Food shape and texture may increase the risk of choking, especially for babies who are still learning how to chew. Learn how to minimize risk at mealtime from our licensed pediatric pros.
Some foods and non-food objects (such as coins and small toys) pose a high risk of choking, especially when they are small and firm, round, rubbery, slippery, springy, sticky, and/or tapered.
To minimize the risk, be mindful of small objects around your home (especially on your floors) and modify foods to lower the risk of choking and make it easier for baby to practice chewing. Equally important is your meal setting: create a safe eating environment in which the child is safely seated with minimal distractions and supervised by an adult. The latest research and data show a child’s eating environment is the most important factor for mealtime safety.
The breathing tube of a young baby is about ¼ inch (⅔ cm) in diameter. While any food can block the ability to breathe if it becomes lodged in the breathing tube, certain foods come up again and again in conversations about choking. These foods share some or all of the following characteristics:
firm
round
rubbery
slippery
small
springy
sticky
tapered
These foods often come in shapes or textures that increase the risk of choking, but good news: most can be modified to safely share with baby. Download the Solid Starts App to use the First Foods® database to look up how to prepare any food for a child’s age and developmental ability.
Beans (e.g. Chickpea)
Berries (e.g. Blueberry)
Chewing Gum
Chips
Cookies
Fish Bones & Small Meat Bones
Granola Bars
Gummy Candy & Gummy Medicine
Hard Candy
Jelly Beans
Large Whole Seeds (e.g. Black Watermelon Seeds)
Marshmallow, Mochi
Meat Cubes or Chunks
Melon Balls or Chunks (e.g., Cantaloupe)
Nut Butters & Seed Butters
Nuts (Chopped or Whole) and Nut Shells
Orange & Other Citrus
Pretzel
Raisins & Dried Fruit
Shellfish (e.g. Shrimp)
This list is not exhaustive; it contains examples of foods that may pose a high risk of choking based on the evidence base and clinical experience of our multidisciplinary team of licensed pediatric professionals. It includes foods identified as choking hazards by the United States Centers for Disease Control and Prevention and the American Academy of Pediatrics, as well as foods identified as high-risk in the latest medical literature.
Nearly half of all childhood choking fatalities involve objects that are not food. These include:
Choking Hazards In The Kitchen
Can Pop-Tops & Pull Tabs
Condiment Caps & Wrappers
Food Labels
Food Packaging
Foil Wrap
Paper Wrap
Plastic Wrap
Sponge Parts
Straws
Twist Ties, Rubber Bands, & Plastic Clips
Water Bottle Caps
Choking Hazards Around The House
Batteries
Buttons
Chapstick Tubes & Caps
Coins
Cough Drop Paper Wraps
Decorative Glass Beads
Door Stop Caps & Springs
Erasers
Hair Accessories
Loose Pieces of Paper & Stationery
Magnets
Packets
Paper Confetti, Inflatable Plastic, Foam Polystyrene Packing
Paper Clips
Pens & Pen Caps
Pills
Rings, Earrings, & Other Jewelry
Safety pins, Thumbtacks
Stickers
Choking Hazards In the Playroom
Balloons (Deflated)
Beads (Glass and Plastic)
Charm Bracelets & Other Toy Jewelry with Beads
Collectible Rocks
Confetti
Legos & Other Small Toy Pieces
Magnetic balls (e.g. Buckyballs) & Other Toy Magnets
Toy Marbles and Small Balls
Water Beads
Wait until you see all signs baby is ready before starting solids.
Learn how to set up a safe eating environment for baby.
Make sure baby is seated, properly positioned, and supervised when eating.
Learn how babies learn to chew real food.
Do not force food: the choking risk is lower when you let baby feed themselves.
Prepare safe food shapes and sizes for a child’s age and developmental ability.
Regularly offer foods to build chewing skills so baby can practice.
Understand the difference between gagging and choking and how to respond.
Regularly check the floor (and other surfaces where baby spends time) and remove small objects that baby can grab and put in the mouth.
Get trained in infant rescue in the unlikely event of an emergency.
As baby grows into toddlerhood, it is important to actively teach how to safely eat high-risk foods such as chewy foods, fruit with pits, and whole nuts.
First, know that you’re not alone. Introducing solid food feels overwhelming to many. To help calm anxiety, start by letting baby practice feeding themselves with a spoon dipped in a mash or puree. Next, move on to less challenging foods, such as food teethers that do not break apart as baby munches. Remember that letting baby feed themselves lowers the risk of choking.
Even if not much (or any!) food makes its way into the belly, practicing with spoons and food teethers starts to teach baby what real food feels like and how it works. Many families gain confidence as they see how capable baby is at chewing, and more confidence can help ease your nerves once you feel ready to offer food that needs to be chewed.
Go at your own pace and remember: it is normal for baby to not consume much (or any!) solid food at first. Touching, grabbing, holding, munching, and exploring food are part of learning how to eat. If you feel so much fear that you are unable to start solids, talk to your pediatrician and ask for support in getting started.
This article is for informational purposes only and it is not a substitute for professional advice from or consultation with a pediatric healthcare professional. This information has been created with typically developing infants and children in mind. If your child has underlying medical or developmental differences, discuss your child's feeding plan with their primary medical provider. Please review our Terms and Conditions of Use.
J. Longbottom, MS, CCC-SLP, CLC, Pediatric Feeding/Swallowing Specialist
K. Grenawitzke, OTD, OTR/L, SCFES, IBCLC, CNT, Pediatric Feeding/Swallowing Specialist
M. Suarez, MS, OTR/L, SWC, CLEC, Pediatric Feeding/Swallowing Specialist
R. Ruiz, MD, FAAP, CLC. Pediatric Gastroenterologist
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