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

• hard foods
• foods that are hard to chew
• foods that have a shape and size that can block the airway of a young child
• foods that are both smooth and sticky

There are many ways to reduce a child’s risk of choking on food.

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.

Do not serve these foods to children under the age of four years:

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

Prepare foods so they are less of a choking risk:

• Cut large chunks of food into smaller pieces, such as:
  • fruits
  • vegetables
  • foods that are harder to chew, like meat, poultry and some shellfish
• Make sure chunks are cut into smaller pieces in foods such as:
  • soups
  • stews
  • salads
  • casseroles
  • pizza toppings
• Grate cheese
• Break up clumps of raisins or dried berries into individual pieces, and cut large dried fruits (such as apricots, dates and prunes) into raisin-size pieces.  Dried fruits can be a part of healthy eating, but they can stick to the teeth and cause cavities. If you offer dried fruits, serve them with meals and brush your child’s teeth after.
• Cut foods with a large round shape into quarters lengthwise and then cut into smaller pieces as needed – for example, grapes, cherry tomatoes, whole cooked carrots, etc.  The size and shape of wieners and sausages make them a choking hazard, so they would need to be cut the same way.  However, they are usually high in salt (sodium), so do not give them to your baby.
• Spread peanut or nut butter thinly on toast or crackers – never serve peanut or nut butter spread thickly on something or alone in a lump or on a spoon. It could get stuck and block your child’s airway.
• Remove all bones from fish, meat and poultry before serving.
• Remove the pits from fruits.
• Grate hard raw vegetables and fruits such as carrots and apples, or cook them until soft but not mushy.
• Finely chop foods with fibrous or stringy textures such as celery or pineapple.