Airway Obstruction—Identifying High-Risk Situations

Most incidences of accidental child strangulation, suffocation, and choking happen in the home. Parents, take extra care to childproof the house for young children. Keep in mind that the airways of young children are much smaller and easier to obstruct.


The American Academy of Pediatrics recommends that children younger than 4 years old should not be fed any round, firm foods unless they are cut into small, nonround pieces. Young children may not chew food properly before swallowing. This increases the risk of swallowing the food whole and choking. Food to avoid or cut into small pieces for children under age 4 include the following:

  • Hot dogs

  • Nuts

  • Meat chunks

  • Grapes

  • Hard candy

  • Popcorn

  • Chunks of peanut butter

  • Raisins

  • Raw carrots

In addition, always supervise your young children when they are eating. Sometimes, choking can happen when an older child feeds his or her younger sibling unsafe food. Young children should also sit while eating, and never walk, play, or run with food in their mouths.

Special Note: Hot dogs and grapes can be eaten by young children as long as the skins are taken off and the food is cut into small, nonround pieces.

Other choking hazards

Nonfood items that are small, round, or conforming can be a choking hazard to young children. Examples include:

  • Coins

  • Small balls

  • Balloons (inflated and deflated)

  • Marbles

  • Small game parts

  • Small toy parts

  • Safety pins

  • Jewelry

  • Buttons

  • Pen caps

  • Small button-like batteries (for example, watch batteries)

Strangulation and suffocation hazards

These hazards include the following: 

  • Infants can suffocate in soft bedding, or when a person rolls over onto them in an adult bed.

  • Plastic bags that cover the nose and mouth of infants are another common cause of suffocation.

  • Children can also suffocate or otherwise injure themselves when they become trapped in household appliances, such as dryers, and toy chests.

  • Children can strangle themselves with consumer products that wrap around the neck, such as clothing drawstrings, ribbons, necklaces, pacifier strings, and window blind and drapery cords.

  • Small passages through which a child can fit body, but not the head, can strangle a child. This includes spaces in bunk beds, cribs, playground equipment, baby strollers, carriages, and high chairs.