I can still remember the flavor, a synthetic, buttery and sugary confection that was velvet-like and somewhat cloying, and I can still remember the terror of having this benign sweetness blocking my airway. It was a butterscotch candy (the round variety routinely wrapped in brightly colored cellophane with resplendent ponytail twists on either side) and moments earlier it was a yet to be unwrapped treat that I had been holding out for, and now it was something I desperately wanted out of my throat.
I was probably choking for no more than 10 seconds when my mother took the necessary action of doing some modified form of the Heimlich and getting the darn thing out of my throat. The sight of the cracked and broken canary yellow candy resting in the sink basin served as a reminder never to allow one of those butterscotch candies to pass through my lips ever again.
I was lucky, as I had a parent there to help me, and my choking incident was relatively uneventful (but obviously eventful enough to recall some 30 years later), however many of these incidents don’t end so well. In 2000, 160 children died from an obstruction of the respiratory tract, and many of those obstructions were caused by food.
The ten foods that pose the highest choking risk for young children are hot dogs, peanuts, carrots, boned chicken, candy, meat, popcorn, fish with bones, sunflower seeds and apples.
A child is innocently gobbling down bits of a hot dog when a cylindrical chunk gets lodged in the back of his/her throat and then the panic sets in. The reason for this phenomenon is because children under 4 are at the highest risk, not only because their airways are small (the back of a toddler’s throat narrows to the diameter of a straw) but also because of the way their eating abilities develop. Front teeth usually come in at 6 or 7 months — so babies can bite off a piece of food — but the first molars, which grind food down, do not arrive until about 15 months, and second molars around 26 months.
There exist loads of warnings on small toys and retail items aimed at young children that reveal possible choking hazards, but very few of the above mentioned food items carry any sort of warning or advisory for parents or children. As reported in the New York Times last week, the American Academy of Pediatrics, the nation’s leading pediatricians’ group, asserts that food should be subject to as much scrutiny as toys, and be outfitted with the required warning labels, especially on foods that are known choking hazards. The AAP is making a recommendation to the Food and Drug Administration that these changes become standard.
However proactive this AAP proposal is, it may not be enough. The AAP is also suggesting that manufacturers of some of the offending items redesign some of their most dangerous foods — especially the hot dog, a leading choking hazard. For instance, a new hot dog that is soon to be marketed on the East Coast looks like your average hot dog in the package, but has eight deep slits that open when cooked, causing it to break apart into small pieces when eaten and therefore be far less of a choking risk. Of course many manufacturers are reluctant to take the next step and modify their products (how could popcorn really be modified?) as it would be logistically difficult and cost prohibitive.
While common sense surely plays a large role in this issue (e.g. don’t let your young children consume these offending items, especially without adult supervision) the question of culpability and liability factor heavy in this matter. Is parental vigilance enough or should food items (especially those marketed toward young children) come with suitable and visible warnings? Will this mean that we will soon need to put a warning label on every single edible item on Earth, as anything you could fit into your mouth holds a potential choking hazard?