Parents, be careful when passing your little ones a Werther's Original or Jolly Rancher.
According to a new study, hard candies are the most common culprits in kids' nonfatal choking-related visits to the emergency department.
Published in the journal Pediatrics, the study lists the most common foods that sent American kids under the age of 14 to the emergency room between 2001 and 2009, for a total of almost 112,000 visits. That's about 34 children a day.
This doesn't account for all the choking incidents at homes across the nation that don't lead to hospital visits.
"As dramatic as this study is, this is clearly an underestimate," says Dr. Gary Smith, co-author of the study.
Researchers from Nationwide Children's Hospital in Columbus, Ohio, found more than 16,100 children landed in hospital because they were choking on hard candies. That's over 15 per cent of choking cases. Another 13,324 visits were linked to other candies.
Meat and bones landed 12,671 and 12,496 kids in hospital, respectively.
"If you were going to get the best engineer in the world, you couldn’t design a better plug for a child’s airway than a hot dog," Smith tells NBC News.
The top foods that send kids to the emergency room are as follows:
Hard candy: responsible for 15.5 per cent of cases
Other candy: 12.8 per cent
Meat other than hot dogs: 12.2 per cent
Bone: 12 per cent
Fruits and vegetables: 9.7 per cent
Formula, milk or breast milk: 6.7 per cent
Seeds, nuts or shells: 6.5 per cent
Chips, pretzels or popcorn: 4.6 per cent
Biscuits, cookies or crackers: 3.1 per cent
Hot dogs: 2.6 per cent
Bread or pastries: 2.3 per cent
French fries: 0.8 per cent
"The majority of children who came to the emergency room because they were choking on food were treated and released, but about 10 percent needed to be hospitalized. Kids who choked on hot dogs or seeds, nuts or shells were more likely to require hospitalization than those who choked on other foods," LiveScience reports.
"These foods have high-risk characteristics that make them more likely to block a child's airway or make them more difficult to chew, which can lead to more serious choking events," Smith says in a press release.
According to the Canadian Paediatric Society (CPS), for every choking-related death, there are an estimated 110 children treated in emergency departments:
"Most foods implicated are small, round or cylindrical in shape, conforming to the contours of a child’s airway (eg, hot dog rounds, whole grapes, carrot slices, peanuts, seeds and hard candy)."
The CPS recommends that parents avoid giving their young children (under the age of 4) hard candies, cough drops gum, gummy candies and chewable vitamins, peanuts, sunflower seeds, fish with bones, and snacks on toothpicks or skewers.
Grapes, hot dogs and sausages should be sliced lengthwise. Raw carrots and apples should be chopped or grated.
The American Academy of Pediatrics (AAP) advises that all parents and caregivers be familiar with choking first aid and CPR should the young ones in their care start to choke.
Kids should always be supervised when eating.
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Researchers of the study are calling for new warning labels to be applied to foods that pose choking hazards in the same way small toys are marked.
"What's been done there, we know it works…there are labels on packages so parents can make informed decisions when they are making purchases," says Smith.
"There's nothing like this for food."
"Despite the frequency of paediatric food-related choking, and the risk similarities to hazardous toys, choking on food remains a relatively under-addressed problem in the United States," the study says.
"The main thing with these cases is that they are almost always preventable," Dr. David Walner, a paediatric ear, nose and throat specialist at Rush University Medical Center in Chicago, tells USA Today.
"Some things we can't prevent in medicine, and they're sad stories. But these are the saddest because they are almost always preventable by using common sense."