Choking Prevention for Infants and Young Children

Childhood choking: An overview

A baby or toddler must explore to grow. “Babies and toddlers learn by being curious. Curiosity and intelligence compel babies to touch, handle, put things in their mouth, and take things apart” (American Academy of Pediatrics [AAP], 2020). Yet, they must explore and examine objects in a safe and supervised manner.

Choking is a significant, preventable cause of morbidity and mortality among children, especially those ages 3 years and younger (AAP, 2020). Moreover, it is the leading cause of unintentional injury deaths in infants and the fourth leading cause of unintentional injury death among preschool children (Salih, Alfaki, & Alam-Elhuda, 2016).

It is difficult to estimate how many nonfatal choking episodes occur in young children every year because many episodes are not reported and do not involve an exam by a health-care provider. However, following are choking statistics from a Centers for Disease Control and Prevention (CDC) study cited by the AAP policy statement, “Prevention of Choking Among Children” (2020). The CDC analyzed nonfatal choking episodes in children 14 years and younger who were treated in emergency departments.

Accidental choking in young children: By the numbers

  • Nonfatal choking


    60 percent: Food, 19 percent of food: Candy and gum, 31 percent: Nonfood objects, 13 percent of nonfood: coins, 9 percent: Unknown


    30 percent: Infants, 77 percent: Ages 3 years and younger


    Male and female children treated at similar rates

    50 percent: Female, 50 percent: Male
  • Fatal choking

    Top causes

    29 percent: Latex balloons, Food causes include: 17 percent: Hot dogs, 10 percent: Hard candy, 9 percent: Grapes, 8 percent: Nuts


    65 percent: Ages 35 months and younger

    184 children and adolescents in the United States died in 2017 after choking on nonfood objects.

    (JAMA, 2019)

    Between 66 and 77 children younger than 10 years of age die from choking on food each year in the United States.

    (AAP, 2020)

Sources: CDC in AAP, 2020. Additional details from Johns Hopkins Medicine, 2020.

Frank talk: Why a hot dog is a dangerous choking hazard

Hot dogs are ubiquitous in the United States. An estimated 20 billion hot dogs are consumed in this country every year, according to the National Hot Dog and Sausage Council (2016). That’s 60 hot dogs per person, using 2020 population data.

“Every food poses a choking risk in young kids but the hot dog has just the right size and consistency to perfectly block the airway. It’s the perfect plug that doesn’t allow any air to get through” (Johns Hopkins Medicine, 2020).

hot dog

Role of health-care and dental professionals in choking prevention

Pediatricians, dentists and other health-care providers should counsel parents and caregivers about how to prevent accidental choking as part of anticipatory guidance during preventive medical and dental checkups (AAP, 2020). Texas Health Steps recommends that primary care providers address choking hazards in the child’s home beginning with the 2-month Texas Health Steps preventive medical checkup. A complete list of guidance topics can be found in the Texas Health Steps Anticipatory Guidance Provider Guide. Counseling tips will be discussed in detail later in this course.

Oxygen deprivation

If the brain does not receive oxygen for more than four minutes, permanent brain damage and death can occur (AAP, 2015).