The shapes and textures of some foods are more likely to cause choking. The foods commonly associated with choking are described below, along with ways of reducing the risks.
Small hard foods
These are difficult for children to bite through and break down enough to swallow safely – pieces can become stuck in children’s airways. Examples are:
- Nuts and large seeds (e.g., pumpkin and sunflower seeds)
- hard dried fruit
- pieces of raw carrot, celery, or apple
- foods that break into hard sharp pieces (e.g., crisps, rice crackers)
To reduce the risk of choking:
- avoid giving whole nuts, large seeds, or hard dried fruit
- use thinly spread smooth peanut butter instead of whole or chopped nuts
- consider nut allergies
- carrot, apple, and celery can either be cooked until soft or finely grated.
Small round or oval foods
These can lodge in children’s airways. Examples are:
- sausages, grapes, berries, peas, olives, and cherry tomatoes
- raisins and sultanas
- fruit with stones and large seeds or pips (e.g. watermelon, small stone fruits)
- lollies/sweets, Cheerio’s or other round shape cereals.
To reduce the risk of choking:
- sausages, grapes, berries, olives, and cherry tomatoes can be quartered or chopped to the size of a child’s smallest fingernail, no bigger than a ¼ inch.
- soak raisins and sultanas to soften, and cut in half if large
- remove stones from fruits, peas can be squashed with a fork.
Young children don’t have the ability to chew small round hard, chewy, or sticky gum, lollies/sweets. These shouldn’t be given under the age of three.
Consider oral health and hygiene for children.
Foods with skins or leaves
These are difficult to chew and can completely seal children’s airways. Examples are:
- chicken, sausages, saveloys, frankfurters, etc
- stone fruits (e.g. plums, peaches, nectarines, cherries)
- apples and pears
- tomatoes, lettuce and other raw salad leaves
- spinach and cabbage.
To reduce the risk of choking:
- remove or peel skins before serving,
- chop up (to size of the child’s small fingernail) and add to mashed food
- finely chop salad leaves, remove stones from fruit
- cook spinach and cabbage until soft and chop finely.
Compressible foods
These can squash into the shape of a child’s throat and get stuck there. Examples are:
- sausages, saveloys, frankfurters, hot dogs, etc
- pieces of cooked meat
- marshmallows and popcorn
To reduce the risk of choking:
- chop up (to as small as the child’s small fingernail)
- as above– remove skins before serving
- cook meat until very tender, and chop finely
- marshmallows and popcorn should not be given to children under three
- do not give chewing or bubble gum.
Thick pastes
Foods like this can form to the shape of a child’s airway and stick to its side. Examples are:
- chocolate spreads or peanut butter.
To reduce the risk of choking:
- use thick pastes sparingly and spread evenly onto bread.
Fibrous or stringy foods
The fibres in this sort of food can make it hard for children to break the food up into smaller pieces. Examples are:
- celery, rhubarb or raw pineapple.
To reduce the risk of choking:
- peel the skin/strong fibres off celery and rhubarb
- slice these foods thinly across the grain of fibres.
Cheese
Young children are safe to have pasteurised full-fat cheese from 6 months old. This includes hard cheeses, e.g. mild cheddar (cut to ¼ inch size), cottage and cream cheese.
Babies and young children shouldn't eat mould-ripened soft cheeses, such as brie or camembert, or ripened goats' milk cheese and soft blue-veined cheese, such as Roquefort, as there's a higher risk that these cheeses might carry a bacteria called listeria.