Did you know that choking is a leading cause of morbidity and mortality in children ages 3 years and under? (1)   One study of children in the United States found that 1 child (ages 0-9 years) died about every 5 days from “food-related asphyxiation.” (2)  

All Choking IncidentsAge 
90%Under 5 Years Old
65%Under 2 Years Old

Food, coins, and toys are the primary causes of choking-related injury and death. Amongst food related choking, the following were identified as the top 4 foods identified on death certificates (ordered from most to least):  hot dogs, candy, nuts, and grapes (2).

It’s clear that choking is something parents need to be aware of in order to take all possible steps to prevent it and in the worst case scenario, know how to respond when it does happen. This article covers everything you need to know about choking so you can be prepared. 

Are raisins a choking hazard for children?

Are Raisins a Choking Hazard?

One of the most debated foods in terms of choking risks might be raisins.  If you search for an answer to this question, you’ll find a wide range of answers, so let’s take a closer look at reliable sources.

According to one site, raisins were once on the American Academy of Pediatrics (AAP) list of choking hazards, but were removed in 2010 since there were no reported cases of choking incidents related to raisins.  

However, when I attempted to find this information directly from the AAP, I was unable to locate any resource that had a previous list versus the list they provide currently.  On their current list at healthychildren.org, you will find (reviewed 1/2022) that raisins or other dried fruits aren’t on the list of choking hazards.

However, another source that is considered reliable for this type of information is the CDC and they do include “uncooked dried vegetables or fruit, such as raisins” on their list of potential choking hazards for young children.

So what’s a parent to do?  Raisins make a portable and shelf stable snack that is an easy finger food to provide at home or on the go.  Dare I say, they are superior to pouches, which is often used to meet these same needs of ease and portability.  

While pouches are absolutely OK in moderation, we really want kids, especially hesitant eaters to see, touch, and smell their food as part of the learning process and this is just not possible when it’s packaged up in pouch form.  Can raisins be a safe alternative?

In addition to the ease of providing them anywhere, raisins also contain:

  • Iron – a critical nutrient in the toddler years
  • Potassium – a great thing to add to any kids diet that doesn’t have many vegetables 
  • Fiber – very important as babies start solids, toddlers learn to use the potty, or for picky eaters that prefer more processed foods with less fiber
  • And more!

Raisins clearly have a lot to offer, and I think they are a worthwhile food to modify in order to include them in your child’s diet in the safest way possible.  Here’s how you can provide raisins to your child based on their age to reduce choking risk:

  • Raisins in the first year (after starting solid foods)
    • 6 months+ – after soaking raisins in warm water and draining, puree with yogurt, formula or breastmilk; add cinnamon for more flavor exposure
    • 9 months+ – chop in a food processor with other ingredients (nut/seed butter, oats, etc.) to make mini snack balls (size of chickpea) once your child has a pincer grasp, mince into small pieces (a kitchen shears works well for this!) and serve a few at a time, or bake minced raisins into muffins and breads
  • Raisins for toddlers
    • 1 year+ – be sure to separate raisins that are stuck together, provide only a few at a time to prevent your child from scooping them up into a clump again, and avoid stale raisins that can get hard and extra sticky; alternatively you can soak raisins in warm water to soften and decrease stickiness or add to hot cereal
  • Raisins for kids
    • 4 years+ – no modifications officially recommended, but use your judgement since you know your child best; it never hurts to modify longer than necessary and be sure to follow all other recommendations to decrease choking risk shared later in this article

You might also be wondering about the sugar content in raisins.  Fruit contains natural sugars and is an unsweetened dried fruit.  There are no recommendations to avoid natural sugars for healthy children at any age and you should feel comfortable offering a variety of fruit to your family.  

Raisins and fruit in general offer children calories for growth and activity, vitamins, minerals, fiber, phytochemicals and more.  

In short, they might not make the cut for a snack on the go due to safety risks, but they are definitely a worthwhile addition to any diet in modified forms.

Other high risk choking foods  

Now that we’ve answered the question, are raisins a choking hazard for my child, let’s take a look at other foods that can also be a risk.

The following foods are a choking risk for children under 4 years old, unless modified:

  • Cylindrical foods, such as hot dogs, sausage or meat sticks
  • Whole nuts and large seeds (excluding chia and hemp seeds)
  • Chunks/spoonfuls of nut and seed butter
  • Large chunks of meat and/or cheese
  • Bones in meat or fish
  • Round foods, such as whole grapes, cherries, cherry/grape tomatoes, or melon balls
  • Hard or sticky candy and chewing gum
  • Popcorn
  • Very hard, crunchy snacks, such as corn chips, kettle chips, or hard pretzels
  • Chunks of raw vegetables or fruits, such as carrots, celery, apples, or pineapple

How can I decrease the risk of my child choking on food?

To reduce the risk of your child choking on any food at any age, keep the following in mind:

  • Serve food when your child is seated and upright (not walking, running, jumping, laying, etc.)
  • Offer small portions (you can always give more)
  • Avoid distraction while eating (screens, etc.)
  • Teach children to avoid talking while they have food in their mouth
  • Avoid eating in the car or stroller
  • Model safe eating such as eating slowly, taking appropriately sized bites, and chewing food completely
  • Always supervise your child while eating for early intervention if they do choke
6 best practices to decrease choking risk in children

You can also modify many of the high risk foods to make them safer for your child or substitute similar foods.  Consider these alternatives depending and modifications to decrease choking hazards by age:

Decreasing Choking Risk Under Age 1

In general, food should be soft and easily mashed or able to dissolve when wet.

Common Choking HazardModification or Substitution
Cylindrical foods, such as hot dogs, sausage or meat sticksQuarter lengthwise, then cut crosswise into many small pieces*Consider limiting portion due to sodium content
Whole nuts and large seeds Grind nuts and seeds finely or use small seeds such as chia and hemp seeds which do not need to be modified*To decrease mess, stir into foods like yogurt or applesauce
Chunks/spoonfuls of nut and seed butterSpread very thinly on toast, stir completely into yogurt or hot cereal, thin with breast milk or formula
Large chunks of meatSubstitute very tender meat that is shredded or ground, serve with juice or gravy
Large chunks of cheeseShred
Bones in meat or fishAvoid small bones; large bones that do not have pieces that can easily break off can be used as a handle for babies to hold
Round foods, such as whole grapes, cherries, cherry/grape tomatoes, or melon ballsQuarter
Chunks of raw vegetables or fruits, such as carrots, celery, apples, pineappleCook until soft and mashable, shred finely, or slice paper thin
PopcornSubstitute easily dissolved snacks such as puffs
Very hard, crunchy snacks, such as corn chips, kettle chips, or hard pretzelsSubstitute easily dissolved snacks such as veggie chips/straw, apple straws, etc.
Hard or sticky candy and chewing gumAvoid

Decreasing Choking Risk Ages 1-3

Common Choking HazardModification or Substitution
Cylindrical foods, such as hot dogs, sausage or meat sticksQuarter lengthwise, then cut crosswise into many small pieces
Whole nuts and large seeds Coarsely grind nut and seeds or use small seeds such as chia and hemp seeds which do not need to be modified
Chunks/spoonfuls of nut and seed butterSpread very thinly on toast, stir into yogurt or hot cereal
Large chunks of meatSubstitute tender meat that is shredded or ground
Large chunks of cheeseShred or cut into small pieces or strips
Bones in meat or fishAvoid small bones
Round foods, such as whole grapes, cherries, cherry/grape tomatoes, or melon ballsCut in half lengthwise or continue to quarter
Chunks of raw vegetables or fruits, such as carrots, celery, apples, pineappleShred coarsely, slice thin, or cut into matchsticks
PopcornSubstitute easily dissolved snacks such as puffs
Very hard, crunchy snacks, such as corn chips, kettle chips, or hard pretzelsSubstitute easily dissolved snacks such as veggie chips/straw, apple straws, think pretzel sticks, etc.
Hard or sticky candy and chewing gumAvoid

Decreasing Choking Risk Age 4 and Up

No formal modifications recommended, but use your judgement since you know your child best.  It never hurts to modify longer than necessary and be sure to follow all other recommendations to decrease choking risk shared in this article for children of any age.

What non-food items are a choking risk?

Equally important to food related choking risks are non food items.  Be aware of the following items around your home that are high risk for choking under the age of 4:

  • Balloons (most common non-food cause of choking death)
  • Coins
  • Buttons
  • Toys with small parts
  • Toys that can fit entirely in a child’s mouth
  • Small balls, marbles
  • Small hair bows, barrettes, rubber bands
  • Pen or marker caps
  • Small button-type batteries
  • Small magnets
  • Pieces of pet food

What are signs my child is choking?

Being able to recognize early signs of choking can save your child’s life.  Signs can present differently for each child, but may initially include:

  • Ongoing coughing that doesn’t resolve or weakens
  • Wheezing, often when breathing out

If your child is unable to cough and dislodge the object, symptoms can progress to include:

  • A high pitched sound while breathing (stridor)
  • Pain in throat or chest
  • Hoarse voice
  • Difficulty breathing – ribs and chest pulling inward
  • Blue tint around the lips
  • Inability to cry/speak
  • No breathing
  • Loss of consciousness (unresponsive)
7 signs of choking that tell you it's time to call 911 or emergency services

What should I do if my child is choking?

If your child has any breathing difficulties, call 911 immediately.  Even a partial obstruction can turn into a full obstruction, so it’s better to be safe and make the call to emergency services.  

If your child is still able to produce a strong cough and/or talk, do not intervene as you wait for emergency care.  If at any point their cough weakens, they lose the ability to speak, or breathing stops begin treatment immediately while waiting for emergency care.

In order to act immediately if your child chokes, it’s important that parents take a child first aid and CPR course.  The best option is an in person course that allows for hands-on instruction and official certification such as the American Red Cross or American Heart Association.  

How can I recognize gagging versus choking?

When starting solids, babies often gag on food.  For parents that are already anxious about the risk of choking, this can be stressful and confusing to watch.  However, gagging is natural for babies, and in fact actually helps prevent choking.

It’s important to allow babies to gag and work it out themselves.  Parents that remain calm in this situation, help their baby remain calm too.  And calm, positive mealtimes help kids feel comfortable coming to the table and eating.

In general, gagging is a loud response.  Babies that are gagging might make coughing, gurgling, or sputtering noises.  They may thrust their tongue out.  Their face may turn red and they may spit up or vomit.

In contrast, choking can often be silent, as a child that isn’t getting any air won’t be able to cough, cry, or speak.  A child may also turn blue due to lack of oxygen, although this is not always an evident sign for children with darker skin tones.  

However, it is important that we don’t generalize and consider gagging to be loud and choking to be silent.   Wheezing, high pitched sounds while breathing, weakening cough and the signs listed in the above section are all signs of an emergency and if seen, you should call 911.  A partial obstruction of the airway can lead to a full obstruction and damage the airway.

Take home points to prevent choking in kids

Choking can be terrifying for parents to even think about and traumatizing for both parents and children to experience.  That’s why it’s so important to take recommendations to reduce risk seriously.  Keep the following take home points in mind:

  1. Prevention is best – reduce risk by modifying, substituting or avoiding high risk foods and keeping non-food choking risks out of reach of your child; do an audit of your home after reading this article!
  2. Early intervention is key – understand the signs of choking, know when to call 911 and take a first aid and CPR course to be able to appropriately respond if choking does happen; research a course in your area after reading this article!

For more reliable, researched based, and real life strategies on feeding kids, join the Mastering Mealtimes Membership.  As a registered dietitian, parent coach and fellow mom, I walk you step by step through not just nourishing healthy kids, but how to deal with all the parenting challenges along the way.  


Kim Slack is a Registered Dietitian, Quality Improvement Professional, Parent Coach and founder of On Your Table, LLC.  She coaches parents on feeding strategies and parenting styles that support children to learn to eat a varied diet.  Kim has helped countless families have happier, calmer mealtimes and grow competent eaters.  Kim also has 2 boys of her own at home.  Learn more about her from her about page.

Helping picky eaters starts with EXPOSURE!

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