Children younger than four years of age are most at risk of choking on food because they are still learning to chew and swallow.  It is possible for any type of food to cause choking but certain foods are more of a risk for choking than others.  These include:

• hard foods (e.g., raw carrot)
• foods that are hard to chew (e.g., meat)
• foods that have a shape and size that can block the airway of a young child (e.g., cherry tomato, large grape, chunk of cheese)
• foods that are both smooth and sticky (e.g., peanut butter)

The following items can be a choking hazard and should not be given to children under four years of age:

• popcorn
• hard or gummy candies or fruit chews, marshmallows
• peanuts or other nuts, seeds
• fish, meat and poultry with bones
• cough drops, gum, chewable vitamins

Be careful that your child does not get these items by mistake – for example from items dropped on the floor, from a dish on a coffee table, between couch cushions, etc.

There are many ways to reduce a child’s risk of choking. You can prepare foods so they are less of a choking risk.

• Foods with a large, round shape (e.g., grapes, grape/cherry tomatoes, whole cooked carrots, etc.)
  • Cut into quarters lengthwise and then cut into smaller pieces as needed.

Note: Wieners and sausages are highly processed foods, so they shouldn’t be offered to children. Their size and shape make them a choking hazard, so if offered, cut them into quarters lengthwise and then into smaller pieces.

• Vegetables and fruits
  • Remove pits and large seeds.
  • Cut into small pieces or thin strips (e.g., pears, peppers), including chunks of food in mixed dishes such as soups, stews, salads, casseroles and toppings on pizza.
  • Finely chop any fibrous or stringy foods (e.g., celery, pineapple).
  • Cook hard, raw vegetables and fruits (e.g., carrots, broccoli) until soft but not mushy, or grate them.

Note: Vegetable “sticks” (e.g., for dipping) can be made by taking root vegetables like carrot or turnip and cooking until just tender, chilling and cutting into thin sticks.

• Cheese
  • Grate or cut into small thin strips
• Peanut butter and other nut butters
  • Spread thinly on crackers or toast. Do not offer peanut butter or nut butter spread thickly on something or alone in a lump or on a spoon, as it could get stuck and block a child’s airway.
• Fish, meat and poultry
  • Remove all bones before offering.
  • Cut into small pieces or thin strips, including chunks of food in mixed dishes such as soups, stews, salads, casseroles and toppings on pizza.

Help keep your child safe while eating and drinking:

• Always stay with your child when they are eating because a child who is choking may not be able to make noise or get your attention. Coughing is a sign that a child is removing the food on their own.
• Make sure your child is sitting upright when eating or drinking, not lying down, walking, running, jumping or laughing.
• Do not allow an older child to feed a younger sister or brother.
• Encourage your child not to speak with food in their mouth, not to put too much food in their mouth at one time, and to chew food well before swallowing it.
• Do not allow your child to eat or drink in a moving vehicle. If your child starts to choke, it is hard to help them right away, especially because they are in a car seat and in the limited space of a vehicle.  Also, there are safety risks in getting the vehicle off the road to help your child, especially in busy traffic.  Eating or drinking in a moving vehicle increases the risk of choking if it stops suddenly.
• Always use metal or thick plastic cutlery, and non-breakable plates and cups. Do not use thin plastic cutlery or foam plates and cups, as these break easily and children can choke on the pieces.
• Do not serve food on toothpicks or skewers, or foods that are on wooden or plastic sticks, such as frozen treats.
• Consider learning choking first aid for infants and children.