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October 22, 2018

This X-ray went viral, and it got parents talking about choking risks

Daily Briefing
    Editor's note: This popular story from the Daily Briefing's archives was republished on Jul. 18, 2022.

    An Australian blogger earlier this year shared an X-ray that showed a grape lodged tightly into the throat of a five-year-old child. The striking image went viral—and led pediatricians to warn that parents must be alert to choking hazards even past a child's infant and toddler years.

    Blogger Angela Henderson posted the X-ray on her Facebook page:

    In a caption, Henderson said, "Attention Parents! Do you know what this X-ray is of? A grape! A grape that was lodged in the top of a 5 year olds airway today. This sweet soul had to be operated on, under general anaesthetic to remove the grape. He is VERY lucky that part of his airway was open or else this could have ended badly. So please be mindful that not all kids chew their food, are in a rush at school to get in the playground etc. Please be careful. And when in doubt just cut the damn grapes, baby tomatoes etc."

    The most common choking hazards for infants, toddlers—and even young children

    Jaime Friedman, a pediatrician who spoke to People Magazine after the X-ray went viral, stressed that it's critical for parents of young children—not just infants and toddlers—to be aware of choking hazards.

    Friedman said, "Parents are surprised when they come in for their child's 3-year check up and I still mention choking risks like grapes and popcorn. Most parents aren't aware that we worry about choking up until age 4. They seem pretty resistant to cutting grapes for their 3-year-old."

    In fact, the American Academy of Pediatricians (AAP) has identified "mechanical airway obstruction" as the leading cause of unintentional death in children younger than one, and fourth-leading cause among children ages one to nine.

    According to AAP, everyday food items that present a choking hazard include:

    • Apples;
    • Carrots;
    • Chunks of meat or cheese;
    • Chunks of raw vegetables;
    • Cookies/biscuits;
    • Grapes;
    • Hard/sticky candy;
    • Hot dogs;
    • Meat;
    • Nuts;
    • Peanut butter; and
    • Popcorn.

    AAP warns that parents also should also be aware of non-food items that can present choking hazards, which include:

    • Buttons;
    • Disc batteries;
    • Marbles;
    • Magnets;
    • Pen caps;
    • Pieces of dog food;
    • Rubber balloons;
    • Small balls/foam balls; and
    • Small toys.

    How to avoid choking—and what to do if a child starts choking

    To reduce the risk that a child will choke, Friedman recommends cutting food smaller than a thumb's width before giving it to children. "Anything that is the size of the airway (thumb size) that is solid or unforgiving is a choking risk," she said. She added that peanut butter should be watered down when being introduced to an infant "so that it doesn't cause choking."

    Friedman also recommends that caregivers "should have at least one class on infant CPR and choking care."

    And if a child does start choking? "Never perform a blind sweep in the mouth if they are choking as they may push items further into the trachea," she said. "If the child is not breathing, call 911 and start rescue breaths. If the child is drooling or can't swallow, keep them calm; a child in distress can block their airway further. If there is any question about a swallowed or aspirated item, X-rays can be helpful, so have the child seen" (Apatoff, People, 8/30; Willets, People, 8/28).

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