Hot dogs need to be redesigned so they aren’t potentially lethal to small children, American pediatricians said Monday in a new policy statement.

“We have laws and regulations that require warning labels on toys that pose choking hazards,” said Dr. Gary Smith of Nationwide Children’s Hospital, the lead author of the policy published in the current issue of Pediatrics.

“There are no such regulations on high risk foods, and children are much more likely to put food in their mouths than a toy.”

The highest risk food is the hot dog, Smith said. Its size and shape means it can wedge itself tightly into a child’s throat, entirely blocking air passages.

“If you were to design the perfect plug for a child's airway, you couldn't do much better than a hot dog,” he told the Star. And unlike other risk foods such as grapes and popcorn, however, hot dogs are man-made and manufacturers can easily change their shape, he said.

Other risky foods for small children include grapes, popcorn, hard candy, carrots, pears, apples and celery.

In Canada, about 44 children age 14 and under die every year from choking and another 380 are hospitalized, according to SafeKids Canada. Almost half of those cases are from choking on food.

SafeKids concurs with the American Academy of Pediatrics’ recommendation to slice hot dogs lengthwise. The pediatricians go one step further, calling for a new shape for the dogs.

“No parents can watch all of their kids 100 per cent of the time,” Smith says. “The best way to protect kids is to design these risks out of existence. There is nothing to stop you from redesigning the hot dog. Safety sells. Someone can create a safety dog that isn’t round and airways-sized.”

Sweden has had age-labelling on foods for infants and young children since 1979 and warning labels on prepackaged shelled peanuts since 1981, Smith noted.

Janet Riley, president of the U.S. National Hot Dog & Sausage Council, told The Associated Press she agrees with the need for education, and points out more than half the hot dogs sold in the United States have warnings to parents to cut them into small pieces.

“As a mother who has fed toddlers cylindrical foods like grapes, bananas, hot dogs and carrots, I 'redesigned' them in my kitchen by cutting them with a paring knife until my children were old enough to manage on their own,” Riley says.

Smith disagreed. “Just telling people to be careful or blaming the parents is an uninformed approach.”

The pediatricians are calling for:

• Warning labels on foods that pose a high choking risk

• A recall of food products that pose a significant choking hazard

• The establishment of a nationwide food-related choking-incident surveillance and reporting system

• A commitment from food manufacturers to design new food and redesign existing food to minimize choking risk, to the extent possible

In the meantime, the policy recommends parents and caregivers:

• Do not give children younger than 4 any round, firm foods unless they have been cut into very small pieces. Cut hot dogs lengthwise and cut grapes into quarters.

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• Do not give toddlers other high risk foods, such as hard candy, nuts, seeds and raw carrots.

• Never let small children run, play or lie down while eating.