Hot Dogs, Marshmallows, Candy Choking Kids
Pediatricians Urge Warning Labels on Foods Risky to Kids
Feb. 22, 2010 -- Every five days, a child in the United States chokes to
death while eating. Even more children die after swallowing items like balloons
and small toys.
Things have to change, says the American Academy of Pediatrics (AAP),
perhaps starting with labels on hot dogs, marshmallows, and round or
cylindrical hard candies, which pose a high choking risk to children.
In a policy statement released today, the group is also asking the FDA to
establish a nationwide food related choking-incidence surveillance and
reporting system “to warn the public of existing and emerging hazards.”
“This is a call to action,” pediatric emergency medicine specialist Gary A.
Smith, MD, tells WebMD. “Choking is preventable; and government, industry, and
consumer protection groups need to work together to protect children.”
Hot Dogs, Balloons Most Deadly
Very young children who are just beginning to eat solid foods have the
highest choking risk, but older children are at risk too.
In a 2001 CDC review of choking injuries, about one-third of choking
episodes occurred in infants and three-fourths occurred in children under the
age of 3.
According to one analysis, each year in the U.S., between 66 and 77 children
under the age of 10 die after choking on foods, and more than 10,000 children
under age 15 are treated in emergency departments.
Hot dogs are the biggest culprits, Smith says, because they are cylindrical,
compressible, and about the size of a young child’s airway.
Whole grapes, popcorn, peanuts, other nuts and seeds; round, hard candies;
meat, marshmallows, carrots, apples, chewing gum, and chunks of peanut butter
also pose a choking risk.
“Many of these foods ... share the same high-risk physical characteristics
that create effective plugs for the pediatric airway,” the AAP report states.
“Similar to latex balloons, peanut butter can conform to the airways and form a
tenacious seal that is difficult to dislodge or extract.”
For every choking-related death, there are 100 ER visits every year,
according to the CDC.
And choking is a leading cause of brain injury in young children. When
food or other small objects get caught in the throat and block the airways,
oxygen cannot get to the brain. Even a few minutes without oxygen can result in
In one analysis of about 450 choking fatalities among children over two
decades, the inhalation of latex balloons was responsible for 29% of deaths and
17% of deaths were caused by hot dogs.
Lessons From ‘Gel Candy’
Smith, who co-authored the AAP policy statement, says the FDA needs to take
a more active role in protecting children from manufactured foods that pose a
He directs the Center for Injury, Research and Policy at the Nationwide
Children’s Hospital in Columbus, Ohio.