Peanuts: The biggest choking hazards

It is hard to imagine that the small unassuming ubiquitous peanut, that we love to munch, could be the number one hazard for infants, toddlers or preschool children.

I recently heard the story of a toddler who choked while eating peanuts and died a couple of days later after a traumatic and tragic course.

That morning was like any other with a session of munching peanuts at home with his sibs, when this two-year old suddenly choked, started coughing and became breathless. His parents rushed him to a nearby hospital where xrays and scans showed up a “nut” stuck and obstructing the windpipe near its bifurcation in the chest. He was then shifted to a center that had facilities for bronchoscopy, a procedure that involves passing a type of endoscope into the windpipe, for removing the nut.

As one can imagine, all this took a while and by the time the procedure could be done, it was midnight. The child’s respiration and blood pressure fell during attempts to catch the nut that was by now, stuck in the bronchus. It was bad luck all the way with the nut wedging its way further down, defying all attempts at catching it. The child’s condition deteriorated finally ending in death.

The catapulting of a happy family with a toddling bundle of joy to one of death and gloom, caused by a meager peanut could not have ben more sardonic. I was reminded the jolt we had felt 30 years ago on hearing how our friend’s baby had choked and died on his first birthday that was being celebrated in the USA.

Experience from across the world tells us that peanuts are the commonest cause of death due to aspiration in small kids. It is followed in frequency by other nuts, marsh mellows, carrots and candies.

Small kids like to explore the world by constantly putting any stuff that they can get their tiny hands on, into their mouths.

As a gastroenterologist, we get our share of ingested “foreign bodies” stuck in the food pipe of kids. Two months ago, while I was having dinner at a restaurant with visiting guests, I got an emergency call to retrieve a coin from the food pipe of a three year old. That day had been fortunately easy and lucky for all of us.

Coming back to the question: Why are nuts the commonest items on which kids choke. Well, nuts are hard and need to be chewed and crushed before swallowing, acts that require the molar teeth located at the back of the jaw. It turns out that molars start appearing after 3 years of age. Therefore, we should not get misguided by the toothy smiles of kids. They reveal the front teeth comprising incisors and canines that can bite and cut, but not chew!

It is a gruesome reminder: Do not keep nuts and carrots on the table if you have toddlers at home. And let young parents you can reach out to, know this.