Safe Feeding Practices to Prevent Choking
From the moment babies begin to be breastfed and eat, safe eating is critically important in several aspects: type and quantity of feeds, the way food is eaten, how the baby sits and the types of food the baby should not eat until a certain age.
Choking is the third most common cause of mortality in children, with the majority of choking caused by food, as the trachea of babies and toddlers is narrow compared to that of adults. In addition, their cough reflex is not developed enough, and so they are unable to eject food that was inhaled accidentally into the trachea. Such food blocks the airway and may cause choking. Safe behavior while feeding babies can prevent choking and save lives.
Feeding until the age of six months
A baby’s diet is based on breastmilk or infant formula or a combination of the two.
Sitting
Do not sit babies if they are unable to sit upright on their own.
Lying down
Do not bottle-feed babies when they are lying down.
Attentive feeding
When feeding babies with a bottle, it is important to always hold them in your hands, and maintain eye contact. For more information about proper bottle feeding.
Feeding from the age of six months
Around the age of six months, babies are generally ready to begin trying supplementary food. However, these are generally known as “solid foods”, so why do we say “supplementary food”? Because the food we begin to offer six-month old babies supplements the breastfeeding or infant formula.
When do we begin offering babies supplementary food? When they show signs that they are ready.
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Sitting
When they can sit with support.
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Posture
When they can hold their head steady.
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Willingness to eat
When they show curiosity and willingness to eat when we bring food close to their mouth.
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Putting hands in the mouth
When they can move food in the mouth from side to side and can draw their hands and various objects closer to their mouth.
Feeding from the age of 9 months
In this stage, we can begin the transition to food babies can eat with their fingers.
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Hard fruits and vegetables
Slice into tiny pieces, puree, grate or grind.
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Fruits with pits and olives
Remove and discard the pit in the trash can so that it will not be in the reach of the baby, who may put it in his or her mouth.
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Round vegetables, fruits and food
Such as grapes, olives, cherry tomatoes, carrots, cucumber. Until the age of 5, split round fruit and vegetables in half lengthwise and cut into strips or small pieces. Food that are cut into rings may block the trachea.
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Pieces of meat and chicken, hard cheeses
Cut into small pieces, based on the baby's ability to eat.
Foods that are a potential choking hazard
- Dried fruit: until the age of 5, remove the pit and cut into small pieces since their texture may adhere to the trachea.
- Foods that must not be given until the age of 5: nuts, walnuts, almonds, peanuts and seeds, popcorn, lollipops, gum, marshmallow, toffee, gel candies. These foods have a tendency to block the trachea and are therefore dangerous. Lollipops, gum, marshmallow, toffee and gel candies are not recommended in terms of health even for children over 5 years.
Rules for safe eating
In order for babies to enjoy eating and for us to protect their safety and health, follow the following rules:
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1Feeding method
The baby should sit in an age-appropriate chair that is safe and that supports him or her. Make sure that the head is stable and that the feet are supported, and that the baby can sit upright in a way that allows him or her to easily and freely swallow. If you use a highchair, it is extremely important that you make sure that the baby is secured in the chair with a safety harness that is adapted to it. Never leave babies in highchairs, or other chairs, unsupervised.
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2Parental presence
Babies must always be closely supervised by a parent or a responsible adult for their own safety. Parental presence has an added value in that feedings are a good time to bond with babies, speak with them, learn to identify signs that they are full. During feeding, it is important to remain focused solely on the baby and not engage in any other activity.
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3Safe eating
When babies begin to experiment with solid food, they should be allowed to eat independently and use their fingers or a teaspoon. Avoid using any sharp eating utensils such as a fork and knife.
- Exposure: in a period in which babies are introduced to supplementary food, they learn to eat new food, and gradually become accustomed to changes in mouth movement: the need to perform various actions with the tongue, synchronize swallowing, and so on. In contrast, eating with a pacifier, net or bag with a cap increases the risk of plaque, impairs the hunger and satiety mechanism, fixates the sucking action and does not allow experience in the transition to normal eating.
- Food texture: with the transition to supplementary food around the age of 6 months, every type of food served to the baby should be pureed, including fruit, vegetables, chicken, etc. When the baby’s ability to chew and swallow develops, the transition to rougher food can be made.
For more information about the transition to eating supplementary foods - how can we tell the baby is ready and how should the transition be done.
Written with the assistance of the Beterem organization for child safety.