Cut grapes in half to avoid children choking, advise doctors

Writing in the journal - The Archives of Disease in Childhood, they warn that grapes are the third most common cause of death among under-fives who die in food-related choking incidents.

Because of their softeness and shape, whole grapes can block the 'small, tight' airway of a young child.

They say that a lack of awareness among parents, carers and health professionals that grapes should be cut up before being given to children, could be putting under-fives at risk.

The doctors advise that if giving children foods like grapes, as well as cherry tomatoes, they be chopped in half and ideally quartered.

They go on to describe cases of three young children who required emergency treatment at Aberdeen Royal Infirmary’s Emergency Department after choking on a whole grape, two of which sadly died.

One case involved a five-year-old who started choking while eating whole grapes at an after-school club. ARI medics Dr Jamie Cooper and Dr Amy Lumsden say that 'prompt and appropriate attempts' to dislodge the grape didn’t work and the child went into cardiac arrest. The grape was later removed by paramedics, using specialist equipment, but the child died.

According to Dr Cooper and Dr Lumsden, removing grapes from a young child’s airway often requires specialist equipment that is 'almost never readily available' when standard non-invasive first aid is given. As the smooth soft surface of a grape enables it to form a tight seal that can block a child’s airway completely, it can be very difficult to remove.

‘There is general awareness of the need to supervise young children when they are eating and to get small solid objects, and some foods such as nuts, promptly out of the mouths of small children; but knowledge of the dangers posed by grapes and other similar foods is not widespread', added the doctors.

'While there are plenty of warnings on the packaging of small toys about the potential choking hazard they represent, no such warnings are available on foods, such as grapes and cherry tomatoes.'

The warnings resonate with several reports of fatal incidents in recent years where toddlers have died after choking on whole grapes.

Katrina Phillips, chief executive of The Child Accident Prevention Trust (CAPT), agreed with the report’s warnings and said that many parents and carers they have spoken with were not fully aware which foods can pose a choking risk for small children.

In response to requests from health visitors, community nursery nurses and early years staff, the Trust developed the flyer ‘Finger Food without the Fear’, which is also pinned on their Facebook page.

The flyer highlights the risks of round shaped foods and recommends to serve children ‘long and thin’ batons, as well as to remind children to ‘sit still when they eat’. 

‘Our aim is to outline the main choking risks from food and offer practical safety tips, so that babies, toddlers and young children can enjoy food without the risk of choking,’ said Ms Phillips.