Note: Some of the detail in this article may be distressing to read.

DOCTORS HAVE ISSUED a new warning that very young children can choke to death on whole grapes, saying the knowledge is not widespread enough.

The warning comes from doctors writing in the Archives of Disease in Childhood, which notes that grapes are the third most common cause of food-related choking after hot dogs and sweets.

Foods account for over half the episodes of fatal choking among the under fives – but public awareness of this potential hazard is not widespread, say the doctors.

They described three cases of young children, all of whom required emergency treatment after eating whole 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.

Again, the grape proved impossible to dislodge, and an ambulance was called. Paramedics were on the scene within a minute and successfully cleared the 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.

Why are grapes so dangerous to young children?

The doctors point out out that the airways of young children are small and that they don’t have a full set of teeth to help them chew properly.

In addition, their swallow reflex is underdeveloped. They are also easily distracted, and all of these factors put them at risk of choking.

Plus, 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 more difficult to remove without specialist equipment”, pointed out doctors.

“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,” they say.

They point out that while there are warnings on toys, there are no warnings about possible choking on foods such as grapes and cherry tomatoes.

What should parents do?

The doctors advise:

• Grapes and cherry tomatoes should be chopped in half and ideally quartered before being given to young children (5 and under)
• They also emphasised the importance of adult supervision of small children while they are eating.

Read: ‘New lease of life’: Seriously ill Meath boy doing well after uncle donates kidney>