Not only does the American Academy of Pediatrics want foods like hot dogs to come with a warning label, the organization wants hot dogs (and other foods) “redesigned” so their size and shape render them less likely to lodge in a child’s throat.
In their February 2010 report,” Policy Statement Prevention of Choking Among Children” [pdf], the academy emphasizes that food, coins, and toys are the primary causes of choking-related injury and death among children. The policy statement claims 10,000 emergency department visits annually can be attributed to choking on food among children aged 14 years and younger, and up to 77 die.
The academy’s report notes that choking rates are highest among infants, with nearly two thirds (65%) of the fatalities among children younger than 3 years. Choking on food causes the death of approximately 1 child every 5 days in the United States, the report says.
“If you were to take the best engineers in the world and try to design the perfect plug for a child’s airway, it would be a hot dog,” says statement author Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio. “I’m a pediatric emergency doctor, and to try to get them out once they’re wedged in, it’s almost impossible.”
Hot dogs accounted for 17% of food-related asphyxiations among children younger than 10 years of age in a 41-state study. Smith says he doesn’t know exactly how someone would redesign a hot dog, but he suggests some savvy inventor will find a way. “No parents can watch all of their kids 100% of the time,” Smith says. “The best way to protect kids is to design these risks out of existence.”
One can’t help but wonder how simplicity and the application of common sense sometimes escapes the formally educated mind. Instead of issuing warning labels and redesigning the shape of an American tradition like the hot dog into, say, a triangle, we feel certain we can count on parents to instinctively cut hot dogs into small angular pieces before feeding the tube steak to their children, just like most have been doing for years. We also feel assured that parents who ignore the innate skills of dutifully attending to daily childhood risks, won’t bother reading hot dog warning labels.
Janet Riley, president of the National Hot Dog & Sausage Council notes that more than half of hot dogs sold in stores already have choking-prevention tips on their packages advising parents to cut them into small pieces. “As a mother who has fed toddlers cylindrical foods like grapes, bananas, hot dogs and carrots, I ‘redesigned’ them in my kitchen by cutting them with a paring knife until my children were old enough to manage on their own,” Riley says.
While the academy’s report raised notable issues, the report contained logical inconsistencies. For instance, the report cited as noteworthy that many foods with high-risk characteristics associated with choking are man-made, such as popcorn, chunks of peanut butter, marshmallows, chewing gum, and sausages.
The characteristics of these foods, says the report, are engineered and, therefore, amenable to change, unlike naturally occurring food products such as certain fruits and vegetables. But the report goes on to list other foods considered to be high risk which are not man-made — peanuts, nuts, seeds, whole grapes, raw carrots, and apples. These foods have been around since the the dawn of time. Do they need a warning label, or need their shapes redesigned? I think not.
The American Academy of Pediatrics urges strong FDA involvement and recommends a mandatory system to label foods with appropriate warnings according to their choking risk, and they note that for nearly three decades Sweden has had age labeling on foods for infants and young children and warning labels on prepackaged shelled peanuts to prevent choking among young children.
The American Academy of Pediatrics concern for the welfare of children may be better served in addressing far more pressing issues in which parents have no control. Last September, an investigative report conducted by the United States Government Accountability Office revealed that thousands of schools served contaminated beef, peanut butter and canned vegetables to schoolchildren weeks after recalls were announced.