While there is no way to completely eradicate the risk of your baby choking, you can reduce the risk dramatically by preparing food in an age-appropriate way.
First, it’s important to know what it is about certain foods that creates a choking hazard. In general, there are three characteristics of food that increase the risk of choking:
The more round, hard, and slippery a food is, the higher the choking risk. That’s why foods like baby carrots, apples, and grapes top the choking hazard lists—they can be easily lodged in the throat and once there, difficult to expel.
So to lower the choking risk, you need to prepare the food in a way that negates the characteristics above. For example, blueberries (roundness) can be smashed or quartered, raw vegetables (firmness) can be steamed and sliced lengthwise, and mango (slipperiness) can be rolled in ground coconut flakes to add texture.
Modifying High-Risk Foods for Babies
- Apple: cook until very soft, grate or mash
- Berries: slice thinly or smash
- Bread with nut butter: avoid until you feel your baby is an advanced eater
- Carrots: grate or cook until very soft and slice lengthwise (never in coins)
- Celery: slice into half-moons and cook until soft
- Cheese: cut into ruler-thin slices (never in cubes)
- Cherries: pit and quarter
- Chickpeas: smash or purée
- Corn: avoid whole kernel corn until age one, then serve as you wish
- Dried Fruit: avoid until age one then chop finely
- Fish: de-bone thoroughly
- Grapes: quarter lengthwise (never at the equator)
- Melon: cut into ruler-thin slices (never as melon balls or cubes)
- Peanuts: finely grind or mix peanut butter with yogurt to thin out
- Peas: smash, mash, or purée until age one
- Pear: cook until soft and mash or serve in ruler-thin slices without the skin
- Nuts and seeds: finely grind and mix into other foods
- Nut butters: thin out with yogurt, applesauce, breastmilk or formula
- Oranges: remove membrane and slice thinly
- Raw vegetables: cook until soft then slice
- Rice, barley and grains: cook well and smash until age one
- Sausage: avoid until at least age one and then quarter
- Shrimp: avoid until age one and cut lengthwise into quarters
- Tomatoes (cherry and grape): quarter
Food Sizes by Baby’s Age
Now let’s talk food sizes for babies. The size of a baby or child’s windpipe is about that of a straw in diameter.1 Foods that could get stuck in a straw, form a plug over it, or block its opening are choking risks.
Food size safety varies with age and even a couple of months can make a difference. Below is a guide you can use, but follow your gut: if your baby is struggling with a certain food or if it is making you nervous, take the food away and modify it further.
6-9 Months Old
There is a bit of irony when it comes to the youngest eaters: often the bigger the piece of food, the safer it is from a choking perspective (unless you are spoon-feeding, in which case you must focus on purées and mashes). For example, it would be hard for 6 month old to choke on a two-inch thick, long strip of steak they are sucking on but entirely possible for them to choke on a small chunk of meat that makes its way to the back of their tongue. In general, you want to have food to be the size and length of two adult fingers and to either be resistive (like a rib or steak that won’t break off in pieces) or completely soft. Cook hard fruits and vegetables until soft and avoid serving food that your baby is not able to pick up and hold on to, which will only frustrate them.
Around 9 months, your baby should start to develop a pincer grasp (where the pointer finger and thumb come together) and be able to pick up smaller pieces of food. If you have been spoon-feeding your baby, this is a good time to transition away and encourage self-feeding. Baby may also have some teeth coming in and may be able to tear at foods. This is also the time to decrease the size of the food down from the long, wide strips to ruler-thin slices, shreds, or small diced pieces. Note: food at this stage should still be be soft or cooked to a soft consistency. If you are not sure how to cut or prepare a particular food, you can look it up in our First Foods library.
At 12 months old, your baby can eat modified versions of what you eat (just hold the salt and continue to cook meats and fish well done). If you have not transitioned away from spoon-feeding, aim to do so as soon as possible. Hard foods should still be cooked down to a soft consistency and foods should either be served in ruler-thin slices, shreds (such as shredded chicken), or diced into small pieces for your baby to pick up with her fingers or with a fork, which you can pre-load to encourage self-feeding.
By 18 months, you should have a fairly advanced eater on your hands. Still, it is important to modify high-risk foods that are round, firm, and slippery and to continue to shred meat and cut pieces of food into ruler-thin slices or diced small pieces. Many babies at this age will be adept at using their spoon and fork by themselves and those who are not quite there yet will benefit from pre-loaded spoons and forks.