Choking Hazards for Babies: Foods to Avoid and Modify

Choking is one of the leading causes of injury and death in young children. The good news is that most choking incidents are preventable. Knowing which foods are dangerous, how to modify them safely, and what to do if choking occurs can literally save your baby's life.

Why Babies Are at High Risk AAP

Understanding the risk helps you take it seriously.

Why babies choke easily:

• Learning to chew and swallow
• Few or no teeth
• Small airway
• Less coordinated oral motor skills
• Tendency to put everything in mouth
• Get distracted while eating

Most dangerous ages:

• Under 4 years old is highest risk
• Babies starting solids (6+ months) need close attention
• Risk decreases but doesn't disappear after age 4

Types of choking hazards:

• Small, hard foods
• Round foods (shape fits perfectly in airway)
• Sticky foods
• Foods that don't dissolve
• Foods that are difficult to chew

Top Choking Hazards to Avoid AAP

These foods should be avoided or significantly modified.

Round foods (shape matches airway):

• Whole grapes
• Cherry tomatoes
• Hot dog rounds
• Whole berries
• Round candies

Hard foods:

• Whole nuts
• Hard candy
• Popcorn
• Raw carrots
• Raw apples
• Ice cubes

Sticky/gummy foods:

• Peanut butter (thick globs)
• Marshmallows
• Gummy candy
• Thick cheese cubes
• Sticky dried fruit

Other hazards:

• Hot dogs (even cut up—still problematic)
• Chunks of meat
• Chunks of cheese
• Whole seeds
• Fish with bones
• Bread with hard crusts

How to Modify Foods Safely AAP

Many hazardous foods can be made safe with proper preparation.

Grapes:

• Cut lengthwise (quarters for young babies)
• Never serve whole
• Continue modifying until age 4

Hot dogs:

• Cut lengthwise first, then into small pieces
• Better: avoid for young children altogether
• The round shape is particularly dangerous

Berries:

• Mash or cut in half/quarters
• Small blueberries can be served whole for older babies if you're watching closely
• Larger berries should be cut

Cherry tomatoes:

• Cut in quarters lengthwise
• Press to flatten slightly

Cheese:

• Shred or cut into small pieces
• Avoid thick cubes that can compact

Meat:

• Shred or cut very small
• Ensure tenderness
• Remove all bones and gristle

Peanut butter:

• Spread thin on bread
• Never give by the spoonful
• Mix with purees for young babies

Raw vegetables:

• Cook until soft
• Grate if serving raw (for older toddlers)
• Avoid raw until appropriate age and skill

Age-Appropriate Food Preparation AAP

How to prepare foods safely at different ages.

6-8 months:

• Very soft, mashable foods
• Dissolves easily in mouth
• Purees or very soft finger foods
• No hard pieces

8-10 months:

• Soft chunks baby can mash with gums
• Size: about adult pinky fingernail
• Easily squishable between your fingers

10-12 months:

• Small, soft pieces
• Soft table foods
• Still modifying all choking hazards

12-24 months:

• Expanding textures but still modifying hazards
• Continuing to cut grapes, etc.
• Teaching chewing

2-4 years:

• Still supervising closely
• Continuing to modify round foods
• Teaching to chew thoroughly and not stuff mouth

Safe Eating Practices AAP

Beyond food preparation, how eating happens matters.

During meals:

• Always supervise eating
• Baby should be sitting upright
• No walking or running with food
• No eating in car (harder to supervise and respond)
• No lying down while eating

Eating behavior:

• Encourage small bites
• Model thorough chewing
• Don't rush meals
• Don't let baby stuff mouth
• Remove food if baby is putting too much in mouth

Feeding environment:

• Minimize distractions
• No screens during eating
• Calm environment
• No siblings throwing food at baby

Gagging vs. Choking AAP

These are different and require different responses.

Gagging:

• LOUD—coughing, sputtering
• Baby is getting air
• Face may redden but baby is responsive
• Baby will clear it themselves
• Part of learning to eat

What to do for gagging:

• Stay calm
• Let baby work it out
• Don't pat back unless choking
• Don't put fingers in mouth
• Wait it out

Choking:

• SILENT—little or no sound
• Baby cannot cough, cry, or breathe
• May turn blue
• May be clutching at throat
• Life-threatening emergency

What to do for choking:

• Call 911 or have someone call
• Begin infant choking first aid immediately
• Don't wait to see if it resolves
• Take an infant CPR/first aid class

Infant Choking First Aid AAP

Every caregiver should know this.

For infants under 1 year:

1. If baby is choking but conscious:

• Place baby face-down on your forearm, supporting head
• Give 5 back blows between shoulder blades with heel of hand
• Turn baby over
• Give 5 chest thrusts with two fingers on breastbone
• Alternate back blows and chest thrusts until object is expelled or baby becomes unconscious

2. If baby becomes unconscious:

• Begin infant CPR
• Look in mouth before giving breaths—remove visible objects only
• Call 911 if not already done

IMPORTANT:

• Take an infant CPR class (in person)
• Practice on a doll
• Know the technique before you need it
• American Red Cross and hospitals offer classes

Non-Food Choking Hazards AAP

Food isn't the only choking risk.

Small objects to keep away:

• Coins
• Buttons
• Batteries (especially dangerous)
• Small toy parts
• Balloons (very dangerous)
• Pen caps
• Jewelry
• Anything that fits through a toilet paper tube

Safety measures:

• Get on floor level and look for small items
• Check under furniture
• Keep small toys away from babies
• Check toy age recommendations
• Watch older children's toys around babies

The Bottom Line

Choking is preventable with proper food preparation and supervision. Know which foods are hazardous, modify them appropriately, supervise all eating, and learn infant choking first aid. These precautions can save your baby's life. AAP

Remember:

• Round foods are especially dangerous
• Cut grapes and similar foods lengthwise
• Supervise all eating
• Know infant choking first aid
• Gagging is loud; choking is silent

Clara is here when you need help with food safety for your baby.