8 Choking Hazards for Babies and Infants

by Russell A. Faust, PhD, MD

For Infants and Toddlers Less Than 2 Years Old

Because I am the “children’s airway doctor” for the hospitals that I serve, the list below is a sample of the things that I routinely remove from the lungs of children.  Some of these things seem pretty common sense.  That is, most parents wouldn’t think of giving a 1-year-old peanuts or sunflower seeds to eat (I hope).  Some of these foods you may not have thought of.

Here is a review of the symptoms, the list of risky foods, and what to do if you think YOUR little boogor head has aspirated something.

Symptoms

” It was last week:  I was in the kitchen and the kids were playing on the porch.  That’s when little Sally started choking and coughing.  I ran onto the porch to see what the problem was.  It looked like her older brother was sharing his peanuts with her.  She was choking and coughing, but that stopped quickly.  After that she had a little wheezing.  She was crying. Her cough stopped after awhile, maybe 10 or 15 minutes.   She has had just a little cough ever since, and she is not eating as well.  She is having low-grade fevers. “

That’s how many parents describe the “event.”  Symptoms after a child aspirates (breathes in) a bit of food or other object (foreign body) can be very subtle.  The initial choking and coughing are the biggest clues to aspiration.

If in doubt, take your little one to the Emergency Department of (this is KEY) your Children’s Hospital. Your CHILDREN’S Hospital, not an adult, general hospital if you have a choice.

And, here’s the other key – make sure they dont’ eat or drink anything starting now, while you head over to the Emergency Department.  That way, if they DO need to have anesthetic to remove something, the anesthesiologist will be happier, and your child will be safer!

They will listen to the lungs, likely obtain a chest Xray.  Depending on their level of suspicion, they may consult a specialist – a Pulmonologist or Otolaryngologist.  They may obtain a fast CT scan of the lungs.  They may need to go to the operating room to remove something.

Note:  it is better to take a child to the operating room to look for an aspirated foreign body and be wrong, than to let them go home when there is a foreign body there.  A foreign body remaining in the lung for a long time can become a problem later (see below).

It’s All About Oral Control

What we don’t consider is that good oral control of food doesn’t really develop until around age 2 years.  We simply don’t develop the sensory nerve awareness and the muscle control of the tongue and swallowing muscles until around 2 years.  Sometimes earlier, often later.

Inflammation

A couple of the most common things that I remove from lungs in toddlers (say, around 1 ½ to 2 years) are popcorn and (surprise) raw carrots.  Some of these really make a mess in the lungs from the body’s reaction.  Peanuts are notorious for this.  Must be the oils and proteins.  Some of the items don’t cause much irritation, but can be very challenging to remove it all.

Some Objects May be Impossible to Remove

ANYthing that ends up in the lung may be impossible to remove.  Think of the tiny chewed up pieces of popcorn or other food that we swallow.  If those little pieces are aspirated into (breathed-in) the lungs instead, they can go everywhere.  If “foreign bodies” (what we call this stuff in medicine) remain in the lung long-term, they can cause permanent damage.  Occasionally, this requires a portion of a lung to be removed.  Big-time surgery.  Bid deal.  Do what you can to avoid these issues.

Airway Foreign Body - Pumpkin Seed Obstructing Right Bronchus in a 9-Month-Old

Even worse:

Some Objects Can Be Fatal

ANY of these items can cause spasm of the airway and can be fatal.  Some of these items are more likely to obstruct a child’s airway and be fatal, like grapes or cherry tomatoes.

The List

So, think about it before handing your 18-month-old a chocolate-peanut candy bar:

• Nuts – any nuts
• Large chunks of fruit or vegetables, raw or cooked
• Raw Carrot – requires great oral motor coordination to chew, swallow; wait until your toddler has teeth and is chewing well
• Large chunks of meat
• Hotdogs – perfect for blocking the airway
• Whole grapes or cherry tomatoes – always cut into quarters
• Popcorn
• Seeds
• Raisins – wait until your baby has teeth and is chewing well

Of course, this list doesn’t include ALL of the possible things that a baby might aspirate into their lungs.  Just the most common.

And I am focusing on FOOD here – not the usual objects that little tykes aspirate like coins and toy pieces.

Party Mix / Trail Mix

If you look at the list, notice nuts, raisins, seeds, and popcorn.  Think “party mix”.

I see a lot of these items in lungs of infants during the Holidays, when bowls of party mix are put out.  People scoop up a handful, innocently drop some on the floor.  Your little rug-rat comes along and puts it in their mouth, can’t handle it.  Voila, aspiration.

Watch for Older Siblings Feeding Younger Siblings

Warning:  older siblings like to feed their younger siblings.  They think that they are helping.  So, when you let your 3-year-old have raisins, or any of these other goodies on the list above, be certain they are not feeding them to your 1-year-old.

One Final Warning: If you think that your infant or toddler has swallowed or aspirated a small disk battery (like a watch battery, commonly found in remote controls), get them evaluated NOW.  Those batteries can cause severe injury, and fast.

To read more: http://www.homemade-baby-food-recipes.com/babyfoodstoavoid.html#ixzz0lkuMfpQi

Let’s keep your little boogor-heads safe!  If I NEVER need to remove something from a child’s lungs again, I will be a happy camper.

To download this post as a pdf file, go to the Free DOWNLOAD page here: http://wp.me/PR4iB-s7

Thanks for visiting, and see you here again. I appreciate your comments and questions.  Keep ‘em coming.  Please, “be excellent to one another.”

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Best of health and success to you and your families.

Until next time, remember … you can pick your friends, and you can pick your nose, but you can’t pick your friend’s nose (unless you’re a boogor doctor :~D)

Image Credits: I gratefully acknowledge the excellent pics used above from flickr:

http://www.flickr.com/photos/bastique/2616667677/ party mix

http://www.flickr.com/photos/farlane/127551550/ grapes

http://www.flickr.com/photos/viralbus/3160545557/ little girl chewing grape

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Tags: airway, airway obstruction, babies, choking hazards, foods, infants, pediatric airway, toddlers