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Very young children can choke to death on whole grapes, doctors writing in the Archives of Disease in Childhood have warned.
Foodstuffs account for over half the episodes of fatal choking among the under 5s, with grapes the third most common cause of food related choking after hot dogs and sweets. But public awareness of this potential hazard is not widespread, they say.
They describe three cases of young children, all of whom required emergency treatment after eating whole grapes.
The airways of young children are small; they don’t have a full set of teeth to help them chew properly; their swallow reflex is underdeveloped; and they are easily distracted, all of which puts them at risk of choking, explain the authors.
Grapes tend to be larger than a young child’s airway. And unlike small hard objects, such as nuts, the smooth soft surface of a grape enables it to form a tight seal in an airway, not only blocking this completely, but also making it more difficult to remove without specialist equipment, they emphasise.
“There is general awareness of the need to supervise young children when they are eating and to get small solid objects, and some foods such as nuts, promptly out of the mouths of small children; but knowledge of the dangers posed by grapes and other similar foods is not widespread,” write the authors.
While there are plenty of warnings on the packaging of small toys about the potential choking hazard they represent, no such warnings are available on foodstuffs, such as grapes and cherry tomatoes, they point out.
As such, they advise that grapes and cherry tomatoes “should be chopped in half and ideally quartered before being given to young children (5 and under),” and emphasise “the importance of adult supervision of small children while they are eating.”