a few years. Even when your son plays with toys appropriate for his age, it is important to keep an eye on him.

During parties and celebrations, be mindful of the kind of food being served to your child, as well as of treats that may be left out in the open and within his reach. Many foods that are safe and even healthy for adults and older children can be serious choking hazards for children under 5. Whole grapes, raw vegetables, raw peas, fruit with skin, seeds, carrots, celery, and cherries can all pose a risk. Your son can still eat these foods as long as he is supervised and they are mashed, cooked, or otherwise softened. Dried fruits, sunflower seeds, nuts, peanuts, and spoonfuls of peanut butter or peanut butter on soft bread, popcorn, and bony fish can also easily block the airway. Candy—always tempting to children—can be particularly hazardous, especially small, hard candies.

Even when these objects are kept out of reach, it is still important to supervise your son. Little things that you may not even notice or be aware of—coins in the couch cushions or dropped trinkets—can also pose a danger to young children. Make sure to keep floors and surfaces within your son’s reach free and clear of any small objects. If you bring your son to a relative or friend’s house that is not child-proofed, request ahead of time that they be mindful of small objects and be extra watchful while you are there. You can also teach your son safe habits—chewing slowly, not talking while eating, and not putting foreign objects (including toys) in his mouth—which can reduce the risk of choking.

If, despite all precautions, the worst happens, be prepared with knowledge of how to perform the Heimlich maneuver and CPR. In a choking situation, as with any medical emergency, call 9-1-1 immediately.

Pramod Narula, MD is the Chairman of the Department of Pediatrics at
NewYork-Presbyterian Brooklyn Methodist Hospital.