Writing in the ‘Archives of Disease in Childhood’, doctors said whole grapes are the third most common cause of food-related choking, after hot dogs and sweets.
However they believe public awareness of the danger posed of whole grapes is not “widespread”.
“Any injury, accident and death is a tragedy but it is even more so when that injury, accident or death could have been prevented,” said Dr Julie-Ann Maney, of the Royal College of Paediatrics and Child Health.
“This paper highlights just how dangerous seemingly harmless items of food can be for young children if they are not eaten in the correct way.”
The paper describes three cases of young children, two of whom died after choking on grapes.
One case involved a five-year-old who started choking while eating whole grapes at an after-school club. Prompt and appropriate attempts to dislodge the grape didn’t work and the child went into cardiac arrest.
The grape was later removed by paramedics, using specialist equipment, but the child died.
In the second case, a 17-month-old boy was eating sandwiches and fruit with his family at home, when he choked on a grape. Attempts to try and dislodge it were unsuccessful and the emergency services were called. The grape was eventually removed by a paramedic, but the child still died.
The third case involved a two-year-old who was snacking on grapes in the park when he started choking. The grape proved impossible to dislodge and an ambulance was called. Paramedics were on the scene within a minute and successfully cleared his airway.
The child suffered two seizures before reaching hospital and, on arrival, required emergency treatment to relieve swelling on his brain and to drain a build-up of watery fluid in his lungs. He spent five days in intensive care before making a full recovery.
The authors wrote that whole grapes tend to be larger than a young child’s airway.
Unlike small hard objects, such as nuts, the smooth soft surface of a grape enables it to form a tight seal in an airway, not only blocking this completely, but also making it difficult to remove without specialist equipment, they explained.
“There is general awareness of the need to supervise young children when they are eating and to get small solid objects, and some foods such as nuts, promptly out of the mouths of small children; but knowledge of the dangers posed by grapes and other similar foods is not widespread,” the authors explained.
While there are plenty of warnings on the packaging of small toys about the potential choking hazard they represent, no such warnings are available on foodstuffs, such as grapes, the researchers point out.
As such, they advise that grapes and foods including cherry tomatoes “should be chopped in half and ideally quartered before being given to young children (five and under),” and they emphasise “the importance of adult supervision of small children while they are eating.”
Dr Maney agreed, adding: “As a paediatrician working in a busy emergency department, sadly situations like those outlined in this paper are not all that uncommon.
“To prevent accidents like these from happening, I would urge all parents to cut food up into small pieces to avoid a seemingly harmless situation turning into a deadly one.”
Read the full paper in the ‘Archives of Disease in Childhood’ here.
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