Choking incidents on the rise among children, Quebec study warns

Serious cases of choking, which led to children going to the emergency room and even requiring surgery, have been on the rise for the past 15 years, suggests a new study published by a team from Université Laval and the CHU de Québec-Université Laval Research Centre.

According to the authors, the rise in the number of children admitted to hospitals following a choking episode caused by food could be attributable to a lack of awareness of the risks posed by certain foods and to the enthusiasm that parents have for their kids to eat independently.

“Despite this increase, these are things that we already knew were dangerous for children, such as nuts, seeds and hard vegetables,” said study author Dr. Justine Veilleux, who was a pediatrics resident at Université Laval. “So, what we see is that there may be a lack of awareness among the population of good practices in terms of their diet to reduce risks.”

The authors examined the files of newborns to children aged 17 who had been admitted to the Centre mère-enfant Soleil at the CHU de Québec-Université Laval between April 2006 and December 2020 following a choking episode.

This hospital centre welcomes all children in Eastern Quebec who have had a choking incident and who present symptoms such as difficulty breathing or a persistent cough.

During this period, just under 200 children with an average age of 31 months underwent respiratory examination under anesthesia to determine whether the foreign body was still present and, if so, to remove it.

The number of children requiring hospitalization following a choking episode increased by 87 per cent between the first and last five years of the study period – during which the number of admissions for all causes to the centre increased by only 25 per cent.

In three quarters of the cases, the foreign body was a piece of food. Carrots, nuts, and seeds came were equally in first place, with approximately one in five cases. Peanuts and popcorn followed (about one in 10 cases), then firm fruits or vegetables other than carrots.

One-third of the incidents occurred on weekends, when children often spend more time with their parents. The study authors also pointed out that childcare professionals may be more aware of the choking risks and preventative measures.

Most choking episodes, 85 per cent, occurred at home, eight times out of 10 when the child was under the supervision of their parents. In four out of 10 cases, the situation was serious enough to warrant a parent intervening to help their child clear their airways.

The intervention ranged from a simple pat on the back to cardiopulmonary resuscitation, “which highlights the importance of educating parents in the proper practice of these maneuvers,” the study authors noted.

The authors recorded only one death attributable to choking during their study period, but 10 per cent of patients required intubation and 16 per cent required a stay in intensive care.

“Strategies to prevent choking should focus on educating parents about the risks, including which foods are safe to eat at a young age, safe eating behaviors, and how to keep small objects out of reach of the child,” the authors wrote. “This study highlights the need for better parent education and should encourage clinicians to discuss the risks of foreign body aspiration with families.”

Researchers believe that part of the increase may be due to the popularity of baby-led weaning, an approach that encourages children to play an active role in their diet by eating cut-up foods on their own.

“We cannot say whether this method is dangerous or not, but we wonder if there parents who practise this method without knowing which foods are safe or not to offer to children,” said Dr. Veilleux.

Excluding food, eight per cent of choking cases were attributable to toys and 17 per cent to miscellaneous objects.

The authors added that 10 per cent of choking incidents occurred while the child was running.

Eight percent of the incidents occurred when the child ate something given to them by someone other than a parent, and 13 per cent occurred when the child ate something found on the ground.

More than three-quarters of the patients were under three years old and 65 per cent of them were boys.

“We know that accidents are one of the most significant causes of death among children. So, when we can prevent and prevent events that harm their health, (we must) intervene to keep children healthy. (And in this case), it is still something that can be avoided by being careful,” said Dr. Veilleux.

The findings of this study were published by the Canadian Journal of Respiratory and Critical Care and Sleep Medicine.

–This report by La Presse Canadienne was translated by CityNews