While there is no way to completely eradicate the risk of choking during this exciting and challenging time, the human body is designed to protect itself. Babies have both reflexes and anatomical protections to reduce the risk of choking as they learn to eat a variety of food textures, shapes, and sizes.
Still, you can take steps to reduce the risk of choking by setting up a safe eating environment, learning what not to do when baby is eating, and carefully choosing which foods to serve. Keep in mind that these suggestions mitigate but do not eliminate the risk of choking. Reference our free First Foods® database to find out how to make your favorite foods safe for baby.
Before identifying which foods and food sizes are most risky and how to modify those for baby, it’s essential to understand the steps you can take to reduce baby’s risk of choking regardless of what you serve.
The primary way to reduce choking risk in infants, toddlers, and children is ensuring they are seated in a supported seat with full adult supervision while eating.
Allowing baby to self-feed rather than placing food in baby’s mouth appears to reduce the risk of choking.
Building well-coordinated chewing skills will further decrease the risk of choking as a child grows. It’s tempting to consider avoiding all chewable finger foods for baby in favor of serving purees, but research does not show an increased risk of choking for 6-12-month-old babies when starting solids with finger foods compared to purees when parents are advised on strategies to minimize choking risk.
Regardless of how they start solids, all babies should be introduced to finger foods by 9 months old. There appears to be a critical window where introducing chewable finger foods is essential to developing oral motor skills and preventing picky eating from developing as the child ages.
Chewing skills do not automatically appear as baby ages. To develop efficient and safe chewing skills, baby must gain exposure to and repetitive practice chewing a wide variety of food textures and sizes.
Introducing finger foods to baby between 6-9 months is important, but certain foods and food characteristics are riskier than others. You can reduce the risk dramatically by avoiding high-risk foods with little nutritional benefit (such as hard candy) and appropriately preparing high-risk foods that are nutritionally important. Preparing food for age appropriateness makes foods easier to self-feed, move around the mouth, and break down, which decreases the risk of choking.
What makes certain foods a choking hazard? In general, there are four characteristics of food that increase the risk of choking:
The more small, round, hard, and slippery a food, the higher the choking risk. These foods are more likely to enter and get lodged in the breathing tube and be difficult to expel or cough out if swallowing fails.
Foods like seeds, whole nuts, baby carrots, apples, pomegranate arils, and grapes top the choking hazard lists—they are challenging to manage in the mouth and could slip into the airway, become lodged, and are challenging to expel without assistance. Any food could make its way into the breathing tube, especially when not fully chewed. However, most of the time, babies (and adults) can safely gag the food forward well before it gets into the breathing tube or cough those items back out if swallowing fails. However, small, round, firm, and slippery items that accidentally make their way into the airway can be more difficult to expel, leading to a true choking emergency.
To lower the choking risk, prepare food to negate the characteristics above. For example, blueberries (small, round, and potentially firm) can be smashed or quartered; raw vegetables (firm and potentially round) can be steamed and sliced lengthwise; and mango (slippery) can be rolled in ground coconut flakes to add texture.
Nervous about starting solids? Our Starting Solids Bundle has all the resources you will need to build confidence and create a safe eating environment for your baby. You can also download our Infant Rescue Guide or Toddler Rescue Guide that will help you learn how to identify choking and understand which rescue maneuvers to use.
The size of a baby or child’s windpipe is about that of a drinking straw in diameter. Foods that could get stuck in a straw or form a sticky plug over it are choking risks. On rare occasions, foods smaller than this can enter the windpipe and cause significant discomfort and trouble breathing but are most likely to continue traveling further down, ending in the lungs.
Food size safety varies with age, and even a couple of months can make a difference. Below is a guide to use but follow your gut: if baby is struggling with a certain food or the food makes you nervous, take it away and modify it further. Just remember, building well-coordinated chewing skills takes time and repetitive practice chewing a wide variety of food textures and sizes. Developing these skills will further decrease the risk of choking as a child grows.
Unsure how to cut or prepare a particular food? Look it up in our free First Foods® database. Size and shape recommendations remain consistent whether or not baby has teeth. Every baby develops chewing skills and coordination at their own rate—some babies need easy-to-hold or slightly mashed food a bit longer while others need more challenging foods a bit earlier to stay engaged.
When it comes to food texture, keep in mind that food is highly variable. Even when we look at one type of food, such as a pear, you’ll find a ripe pear is a different texture than an under-ripe one, the inside of the pear will be softer and move differently than the skin, and the top of the pear may be a different texture and softness than the wide bottom part. Our goal is for baby to learn to chew and break down a wide variety of textures over time, not to modify all foods to be the same texture for baby.
Unsure of how to incorporate a wide variety of textures in your baby's diet? Check out our First 100 Days Plan for daily meal plans for starting solids.
There is a bit of irony in food sizes for the youngest eaters: the bigger the piece of food, the safer it is from a choking perspective. Research shows the highest risk of choking comes when a person is _fed—_when food is placed in someone’s mouth instead of self-fed. So, the food must be large enough for baby to pick up and self-feed independently to provide the most protection against choking.
For this age group, opt for food that baby can independently pick up and hold. Baby should be able to hold a piece of food in their hand with some sticking out on the top and bottom of their fist. Stick or spear-shaped foods are generally the easiest for baby to pick up and self-feed, but this is not an essential shape. For example, a large, soft strawberry works just as well as a spear of roasted zucchini. In general, prepare food size to fit the following characteristics:
Length and width of two adult fingers
Large enough that it will stick out above and below baby’s closed fist
As baby learns to chew, there are 3 main food textures that are safest:
Foods that are soft and easily mashed by baby’s tongue and palate and quickly broken down without coordinated chewing skills
Foods that are slightly firmer but still start to break down into smaller pieces with a bit of sucking or gnawing
Highly resistive foods—we also call these “unbreakable” foods—which baby can gnaw on but won’t break off any chunks or big pieces.
Each of these textures advance baby’s oral motor skills and increase their sensory tolerance for different textures in the mouth. Remember, the goal is to keep baby as safe as possible while also introducing them to various textures with gradually increasing complexity to help them build their oral-motor skills over the next several months.
Babies at this age have reflexes that help them chew and break down food but an often overlooked skill required to eat is the ability to pull those broken down bits of food back together into a little ball or package to easily move back to the throat and swallowed. Most 6-month-olds babies are going to find that skill very challenging, but if we give them ample opportunity to practice by serving them soft, mashable finger foods, most babies will develop this skill by 8-10 months.
As baby starts solids, some 6-7-month-olds find soft, mashable foods most challenging because these foods quickly spread around the mouth as they mash or stick to the roof of the mouth. As the food spreads, it tends to lead to strong gags. This is where slightly firmer foods which start breaking down into smaller pieces with a bit of sucking or gnawing or highly resistive foods can also be great options right at first. They allow baby to increase their tolerance to texture and input in their mouth but still enables the control to pull these foods back out of their mouth without leaving mashed food behind.
Keep in mind, these recommendations are the same whether or not baby has teeth.
For the past few decades, persisting even today, many people incorrectly recommend diced and chopped foods for young babies. Diced and chopped foods are too small for most 6-8-month-olds to self-feed; these foods require a pincer grasp (where the pointer finger and thumb come together) to successfully bring to the mouth. Babies can successfully pick up larger strips or chunks of food using an age-appropriate whole-hand (palmar) grasp.
With the smaller pieces, young babies tend to lose interest as they are too challenging to pick up. Additionally, young babies can have a harder time managing small pieces of food in their mouth; it is proposed that larger pieces of food in the mouth cause more brain neurons to fire, thus helping them learn how to safely manipulate food in the mouth.
Maeve, 7 months, struggles to pick up small pieces of pear.
Maeve, 7 months, easily handles a slice of soft, ripe pear.
For example, when a 6-month-old is gumming and mouthing a two-inch thick, long strip of steak, the choking risk is minimal—baby doesn’t have the jaw strength or coordination to bite off a piece. If a piece is removed, baby will most likely spit or gag it out. When babies are allowed to self-feed, the brain engages in the act of eating: what’s in the hand, locating the food on the lips and in the mouth, and activating certain protections like spitting and gagging if the food gets too far back in the mouth. Comparatively, research shows that it’s much more likely for babies to choke on a small chunk of meat placed in their mouth because the brain and baby are not aware of the food as it moves toward the back of the tongue without attempting to chew and break it down.
Around 9 months, babies develop a pincer grasp, a fine motor skill where the pointer finger and thumb come together. The pincer grasp gives babies the ability to pick up smaller pieces of food. Baby may also be stronger and more coordinated at tearing foods.
With these skills developing, it’s also time to decrease the size of the food. Around 9-12 months old, baby may now have the skills and ability to self-feed food shapes and sizes including:
Small, bite size pieces
What does "bite size" mean?
To date, baby has been grasping bottles and food with the palms of the hand. Between 8 and 9 months of age, many babies start to connect the tips of the thumb and pointer finger. This is called the pincer grasp, and when you see signs of this development, it is a signal that you can move down in size by offering bite-sized pieces of food. By a “bite-sized piece” of food, we mean the shape should resemble the size of your thumb knuckle: small enough for baby to grasp with the pointer finger and thumb and fit in the mouth without biting into it, but not so small that it can easily block the airway if it is accidentally moved back whole and mis-swallowed. At this stage of life, a baby’s airway is about the size of a chickpea or garden pea, so the piece should be a bit larger. And just remember, it's not only the fact your babe has developed the pincer grasp that makes them ready for this next stage of solids. You may want to consider their exposure and experience with chewable foods when thinking about their ability to effectively manage this size.
At this age, most babies can handle foods which are soft and easily mashed by the tongue, palate, and gums. The safest options are soft foods or foods which are cooked to a soft consistency.
Babies at this age commonly over-stuff their mouths as they get more confidence in self-feeding. If this happens, continue offering bigger pieces of food (larger than could fit in their mouth at once) to help babies learn how to take a bite, learn about their mouth's borders, and draw a “mental map” of what fits and what doesn’t.
Another common occurrence at this age is swallowing smaller pieces of food whole. If this happens, continue offering bigger pieces of food to help practice and build chewing skills. Babies also learn by watching. Model and show exaggerating chewing while you eat alongside baby.
At 12 months old, a toddler can likely chew a wide variety of textures and sizes if they have been practicing chewing solid foods for a few months. At this age, a toddler can likely eat what you eat with few modifications. Serve foods:
Cut into small pieces (perfect for utensil practice!)
Soft and large so the child has to take bites, such as a whole ripe banana
Sliced or shredded
Cook resistive foods requiring a lot of chewing until soft or serve in ruler-thin slices, shreds, or diced
Cook meat and fish well done
Toddlers may continue spitting out some foods that aren’t chewed well—this is normal. If this happens, offer stick or spear-shaped foods to help the child further “map” the mouth and develop more chewing strength.
If a toddler has been steadily eating a variety of textures and working with foods of challenging shapes and sizes, they should be a reasonably advanced eater by 18 months.
However, it is still important to modify high-risk foods that are round, firm, and slippery (see list below). It is equally important to keep food at the table, as choking risk increases (with all food) when children are moving around or talking/laughing/singing while eating.
At this age, many toddlers will be adept at using a spoon and fork by themselves. Some toddlers may still need some practice and benefit from pre-loaded spoons and forks to practice scooping and spearing foods. Even those who are capable of self-feeding with utensils will likely revert to finger feeding as a meal progresses or at the end of a long day.
Need a visual with real food and real babies? Check out our video on food preparation and safety.
This is a common question from many families.
If the food is soft enough that a baby can tear a piece off with their gums, it is likely soft enough for them to mash in their mouth, similarly to how they would mash any other food.
When a baby actively takes a bite of a food item, the brain gets the message: "Hey, I'm supposed to chew this." Deep, brainstem reflexes are triggered, and baby will most likely engage motor patterns to move the food around in the mouth.
Babies tend to bite with their front teeth, and the side-to-side movements of the tongue are just starting to move food effectively. So, a piece of food in the front and center of the mouth is most likely to stimulate the dominant, and well-known tongue thrust pattern, which spits the food out.
The swallow is a reflex, so even if the food isn't well chewed and it moves towards the back of the mouth, the brain will tell the baby to swallow it—even whole—which is not choking. The pharynx and esophagus (parts that make up the food tube) are elastic, and immediately start pushing food down towards the stomach, squeezing from the top down while digestive enzymes help to soften everything.
If baby bites off a piece of food that makes you nervous, kneel next to the baby so they look down at you, demonstrate sticking out your tongue, and place your hand in front of their mouth. Take a deep breath, and trust that baby knows what to do. Do not place your fingers inside baby’s mouth. In the future, further modify this food if you feel uncomfortable.
Yes. The main tenet of safe feeding and swallowing is self-feeding. If a baby has the skill to pick up a small piece of food (i.e., pincer grasp), it is safe for them to feed it to themselves. Most young babies who break food apart do not have this skill and will struggle to pick up small pieces of food, which means they are not able to bring these smaller pieces to their mouth. If baby can break apart the food, it is likely soft enough for the gums to munch as well. If you are ever nervous or worried, remove those pieces of food from the tray.
Regardless of how many teeth your baby has, the recommendations for ways in which to serve the food would remain the same. The gums are quite powerful, and do the bulk of the work for breaking down food (believe it or not the real "chewing teeth" are the molars, that don't pop until after a year). Although a baby who has teeth early may be more successful in biting off pieces of finger food, there is no increased risk of choking in this population, despite the fact that it may feel more scary. The same protective mechanisms exist--tongue thrusting movement, the gag, closure of the airway, and the swallowing reflex. Babies will break off a too-big piece of food. Often. For many, many months, no matter how many teeth they have. So what to do when it happens: First, try not to intervene and to let your baby work the food forward on their own. Most babies will spit or gag it forward. You might also consider focusing on some bigger, harder long sticks of food like corn on the cob, chicken drumstick, ribs, mango pits etc to work oral development.
Your baby is likely to bite off a piece. We trust that your baby is already innately equipped with all of the skills needed to manage this: the gagging reflex is there in case your baby tries to swallow too big of a piece (and is part of the learning process), your baby may also thrust a too-big piece out of their mouth with their tongue, and/or your baby may have the chewing reflex triggered or have sucked on it enough before breaking a piece off that they are able to manage it and swallow it effectively. All of this is so important for your baby to learn, and by honing in on these skills at a young age, you are really maximizing their safety for once you transition down to smaller pieces (around 9 months old).
Lastly, you can coach your baby to spit food out, which is a great skill for them to have, though often won’t be mirrored until closer to 9 months. See this video: What to do when your baby has too much food in their mouth. Our Starting Solids Video Course also dives into gagging and choking further.
It is a misconception that babies need teeth to eat. Interestingly, the teeth that we actually use to chew (our molars) don’t come in until well after the first birthday. Babies can munch and grind food with their gums. It's really more about the skill level that has been developed up until that point. If you are concerned about your baby's chewing ability, you could focus on working on more skill development to improve this skill. See our page on How babies learn to chew.
While more than 50% of choking incidents in young children do not involve food, here is a list of some potential choking hazards. As always, reference our free First Foods® database for age-appropriate serving suggestions.
Apple: cook until very soft, mash, or slice into thin slices
Blueberries: flatten between your fingers
Carrots: cook until very soft and mash or slice lengthwise, grate raw carrot
Celery: slice into half-moons and cook until soft
Cheese: cut into thin slices
Cherries: pit and quarter lengthwise once pincer grasp develops
Chickpeas: smash or purée
Corn: avoid loose kernel corn and serve on the cob instead
Dried fruit: avoid
Fish: de-bone thoroughly
Grapes: quarter lengthwise once pincer grasp develops
Melon: cut into thin slices (never melon balls or cubes) or offer just rind with thin layer of flesh
Peanuts: finely grind and mix into other foods, spread peanut butter thin on other foods
Peas: smash, mash, mix into a binding food like yogurt or mashed potatoes, smash once pincer grasp develops
Pear: choose a very ripe pear or if it’s firm, cook until soft or serve in thin slices
Nuts and seeds: finely grind and mix into other foods
Nut butters: spread thin on other items or thin out with yogurt, applesauce, breast milk, or formula
Rice, barley, and grains: cook well, mix into a binding food like yogurt, allow to self-feed
Sausage: quarter lengthwise
Shrimp: cut lengthwise into quarters
Strawberries: offer whole, very large, very soft berries that pass the squish test. To check if the berry is soft enough, press it between your fingers and make sure it gives under slight pressure. If you have to press hard for it to give, it is too firm. Smash or slice small, round strawberries
Tomatoes (cherry and grape): quarter lengthwise, wait for pincer grasp to develop
Sign up for new guides, recipes and special offers
The content offered on SolidStarts.com is for informational purposes only. Solidstarts is not engaged in rendering professional advice, whether medical or otherwise, to individual users or their children or families. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or your medical or health professional, nutritionist, or expert in pediatric feeding and eating. By accessing the content on SolidStarts.com, you acknowledge and agree that you are accepting the responsibility for your child’s health and well-being. In return for providing you with an array of content “baby-led weaning” information, you waive any claims that you or your child may have as a result of utilizing the content on SolidStarts.com.