Preventing Choking Hazards in Your Setting

A grape. A sausage. A button. Small, everyday items that can turn mealtimes or playtime into an emergency in seconds.

Choking is one of the most frightening scenarios in early years settings. It happens fast, it's often silent, and it requires immediate action. The Child Accident Prevention Trust reports that choking, suffocation and strangulation is the leading cause of accidental death among under-fives, and recent national data show a small but significant number of deaths each year linked to choking and inhalation*. According to the National Child Mortality Database, grapes, sausages, strawberries and frozen fruit are often among the foods involved.

Young children explore their world, learn to eat, test boundaries – all perfectly normal developmental behaviour. The important thing is that most choking incidents are preventable.

Understanding the risks, preparing food safely, supervising appropriately, and creating a choking-aware culture in your setting can save lives.

 

Why young children are at higher risk

 

Children aren't miniature adults. Their airways are narrower, their chewing skills are still developing, and they're naturally curious about putting things in their mouths.

Babies start learning the complex process of chewing, swallowing and breathing around six months when weaning begins. Even older toddlers and preschoolers are still mastering coordination between eating, talking and moving.

Young children also have developmental behaviours that increase choking risk. They explore objects with their mouths, they're easily distracted whilst eating, and they often move around during mealtimes rather than sitting still.

Round objects are particularly dangerous because they can adapt to the shape of a child's airway and cause complete obstruction. Grapes, cherry tomatoes, and whole nuts fit perfectly into small windpipes. Hard sweets can do the same.

The Child Accident Prevention Trust uses a simple rule:anything smaller than a 2 pence piece can choke a young child.

 

High-risk foods that need extra care

 

Food causes most choking incidents in early years settings. Not because it's dangerous, but because of how it's prepared and served.

According to NHS guidance and the Child Accident Prevention Trust these foods pose particular risks:

Round foods: Whole grapes, blueberries, cherries, strawberries, cherry tomatoes. These should always be cut lengthways and then into quarters.

• Hard foods: Raw carrots, apples, nuts, popcorn, boiled sweets. These can block airways or break into sharp pieces that are difficult to swallow.
• Slippery foods: Whole grapes (again – they're a significant risk), sausages with skins on. The smooth surface makes them easy to swallow whole and hard to dislodge with back blows.
• Sticky foods: Spoonfuls of peanut butter on their own, marshmallows, jelly cubes. These can seal airways when they get wet and become difficult to remove.
• Foods that break awkwardly: Sausages, hot dogs, chunks of meat with gristle or fat. These need cutting into short, narrow strips lengthways – as thin as possible.
• Small hard objects: Peanuts, whole nuts (should not be given to under-fives), hard sweets, mini eggs, lollipops.

The Child Accident Prevention Trust emphasises that whole nuts should be avoided until age five.

 

Safe food preparation: the basics

 

How you prepare food matters just as much as what you serve.

• Cut food into safe shapes. The NHS advises cutting food into batons rather than balls or chunks. For round fruits and vegetables, cut lengthways first, then into quarters. For larger items like melon, mango or cucumber, cut into thin strips.
• Remove hazards before serving. Take out pips, stones and bones. Remove skins from sausages. Cut away any gristle or tough fat from meat.
• Soften harder foods. Steam, simmer, or mash harder vegetables and fruits, especially for babies and younger toddlers who are still developing chewing skills.
• Think about texture combinations. Foods that are round, hard, chunky, doughy or stodgy all need extra attention during preparation.
• Check portion sizes. For babies aged 6-12 months, cut food into pieces no larger than a quarter of an inch. As children grow and their chewing improves, adjust whilst remaining cautious.

 

The three essential rules for safer mealtimes

The Child Accident Prevention Trust promotes three simple rules that dramatically reduce choking risk. They're easy to remember and implement across your setting:

STAY:
Stay with children when they're eating. This is the single most important thing you can do. Choking is silent – a child whose airway is blocked cannot cough, cry, or call for help. Visual supervision means you can spot problems immediately and intervene.

STILL:
Get children to sit still whilst eating. Moving, running, walking, or lying down whilst eating significantly increases choking risk. Children can more easily inhale food if they're active, distracted, or not sitting upright.

SUPERVISE:
Children must be closely observed and listened to whilst eating and drinking. The EYFS 2025 framework now requires that supervising staff face children during mealtimes, allowing them to react quickly in cases of choking or allergic reactions.

 

EYFS requirements for mealtime supervision

 

The EYFS Statutory Framework sets clear expectations around supervision during eating.

From September 2025, the updated framework specifies that providers must ensure children are supervised whilst eating, with supervision meaning staff can see and hear children. Staff should be positioned to see all children's faces.

At any time when children are eating, a paediatric first aid trained member of staff must be present and available. This applies to all mealtimes and snack times.

Settings must also gather information about special dietary requirements, preferences, food allergies and intolerances before the child enters the setting, and at each mealtime a specific person must be responsible for checking that food is safe for the child consuming it.

These are practical safeguards based on learning from serious incidents.

 

Non-food choking hazards

 

Food isn't the only risk. Small objects cause choking incidents too.

• Toys and small parts: Check toys for loose or broken pieces. Toys designed for older children often contain small parts unsuitable for younger ones. Look for age-warning symbols and the Lion Mark showing toys meet safety standards.
• Coins and buttons: Keep these stored out of children's reach. They're exactly the right size to lodge in small airways.
• Balloons: Deflated or burst balloon pieces are particularly dangerous. The rubber can seal airways and resist removal attempts. Never let young children blow up balloons and clear away any broken pieces immediately.
• Button batteries: These pose dual risks – choking and severe internal burns if swallowed. Keep devices containing button batteries completely out of reach.
• Small household items: Marbles, beads, small balls under 4.45cm in diameter, pins, screws – all present choking hazards if accessible to children.

The best prevention? Get down to a child's eye level in each room and look for anything small enough to fit in their mouth.

 

Creating a choking-aware culture

 

Prevention isn't just about following rules. It's about building awareness across your entire team.

1. Train all staff on choking risks. Everyone working with children should understand which foods and objects pose dangers, how to prepare food safely, and what supervision looks like in practice.
2. Share information with parents. Many parents don't realise grapes need cutting or that marshmallows are high-risk foods. Sharing practical guidance helps create consistency between home and setting.
3. Review your environment regularly. Walk through your setting looking specifically for choking hazards. Check floor areas, play spaces, and anywhere children can reach.
4. Make mealtimes calm and unhurried. Rushed eating increases risk. Create an atmosphere where children can focus on their food without distractions.
5. Record and review incidents. Even "near misses" where a child gagged but didn't fully choke should be documented. Looking for patterns helps identify areas needing extra attention.

Building this awareness across your whole team means everyone plays a part in keeping children safe.

 

Need insurance that understands early years settings?

 

Working with young children means accepting that risks exist but also taking every possible step to minimise them.

When you insure with Morton Michel, you get specialist cover designed specifically for childcare providers, plus practical support through our Business Benefits Package – including access to safety resources, CPD training, and expert advice.