Doctors: Cut up grapes so children don’t choke to death
PARENTS should chop up grapes for young children to prevent them from choking, doctors have warned.
Experts say grapes are exactly the right size to block a small child’s airway and are the third most common cause of food-related choking, yet few parents are aware of the hazard.
Doctors at the Royal Aberdeen Children’s Hospital issued the warning in a medical journal after treating three children who had choked on whole grapes. Two of the youngsters died, while the third spent a week in intensive care.
Dr Jamie Cooper and Dr Amy Lumsden, writing in the Archives of Disease in Childhood, said parents generally knew about the risks of children choking on small objects or foods such as nuts but
‘Knowledge of danger is not widespread’
could be unaware that fruits such as grapes could be equally deadly.
They said grapes are ‘ideally suited’ to block a young child’s airway and can ‘form a tight seal’ in the throat.
To keep children safe, they recommend that grapes and similar foods, including cherry tomatoes, ‘be chopped in half and ideally quartered’ before being given to children aged five and under.
Small children are at high risk because they have narrow airways, their swallow reflex is underdeveloped and they do not have a full set of teeth. They are also more prone to distraction while eating.
The authors wrote: ‘The majority of choking episodes occur in those under three years of age, the group most at risk of death.
‘We have contacted the Scottish Government regarding the provision of information to parents on the risks of choking.
‘There is currently no specific legal requirement for foods such as grapes to include a choking hazard warning and this may be difficult if such items are being sold loose.
‘NHS Scotland has revised its guidance, given to all parents in pregnancy, to clearly highlight the potential choking hazard posed by grapes and cherry tomatoes and the importance of the need to “halve or chop small fruit, nuts and vegetables such as cherry tomatoes and grapes”.’
The doctors described three different cases of children choking on grapes in Aberdeen.
Five-year-old Louis Emaho was eating whole grapes while attending an after-school club when he began to choke.
Attempts to dislodge the grape did not work and the boy went into cardiac arrest.
The grape was removed by paramedics using specialist equipment but doctors were unable to save Louis.
In the second case study, a 17month-old boy died after choking on a grape while eating sandwiches and fruit with his family at home.
The third case involved a twoyear-old boy who was snacking on grapes in a park when he started to choke.
Again, the grape proved impossible to dislodge but paramedics were on the scene within a minute and cleared the child’s airway.
The boy had two seizures before reaching hospital. When he arrived he needed treatment to relieve swelling on his brain and to drain a build-up of watery fluid in his lungs. He spent five days in intensive care before making a full recovery.
Grapes are the third most common cause of choking in young children, behind hot dogs and sweets.
The doctors concluded: ‘There is a general awareness of the need to supervise young children when they are eating. But knowledge of the dangers posed by grapes and similar foods is not widespread.’
Dr Julie-Ann Maney, of the Royal College of Paediatrics and Child Health, said last night: ‘Any injury, accident and death is a tragedy but it is even more so when that injury, accident or death could have been prevented.
‘This paper highlights just how dangerous seemingly harmless items of food can be for young children if they are not eaten in the correct way.
‘As a paediatrician working in a busy emergency department, sadly situations like those outlined in this paper are not all that uncommon.
‘I would urge all parents to cut food up into small pieces to avoid a seemingly harmless situation turning into a deadly one.’