From the time your child starts grasping things with his fingers until he is 4 or 5 years old, you need to be careful about choking hazards.

Children under the age of 4 are most likely to choke on something. This is partly because they tend to explore their world by putting things in their mouths.

This is also because they are still learning how to chew and swallow food. Babies at 6 or 7 months can bite off a piece of food with their new front teeth, but they won’t be able to chew properly until all their molars have come in and they’ve had a lot of practice with them – usually by the time they’re 4.

The biggest choking hazards for babies and toddlers

Babies and toddlers can choke on a surprising number of things, but you can’t eliminate every potential choking hazard or be on the lookout for them every minute of the day.

That’s why it’s important to baby-proof your home, as well as supervise your little one when he’s cruising around the house.

It helps to know what the biggest choking hazards are for this age group and to focus on limiting access to your child or closely supervising them when something unsafe might happen. These are the biggest choking hazards for children under 4:

• Hard foods that a child cannot chew or squish with the gums, including raw vegetables and hard candies
• Unsliced ​​round foods, such as grapes, cherries and grape tomatoes
• Foods cut into circular or “coin” shapes, such as hot dogs and carrots cut horizontally
• Foods that are sticky, such as peanut butter, candy, or gum and marshmallows
• Stringy foods, such as cheese sticks
• Dry, powdered foods and substances, including baby powder
• Button batteries and other small items such as coins, magnets and safety pins

Even innocuous household items you might not think about can pose a choking hazard. “My oldest took the rubber end off the door stop and put it in his mouth. I had to dig it out,” he says BabyCenter Community member cdh29821. “He scared me so much!”

11 tips to prevent choking

Pay attention. Supervise young children whenever they eat. (Kids usually can’t make noises to warn you that they’re choking.) This means you don’t let your child eat in the car while you’re driving or in the stroller while you’re pushing him. And make sure others don’t give your child something to choke on.

Be prepared for worst case scenarios

Learn how to deal with an emergency directly from an emergency physician in our CPR and Choking Course

Stay seated while eating and drinking. Do not allow children to eat while lying down, walking, playing or running.

Encourage slow eating. One way to do this is to make sure your child has a drink to hand during meals (like water or milk). Encourage sips between bites to make sure your child is chewing and swallowing, not stuffing his mouth with food that could cause choking.

Keep baby food soft. Puree or mash food so that it is soft enough for your baby to chew or chew, and be sure to cook vegetables such as carrots, broccoli and green beans until soft before cutting them into small pieces.

Cut the finger food into small pieces. When your child is ready for finger foods, the American Academy of Pediatrics (AAP) recommends that you cut the food into pieces no larger than 1/2 inch. (See more guidelines for safe finger foods.)

At first, it can be difficult to tell if your baby is choking or just convulsing, and this can cause a lot of anxiety.

– Dr. Liz Donner, Pediatric Hospital

Spread a thin layer of nut butter. Drips from peanut butter and other nut butters are a choking hazard. Spread nut butter thinly on bread or crackers. Or dilute it with water or applesauce.

Choose your snacks wisely. Do not give children popcorn, gum, nuts, seeds, hard or sticky candies, or marshmallows until they are at least 4 years old. (The seeds may be too small to choke on, but they can get stuck in a child’s airway and cause an infection.)

Do not use tooth gels. Do not use teething remedies. It can numb the throat and interfere with the child’s ability to swallow.

Avoid small objects. Do not allow small children to play with buttons, coins, safety pins, magnets, batteries, balloons, small rocks, or anything with parts smaller than 1 1/4 inches around or 2 1/4 inches long. You can use a roll of toilet paper or purchase a “small object suffocation tester” to help you assess the safety of an object. If the object fits completely into the cylinder, there is a risk of suffocation.

Move mobile. Make sure your child can’t reach a hanging cell phone.

Keep baby powder away. Do not allow children to play with baby powder containers. The powder can shake off and clog your child’s throat.

What to do if your child is choking

First, determine whether your child is choking or simply convulsing. Constipation is normal for babies, especially when they first learn how to eat solid food, and is not dangerous.

“At first, it can be hard to tell if your baby is choking or just colic, and that can cause a lot of anxiety for parents,” says Liz Donner, MD, a pediatric hospitalist and member of BabyCenter’s medical advisory board. “Gaping is a normal human reflex designed to clear the throat to prevent choking. Learning to eat involves a lot of gagging, which can manifest as vomiting, near-vomiting, coughing, watery eyes, and tongue thrusting. However, choking occurs when a child no longer can breathe, cough, cry or speak. That’s when you know it’s time to intervene.”

Here’s how to tell the difference:

• A gagging child will gag, cough, and possibly throw up as their body tries to dislodge the object from their mouth. It is usually okay to let go of a child who is convulsing; interfering by patting them on the back or reaching into their mouths can actually make things worse.
• A choking child is often silent. They won’t be able to talk, cry or cough because their airways are blocked. They can also turn blue if they don’t get oxygen. A child who is choking needs emergency help.

If your child is choking, call 911 or have someone else call. For instructions on how to clear a child’s airway, see our infant first aid guide for choking and CPR, as well as our guide for toddlers and older children.