Thursday, August 16, 2012

Finger Foods and Choking Hazards

I get a lot of questions in my office and via email about when to start children on table foods. In reality, as your 9 – 12 month old child begins to eat soft table foods there really are not foods that are off limits. With that being said the issue is not allergic reactions to some foods, but rather airway obstruction and choking. By that I mean that your child can eat almost any food that can be cooked, mashed, squished, slurped, or can dissolve in saliva. (Only rule is no unpasteurized honey until 1 year).

I saw a mother last week who was so nervous about finger foods that she was cutting up cheerios! How can you even cut up a Cheerio? I haven’t tried it, but it seems to me that the Cheerio would just disintegrate into little particles of dust. In actuality, if your child put a Cheerio into their mouth they might gag from a new texture, but the Cheerio itself would break up in the child’s saliva and would not obstruct the child’s airway as it was swallowed. The newer version of Cheerio’s is the Gerber Puff and also the Mum-Mum. Any of these work well as an early finger food.

Young children, under the age of 2 ½ to 3 years, don’t know how to chew. Even if they have a lot of teeth they instinctively put the chunk of food in their mouths and swallow (have you seen teenage boys eat?). If the chunk is large enough or cannot be broken down by the saliva in the mouth, the chunk of whatever might be aspirated and go down the wrong way and cause a child to choke. This is obviously true with not only foods, but with small objects.

So, a child can have peanut butter, but not a peanut. Almonds and cashews are a no-no too, but almond and cashew butters are fine. No worrying about allergies anymore, those guidelines changed several years ago, but I still hear gasps when I tell parents to try peanut butter!

A child can have a strawberry or melon that is really ripe and has been cut into very small pieces, but not a fancy melon ball. No need to worry about allergies to berries or exotic fruits, just watch for choking issues.

What about fish? Flaky fish is a great finger food for a child and very healthy too, but avoid scallops or shrimp that are difficult to eat unless you can chew. (maybe you know of a way to prepare mushy shrimp?)

Questions continue about veggies, and they are all fine. Just cook them well done, some might even say overcooked, and then cut them into little pieces and just hand your child several pieces at a time.

A brussel sprout may be a choking hazard if it is not taken apart, but green beans, peas, carrots, beets, spinach are all great for young children. Experiment with as many fruits and vegetables as you can. You may even find some new foods that you like.

A well balanced diet is the most important rule. Even if your child pushes some of their finger foods away, keep offering a wide variety of foods. Children only learn to try new foods and textures with repetitive exposure. It may take 12 times for your child to smoosh the broccoli between their fingers before they even put it in their mouths.

So… remember airway protection is what you are concerned about, and not reaction to foods. Although food allergies do exist they are much less common than previously thought to be. Let your child try different foods all of the time and eventually you may be surprised at what a good eater your child becomes. It takes practice and time. A little patience with the mess of finger feeding is important too, toddlers do not start out neat, they have too learn those manners along the way.

When did your kids(s) start eating more solid foods? What is your kids favorite finger food? Any suggestions on types of finger foods for other parents?

No comments:

Post a Comment