A lack of awareness of the risks posed by certain foods and parents’ enthusiasm for independent feeding of children could explain an increase in the number of children admitted to hospital following an episode of choking caused by aspiration of food.
This is what a study published in the Canadian Journal of Respiratory, Critical Care, and Sleep Medicine by a team from Laval University and the Research Center of the CHU de Québec — Université Laval. The members of this team reviewed the files of young people aged 0 to 17 who had been admitted to the Soleil Mother-Child Center of the CHU de Québec – Université Laval between April 2006 and December 2020 following an episode of suffocation.
“The Center receives all children from Eastern Quebec who have had an episode of choking and who present symptoms such as difficulty breathing or a persistent cough. We carry out an examination of the respiratory tract under anesthesia to determine if the foreign body is still present and, if so, we remove it,” explains one of the authors of the study, Patrick Daigneault, director of the pediatrics department. at the Faculty of Medicine of Laval University, researcher at the Research Center of the CHU de Québec – Université Laval, and pediatric pulmonologist at the CHU de Québec-Université Laval.
During the reporting period, 191 children, whose average age was 31 months, underwent this examination. In 101 of these cases, a foreign body was still present in their airways. “The number of children requiring a hospital stay following a choking episode increased by 87% between the first five and last five years of the period covered by the study. This is an increase three times higher than that of the number of children admitted to the Soleil Mother-Child Center during the same period. Cases of suffocation clearly seem to be on the rise among children,” summarizes Professor Daigneault.
In 73% of cases, the foreign body aspirated by the child was a piece of food. These were mainly carrots (20%), nuts and seeds (19%), peanuts (10%), popcorn (8%), and firm fruits or vegetables other than carrots ( 6%). The other cases were mainly attributable to toys (8%) or various objects (17%).
Choking episodes mainly occur at home (85% of cases) when children are under the supervision of their parents (79% of cases). “In 41% of cases, it was necessary for a witness to the scene, often a parent, to intervene to help the child free his airways. The intervention ranged from a simple pat on the back to cardiopulmonary resuscitation,” specifies the pediatric pulmonologist.
In 70% of cases, the food responsible for choking is on the list of foods to which special attention must be paid because of the risks they pose for young children. “This leads us to believe that there is a lack of knowledge among parents about choking prevention recommendations or a lack of adherence to these guidelines,” he emphasizes.
Professor Daigneault does not rule out the possibility that part of this increase is linked to the rise in popularity of child-led dietary diversification. This approach allows the child to actively participate in his diet by eating food cut into pieces on his own. “If parents don’t know what is safe for their child, this approach can pose some risks. Websites that promote child-led dietary diversity may not emphasize enough foods or food textures to avoid. »
According to the pediatric pulmonologist, it would be important to carry out interventions with parents in order to better inform them about the recommendations aimed at reducing the risk of choking in children. “Additionally, in an ideal world, all adults should know the basic maneuvers to clear a child’s airway so that they can respond quickly and appropriately when a choking episode occurs. »
Justine Veilleux, who was a resident in pediatrics at Laval University under the supervision of Professor Daigneault at the time of the study, is the first author of the article published in the Canadian Journal of Respiratory, Critical Care, and Sleep Medicine. The other signatories are Sandrine Bellavance and Mahukpe Narcisse Ulrich Singbo from the CHU de Québec-Université Laval.
