Lunchbox Warning: A Tragedy Waiting to Happen

Nursery Teachers across the UAE have urged parents to be vigilant when preparing lunch box food items for young children, and to make sure that items like grapes are cut into pieces to prevent choking.
Lunchbox Warning: A Tragedy Waiting to Happen
By Jenny Mollon
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“The parents insist that their child is ‘fine’ eating grapes at home - and keeps sending him to nursery, despite me asking them not to.  For me, all that means is that an accident hasn’t happened – yet!  I don’t know how to convince them of the dangers here.  I have witnessed a choking incident – it is terrifying how quickly a child can lose consciousness.  How can I get this message across?”

On a popular discussion forum for local Nursery Managers, participants complained that despite awareness campaigns and regular communication within their nurseries, parents continue to send children with lunch boxes containing potentially fatal choking hazards.

The UK has seen a number of distressing, well publicised cases of children choking on grapes.  The outcry surrounding these tragedies has, at the very least, served to raise awareness for the general public. 

In the UAE, Nursery Managers and teachers agree that parents and guardians of young children must also be made aware of the very real dangers.

Doctors writing for the British Medical Journal highlighted a number of deaths and near tragedies in the UK, such as:

  • A five-year-old boy choked while eating grapes at an after-school club. Despite first aid, the grape could not be dislodged and the child had a heart attack and died.
  • A 17-month-old boy choked while eating grapes with his family at home. Paramedics were called and the grape was eventually removed but the little boy still died
  • A two-year-old choked while snacking on grapes in the park. He suffered two seizures and spent five days in intensive care before making a full recovery

Nursery teachers and leaders have asked parents to be vigilant over food items in lunchboxes to avoid a similar and ultimately, preventable tragedy.

Speaking to, Kiara Siddall of Hummingbird Nursery DIFC explained why grapes in particular might be considered dangerous for young children:

“To ensure grapes aren’t a hazard, we make sure that they are cut into quarters for all our children. Grapes are a sweet and healthy snack and we’d obviously prefer fruit over processed foods. However, they should be given to young children with caution as they can block a child’s airway quickly.  Added to this, very young children are still learning to chew and may not yet have a full set of teeth.

"It’s also worth thinking about where these hazardous foods tend to be consumed. Choking in young children seems to be correlated with distracted eating, and many of the foods identified as the most dangerous (candy, hot dogs, grapes) appear in places where kids might be focused elsewhere, like birthday parties, get-togethers and fast food restaurants. So, while some food items might appear more hazardous than others, meal and snack times always require complete adult attention, whatever a child is eating.”

Siog Moore, a Registered Nurse and owner of Little Land Nursery in Umm Suqeim, highlighted that grapes are not the only food choking hazards that nurseries contend with.  Siog cited cherry tomatoes, hotdogs, cocktails sausages and even large blueberries as problematic, stressing that parents should remember that "children generally learn to chew well between the ages of 2½ and 4 years, adding that during this time, "all foods should be cut."

"It’s okay for children to practise with larger bites of food at home when they are being supervised one on one, but this is not practical for life in a busy nursery."

 Little Land, and most other nurseries, have a general policy on cutting food for consumption in class.  "This protects not only the children but their teachers and carers”, Ms Moore notes.

Know your first aid, vital advice from the experts

So whilst the primary solution to choking hazards is to cut your child’s food and to always, always practise vigilance – it is vital that all parents and carers have a basic knowledge of first aid should a child begin to choke.  Rapid intervention could mean the difference between life and death

Kate Lyon, Nurse at Mindchamps Al Safa suggests that anyone responsible for or working with children should take a first aid course and that in the event of a choking incident, the following steps should be followed:

“Should you notice your little one struggling with food, are unable to breathe, or unable to make a sound you need to act very quickly to help them. If they are coughing, encourage this, coughing will help to remove the object."

For Children below the age of 1

  • Sit down and lay you baby face down along your thighs, supporting their head with your hand
  • Give up to 5 sharp back blows with the heel of 1 hand in the middle of the back between the shoulder blades
  • Should this have not removed the item, you need to administer chest thrusts
  • Lay your baby face up along the length of your thighs
  • Find the breast bone and place 2 fingers in the middle
  • Give 5 sharp chest thrusts (pushes), compressing the chest by about a third

If the item is still lodged, call the emergency services and continue the cycle of back blows and chest thrusts until the item is removed or medical help come and take over.

For Children above the age of 1 you need to administer back blows followed by abdominal thrusts.

  • Lean the child slightly forward and administer 5 back blows between their shoulder blades with the heel of your hand, you need to do it firmly to try and dislodge the food item
  • Should the item still be there perform abdominal thrusts
  • Stand or kneel behind the child. Place your arms under the child’s arms and around their upper abdomen
  • Clench your fist and place it between their belly button and ribs
  • Grasp this hand with your other hand and pull sharply inwards and upwards
  • Repeat up to 5 times
  • Try not to apply pressure to the rib cage itself as this can cause damage
  • If the blockage is still present, start again with 5 back blows, and call the emergency services, repeat the back blows and abdominal thrusts until the blockage dislodges, or emergency help arrive and take over

For more information on this important topic: visit ROSPA.

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