In mere seconds, a seemingly innocuous piece of food can turn deadly. And Katherine Zuehlke, of Westerville, Ohio, knows firsthand there's nothing more frightening than realizing your child is choking.
Over Christmas, the Zuehlkes had a scare when their nearly 2-year-old daughter, Tiffany, began choking on a chocolate-covered peanut.
"She had had them before, but right away her eyes got all big and she had this scared expression on her face, and we knew she was choking," Zuehlke says.
Luckily, Tiffany's parents were able to perform the infant Heimlich maneuver and got Tiffany to cough up the candy before she turned blue or had any permanent damage. The toddler is doing fine, and their house will be free of that candy for some time.
In the United States, approximately one child dies every five days by choking on food -- a rate that the American Academy of Pediatrics (AAP) is trying to change.
The AAP released a policy statement today that calls for choking hazard labels on foods that kids might choke on, making a special case for a mandatory warning label on all hot dog packages.
Zuehlke thinks the labels are a good idea. "Parents are so busy, we pick up things and we don't always think twice. If there are warning labels at the grocery store, we may pass on it," she says.
But this is the response hot dog manufacturers might be afraid of: requiring choking warnings on their products may deter consumers from purchasing them at all -- even though this family favorite could be made safe for small children by simply cutting it up properly.
Given that choking is the leading cause of injury and death in small children -- and food items are the culprits the majority of the time -- the authors of the statement call for regulation and warnings on common choking-risk foods similar to what is already required for toys that pose a similar risk. Those includes mandates for product redesign and the option for a government recall of excessively risky items.
"The recommendations represent the first effort to comprehensively address the cause of choking," says Dr. David Cornfield, medical director of the Pediatric Intensive Care Unit at the Lucile Salter Packard Children's Hospital at Stanford.
"I know of several children that have suffered significant neurologic damage as a result of choking on food items," Cornfield says. "The lack of oxygen in the lungs leads to low oxygen levels in the blood stream and subsequent cell death -- [often] in the central nervous system. Choking is a real, highly time-sensitive emergency."
Dr. Gabe Wilson, associate medical director at St. Luke's at Roosevelt Hospital's emergency department in New York, says, "Parents less often consider foods as choking hazards; the recommendation to extend some type of criteria to foods, which cause more choking deaths than toys, is logical and will save lives."
Some foods that pose choking risk, such as grapes, carrots and peanuts, are "naturally occurring" choking risks and thus can only be made safer through handling of the food, such as by slicing grapes in half or cutting carrots into small pieces before giving them to toddlers or young children. As a result, these foods should not require labels, the statement suggests.