Choking Hazards for Babies

If your child is having a health emergency, please call 911 or your emergency medical resource provider immediately.

A choking hazard is any object that could be caught in a child’s throat, blocking their airway and making it difficult or impossible to breathe.1

If you think your child is choking, call 911 or your emergency services number immediately. Do not wait. Brain damage or death can occur within 4 minutes of oxygen deprivation.2

We encourage you to learn about the differences between gagging vs. choking and to watch our course video on how to perform infant rescue.

Minimizing the Risk of Choking

We can talk all day about which foods are choking hazards and how to best prepare them to minimize the risk, but the reality is any food can cause choking, at any age, even when cut and prepared in the most developmentally appropriate and safe manner. This is why setting up a safe eating environment and understanding how babies swallow is key. 

Swallowing is a complex reflex with multiple lines of defense built in to prevent choking. These actions happen reflexively, meaning we don’t have to think about them or do anything special to make them happen. There are three important lines of defense that we have with every single swallow. 

1. Your vocal cords, which are like the front door to the airway, slide closed to keep food out

2. The breathing tube itself is pulled upward and forward to move it out of the way

3. The epiglottis, a tiny flap of cartilage, closes like another door over the larynx. The larynx is a space before the vocal cords. If the vocal cords are like the front door to the airway, you can think of the larynx like a front porch—so items can’t even get close to the front door (vocal cords) because the epiglottis closes off access to the porch.

And just like any good system, we have back up already built in, such as a strong cough response to push things back out in the event that something slips past all those doors. For more on this, check out our Gagging and Choking page.

Here are additional tips to minimize choking risk:

1. Never place food in baby’s mouth with your fingers; set baby self feed when introducing finger food.

2. Never put your fingers in baby’s mouth.

3. Never let baby eat while moving. This includes crawling, walking, climbing, or any other movement.

4. Refrain from offering food in the stroller or carseat.

5. Ensure baby is in a completely upright, supportive seat and never feed baby in reclined chairs or carseats. See our high chair page for tips on modifying high chairs to make them safe for eating as well as how to feed baby if you don’t have a high chair.

6. Remove small non-food related objects from the table at all meals: condiment packets, bottle caps, and small toys can create a high risk situation while eating.

7. When baby is sick (cough, congestion, etc.) exercise caution and, if offering a meal, default to the least challenging food presentations.

8. Stay calm when baby is gagging and give their body a chance to work the food out independently.

9. Modify foods that are firm, round, and/or slippery so that they are no longer hard, no longer round, and no longer slippery. Cut round foods lengthwise in half, cook firm/hard foods until soft, and roll slippery foods in crushed cereal, finely ground nuts, or even leftover infant cereal to give the foods a bit more texture.

Top Choking Hazards

While a baby could even choke on milk, it’s important to avoid or modify foods that are common choking hazards. The below lists include foods identified as choking hazards by the U.S. CDC 3 as well as by the American Academy of Pediatrics.4

Choking is a leading cause of death among children and among these incidents is a recurring pattern of high-risk foods. Whether you are preparing food for a 6 month old or a four year old, be sure to know the foods that carry the highest risk. (An asterisk denotes foods that are not appropriate for babies in any form.)

  • Apple (raw)
  • Baby carrots
  • Berries
  • Bread with nut butters
  • Candy*
  • Canned fruit
  • Carrots (raw)*
  • Celery (raw)
  • Cheese, especially string cheese and cubes
  • Cherries
  • Chickpeas
  • Chips and snack foods*
  • Cookies*
  • Corn kernels
  • Dried Fruit
  • Fish with bones
  • Granola bars*
  • Grapes
  • Hot dogs*
  • Ice*
  • Melon balls
  • Peanuts
  • Peas
  • Pear (raw)
  • Pretzels*
  • Nuts and seeds (whole)
  • Nut butters (chunks of)
  • Oranges (if membrane is not removed)
  • Pomegranate arils
  • Popcorn*
  • Marshmallow*
  • Meat sticks (like those processed round sticks)*
  • Raisins
  • Raw vegetables
  • Rice, barley and grains (whole kernel)
  • Sausage
  • Shrimp
  • Tapioca beads (such as those in bubble tea)*
  • Tomatoes (cherry and grape)

Modifying Foods to Lower Choking Risk

While there are foods on the above list that are not appropriate for babies in any form, there are many nutritious foods you can modify to make them safer for babies. For example, round foods like grapes and cherry tomatoes can be cut vertically into quarters; nuts can be finely ground and sprinkled on other food; nut butters can be thinned out with yogurt or applesauce. For detailed information on age-appropriate food shapes and sizes, check out our page on safe food sizes and shapes or our video on preparing food for babies.

What do I do when food gets stuck to the roof of baby’s mouth?

Many foods that are commonly introduced early are mushy and sticky, like avocado and banana. Baby is still learning how to move food around in the mouth, how to use their tongue in a coordinated way to move food to the side for chewing instead of the center of the tongue for sucking, so it’s common for food to end up stuck to the roof of the mouth. This can be very uncomfortable for baby, and many times, will lead to intense gagging that may cause baby to vomit, which will clear the food from the palate. Unfortunately, it is quite challenging for a young baby to clear this on their own without gagging and/or throwing up. 

Food getting stick to the roof of baby’s mouth can be especially common and problematic for babies with a high arched palate. They can get stuck in this phase (of food getting stuck and then intense gagging and vomiting) for much longer than other babies because the pallet provides a perfect little nook for food to get trapped in. If this is the case for your baby or you feel like this happens frequently, or you’ve been working on this for a while with no progress, it is worth talking with your doctor and seeking out a feeding therapy evaluation. 

What to do:

Start by offering your baby the wrong end of a silicone spoon to bite and suck. A silicone infant spoon that baby holds and munches on can help baby generate more saliva, which will start to slowly break down the item, or it might help dislodge the food either by physically moving it or by helping your baby generate enough suck pressure against the spoon handle to move the food. They may end up sucking the food back and swallowing it.

If the spoon doesn’t work, offer a very small sip of water. This would be a tiny sip to help add a little bit more liquid inside the mouth which could help reduce the stickiness of the bite and loosen it from the pallet. Try to avoid a large cup of water which would just wash the item into the throat—as now the baby would have to manage both the bite as well as a mouth full of liquid.

If neither of those strategies work, this may be an instance where you have to help dislodge the food. While we generally do not advise putting a finger into babies mouth because this can increase the risk that that food will be pushed back in the babies airway this is one instance where you might not have another choice.  First and foremost, keep yourself calm and confident looking. This may feel scary to baby and if you look terrified you are confirming that something is really wrong. Try to keep a soothing demeanor which can help baby trust that you know what you’re doing and that everything is okay. Kneel next to baby so they are looking down. Try to coax baby to open their mouth so you have a clear idea of where the food is in baby’s mouth, or if there are other pieces in there besides what is stuck to the palate. Starting on the side where the upper and lower lip come together, place one finger in baby’s mouth and run your finger along their cheek. Then sweep your finger up and across the palate and to the front to dislodge the sticky food. The motion of the finger should be forward and out. 

In the future, slightly mash these stickier food items for a while as baby is building their chewing skills. Consider serving these stickier foods on an infant spoon or a food teether such as a mango pit, a pineapple core, or a sparerib so that baby has something firm they can bite and suck against right from the start,  which will trigger their chewing reflex and their tongue lateralization reflex. Those resistive foods act as teethers and can help to map the mouth making it more likely over time that baby will know how to move the food around within their mouth and less likely that your baby will lose track of food into their pallet.

The opinions, advice, suggestions and information presented in this article are for informational purposes only and are not a substitute for professional advice from or consultation with a pediatric medical or health professional, nutritionist, or expert in feeding and eating. Never disregard professional medical advice or delay in seeking it because of something you have read or seen here. 

  1. Nationwide Children’s Hospital, Family Resources & Education, Choking Hazard Safety. (Website) Retrieved July 10, 2020.
  2. Nationwide Children’s Hospital, Family Resources & Education, Choking Hazard Safety. (Website) Retrieved July 10, 2020.
  3. United States Centers for Disease Control and Protection, Choking Hazards https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/choking-hazards.html
  4. American Academy of Pediatrics, Prevention of Choking https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/choking-hazards.html