It is important to gradually increase the texture of your little one’s food to help develop their chewing skills. Ensure food is an appropriate soft texture and shape for your young child’s developmental stage and eating ability.
Young children with small air and food passages can easily choke, especially on small hard round foods. They are also still learning to move food around in their mouths and their biting and chewing skills are still developing.
Gagging isn’t the same thing as choking
Gagging on food is quite normal, noisy and prevents choking because it brings food forward in the mouth away from the throat. It is quite common for babies learning to eat to sometimes gag as they master the art of moving food from the front of the mouth to the back and swallowing at the right time. Don’t panic if this happens. The gag reflex is designed to protect baby's airways and helps them 'cough' food to the front of their mouth so they can either spit it out, or 'chew' it more to make it safe to swallow.
Choking on the other hand is silent and scary, because the airway is blocked and they can’t breathe. A child who appears to be choking will require help straight away.
To help prevent choking:
- Make sure your baby or toddler is sitting down while eating
- Always stay close by and keep an eye on them while they are eating or drinking
- Offer food that matches their chewing and grinding abilities
To minimise their risk of food-related choking:
Choking hazards and foods to watch out for include:
- Small hard foods – that are difficult for children to bite or chew e.g. nuts, large seeds, raw carrot, raw apple, hard rice crackers
- Small round foods – that can get stuck in children’s throats e.g. grapes, cherry tomatoes, berries, sultanas, peas
- Foods with skin or leaves – that are difficult to chew e.g. lettuce, nectarines, tomatoes, sausages
- Compressible foods – that are easily squashed into the shape of a child’s throat e.g. pieces of cooked meat, hot dogs, popcorn, marshmallows
- Thick pastes – that can get stuck in children’s throats e.g. peanut butter
- Fibrous or stringy food – that are difficult to chew e.g. celery, rhubarb, pineapple
- Foods with bones – e.g. fish or chicken nibbles
To reduce the risk of choking on these foods – you can:
- Remove the high risk parts of the food – peel off the skin, remove the strong fibres, remove the seeds and pips, carefully remove any bones
- Alter the food texture – grate, cook until soft, and puree, mash or finely chop the food
- Alter the food shape – cut round foods like grapes into quarters, chop salad leaves and meat finely
- Spread thinly - Use smooth nut or seed pastes/butter sparingly by spreading thinly across bread
- Avoid giving some small hard foods, such as whole nuts and large seeds, until children are at least five years old
At around 2-3 years of age children might go through a phase of stuffing their mouth full of food, which can increase the choking risk. You might need to teach your toddler to put less in their mouth and offer smaller and less food at a time.
Learn what to do if your child chokes:
For information and training on choking first aid and cardiopulmonary resuscitation (CPR), speak to your health professional and see your Well Child Tamariki Ora My Health Book.
For more information see the New Zealand Ministry of Health website on food-related choking in young children here.
Food-related choking in young children. Ministry of Health website (accessed 24 November 2021). https://www.health.govt.nz/your-health/healthy-living/food-activity-and-sleep/healthy-eating/food-related-choking-young-children
Ministry of Health. 2021. Healthy Eating Guidelines for New Zealand Babies and Toddlers (0–2 years old). Wellington: Ministry of Health.
The materials published on this website are of a general nature and have been provided for informational purposes only. Always consult your medical practitioner or a qualified health provider for any further advice in relation to the topics discussed.