Choking is a leading cause of injury in children, according to the American Academy of Pediatrics, especially those four years and younger. Although the number of choking incidents involving toys and toy parts has gone down in the last 20 years due to manufacturer and federal government warnings, the number of food-choking cases in youngsters is still high.

"We have done a great job in this country (of) preventing choking in children on toys, “says Dr. Gary Smith, co-author of a new study on choking injuries and a professor of pediatrics at The Ohio State University College of Medicine. “Since the 1990s we've had laws and regulations, systems where we can monitor these injuries when they happen. We have no such systems in place currently for food."

The Research Institute at Nationwide Children's Hospital in Columbus, Ohio, reviewed thousands of statistics on children who had choking-related emergency room visits between 2001 to 2009. The study authors found that an average of 12,400 children under the age of 15 were treated for non-fatal, food-related choking each year, which equals about 34 children per day.



According to the Pediatrics study, foods that caused the most choking incidents were hard candy, meats and bones. High-risk foods, including hot dogs, seeds and nuts, were more likely to require hospitalizations.

“That's because hot dogs, nuts and seeds are hard to chew," noted Smith. “The hot dog is the perfect size to block the airways, in a young child, so that's why those are much more dangerous foods to give to a child."

More than 60% of the choking episodes happened in children 4 years of age and younger, according to the study. Choking incidents decreased as a child got older. After the age of 7 the number of cases remained relatively unchanged through age 14.

Parents need to keep in mind the age of their children when giving them certain foods, the study authors warned, especially when it comes to newborns. There has always been discussion on when to start a baby on solid foods. Dr. Jennifer Shu, a pediatrician with the Children's Medical Group, in Atlanta, Georgia, says 4 months is a good starting point.

“Before 4 months, foods can be a choking hazard” says Shu. "But if you wait much longer than 7 or 8 months then babies get really used to full liquid diet and may have a harder time adjusting to thicker textures.”

Child experts note parents and caregivers should be aware of food choking prevention recommendations and guidelines. The AAP recommends children younger than 5 years of age should not be given hard candies or gum, and raw veggies and fruits should be cut into little pieces. Young children should be supervised while eating and should eat sitting down.

In order to cut down food on related choking incidents, the study authors recommend placing warning labels on foods that pose a high choking risk for babies and children. They also believe a public awareness campaign should be designed to educate parents about the dangers of food-related choking among little ones.