Choking prevention takes teamwork from moms and hot dog makers

The New York Times wrote an article about choking recently—actually I wrote the article.  In the comments section on the website, people took issue with the statement from the American Academy of Pediatrics, which called for putting warning labels on foods that are known choking hazards for children under three. People thought this would be overkill and that parents who feed their young children popcorn or hot dogs not sliced down the middle have no common sense. But I disagree. Not all people are aware of what constitutes a choking hazard.  Not all parents read parenting magazines every month and not all pediatricians are equal in how well they educate parents.

I personally don’t think it’s necessarily common sense to know that something as small as a peanut or even popcorn, which squishes down pretty small once it gets wet in your mouth, are hazards to a young child with some teeth for chewing. A hot dog or grape, which seem to be exactly the right size to plug up a child’s airway, definitely,  but a corn kernel? Not so sure.

In my article, I explained that it’s not just the size of the windpipe that is the issue here. Children don’t develop sophisticated eating abilities until they’re about four years of age. Before then, they chew some but not all of their food up—their tongues don’t have the sensitivity to feel if everything is chewed up, so they chew a little and swallow.  Whole bits of food go down with the mashed up food. And if they’re talking or laughing or walking around (few kids sit silently still while eating), they may inhale a bit of that food into their bronchial tubes, where it can block the air and choke a child.  This takes more than common sense, but an understanding of anatomy and child development, if you ask me.

Chrissy Cianflone, director of Programs for the advocacy group Safe Kids told me that parents often describe their children as smart and mature and therefore not at risk for choking, but they fail to grasp that there are developmental limitations to what their children can do. (Giving an unrelated example she explained that children under 10 may seem mature enough to cross a street by themselves, but up until the age of 10, their ability to determine depth perception and speed is limited).

The message is that prevention is key.  Parents can’t assume they can prevent choking of an unsafe food simply by watching their kids eat.  They need to prevent it from getting in their mouth in the first place. Doctors need to educate parents better. And it’s up to food manufacturers to help parents. Sadly, manufacturers have not risen to the occasion yet. “The food industry likes to control the space on the food label for advertising purposes,” says Bruce Silverglade, legal director of the center for Science in the Public Interest.  “The industry tends to resist any attempt by government to require better nutrition information, better ingredient information, and better safety information,” he says.

Indeed, when I took a trip to the supermarket to check out hotdogs, popcorn, and marshmallows, I was hard pressed to find warning labels. Maybe 30 to 40 percent of the hot dog packages had text indicating a warning to young children, but it was not easy to find on the overcrowded text-heavy hotdog packages. None of the marshmallow packages had warnings, and one brand of microwave popcorn had a warning, but it was on the bottom of the box. As the mom in my story whose daughter choked to death on popcorn said to me, ““What person reads the bottom of a box?”