The call from American pediatricians for actions to prevent children from choking on foods such as hot dogs has led to reactions ranging from killer hot dog jokes to blaming the problem on parents.
The American Academy of Pediatrics (AAP) says choking is a leading cause of injury and death among children. Food, toys and coins account for most of the choking-related events because young children put objects in their mouths as they explore new environments.
In 2000, 160 children ages 14 years or younger died from an obstruction of the respiratory tract due to inhaled or ingested foreign bodies. Of these, 41 percent were caused by food items. For every choking-related death, there are more than 100 visits to U.S. emergency departments. In 2001, an estimated 17,537 children 14 years or younger were treated in emergency departments for choking episodes (Centers for Disease Control).
Since 1960 toys have been regulated to prevent child choking incidents but food has not been regulated. The AAP wants to make choking prevention a priority for parents, government agencies and food makers through a new policy statement in the March issue of Pediatrics. Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus,Ohio is the lead author.
Hot dogs have gotten the most attention. "If you were to take the best engineers in the world and asked them to design a perfect plug for a child's airway, you couldn't do better than a hot dog," Smith said. "It's the right size, right shape. It's compressible so it wedges itself in. When they're in that tight [it's] almost impossible, even with the correct training and the correct equipment, to get out. When it's wedged in tightly, that child is going to die."
The policy statement calls for a "mandatory system . . . to label foods with appropriate warnings according to their choking risk, to conduct detailed surveillance and investigate food-related choking incidents, and to warn the public about emerging food-related choking hazards." Manufacturers would be responsible for adding choking hazard labels to high-risk products and to consider shapes, sizes and textures when designing products.
Journalists and bloggers responded with stories poking fun at the concept of redesigning hot dogs to make them safer. An editorial in The Los Angeles Times titled, “The tail wagging the hot dog,” said, "Are wieners a choking hazard? Sure, but not everything can be made safe for every age.” One blogger asked, “Would they make teenier wienies shaped like Sponge Bob for kids and leave the adult hot dogs alone?” Public comments on news stories included statements such as...The problem isn’t food. It's the parents!!...I don’t know who’s more stupid, these doctors or parents…Hot dogs don’t need to be redesigned, let’s redesign parents so they know how to take care of their kids.”
CNN reporter Jeanne Moos took to the streets to interview people for ideas on how to build a better hot dog: http://www.youtube.com/watch?v=Ea4m6Ckl-nc
The Grocery Manufacturers Association applauded AAP for bringing attention to the need to prevent choking among children, but said in a statement that food products are safe and what doctors and others need is education. "We especially agree that the education of parents, teachers, child care workers, and other child caregivers encouraging them to supervise and create safer environments for children is paramount to the prevention of choking among children. We also strongly agree that pediatricians, doctors and other infant and toddler care professionals should intensify choking prevention counseling including providing parents and care givers guidance on developmentally appropriate food selection for their children.”
While headlines about killer hot dogs may be entertaining, there is nothing funny about watching a child choke. Parents who take baby CPR classes are advised to take the instructions seriously because the odds are very high the child will choke on food at some point. Children who choke run the risk of death, permanent brain damage caused by lack of oxygen, or other complications associated with airway blockage.
What’s your take on all of this? Are the pediatricians right in calling for actions to make food safer? Have the docs gone too far, adding extra costs that will drive up prices for something that’s not needed? Are those who criticize parents right and are some parents so dumb that kids need additional protection? What would be the best way to reduce injuries and death among children from choking incidents?
Resources:
News story: http://tinyurl.com/yl3fb7r
AAP Position Statement: http://tinyurl.com/yhtfky2
CDC-Choking and Children: http://tinyurl.com/yjlqrqd
American Red Cross – Infant and Child CPR: http://tinyurl.com/yzsgdav
About the author: Pat Elliott is a journalist and blogger who has written about health issues for more than 20 years. She is also a cancer survivor who coaches people on how to manage their transition and take control of their new future.