Is feeding nuts to toddlers and young children good?

Do not feed nuts to children less than four years of age!

Our ancestors have prized nuts as a great, dense source of nutrients. In Indian folklore, our forefathers recommended students eat almonds to improve their memory. While most of these beliefs are based on fact, we strongly recommended that you do not feed nuts to your child till he/she is beyond four years of age

Curious children, Indulgent Parents

Growing children are curious and enjoy new learning experiences every day. They are continuously experimenting with various sights, sounds, smells, and tastes. Well-meaning parents who would like their child to ‘get the very best‘ are more than happy to offer their child, the choicest of foods, and if there is an aura of health associated with the food, then ‘more is better’.

Toddlers have only just begun to master the various bodily functions, and that includes chewing and swallowing. Typically, when we swallow food, our airway is isolated from the food pipe by a variety of mechanisms. When children eat firm, small objects like nuts, they cannot complete the process of mashing up the food in the mouth and tend to swallow them intact. Their protective reflexes have not developed completely, and they are mostly in a hurry to get on to the next activity. As a result, the child swallows and, while doing so, inadvertently inhales the food item that may then enter the airway.

Symptoms of inhalation of foreign bodies in the airway

As soon as the child inhales a foreign body, there is a paroxysm of coughing. Coughing is an attempt by the body to expel the foreign body from the airway. Most of the time, the body succeeds, and all is well. However, sometimes, the child is unable to expel it, and now the foreign body gets stuck in the airway.

If it gets stuck in a narrow part in the primary airway, even death can ensue since the child is unable to breathe in oxygen. If it is stuck in the lower airways, the child will have repeated, paroxysmal coughing, may develop a wheeze, or a lower respiratory tract infection with cough, fever, and breathing at a rapid rate. The symptoms may improve a bit with conventional therapies like oral medications and inhalers only to recur again.

If you see any child choking perform the Heimlich maneuver (This is one first aid step that you have to watch and memorize NOW if you have not already done so – it has saved a countless number of lives!)

Watch how to perform first aid on a choking infant

Preventive Measures

• Supervise feeding time: You must not be more than an arm’s length away when the child is eating, as they can choke to death within two to four minutes.
• Feeding Position: only when upright and sitting, not shouting, playing, running, crying, or laughing while eating.
• Do not give any food items that are small, round, hard, rubbery or sticky like nuts, hard candy, whole grapes or popcorn to children who are < four years of age.
• Break food into small pieces and preferably moisten or soften hard food items before giving it to your child e.g., quarter grapes and grape tomatoes, and cook and mash or finely grate fruits and veggies.
• Do not force-feed your child.
• Keep small, colorful, attractive objects out of reach of your children. Children can either swallow them or accidentally inhale them. The blockage of the food pipe or the windpipe can result in disastrous consequences.
• Demonstrate proper chewing techniques to your children.
• See the world through your children’s eyes! Get down to the level of the child and have a look for any objects lurking under furniture that can potentially get stuck in the throat.
• Chewable medicines only after three years of age – i.e., when molars develop.
• Beware of older siblings – they may give dangerous objects to young children.

Emergency / First Aid Measures

• If you see a child choking, give a vigorous thump in the middle of the back – the child may expel the foreign body.
• Do the Heimlich maneuver – If you don’t know what it is, do have a look at this video on YouTube

Watch how to perform Heimlich maneuver on a child more than one year of age or on an adult

• Call for a well-equipped emergency ambulance service (you do have that number written at a known location in your house, don’t you?). Next, rush your child to the nearest well-equipped hospital geared to handle such emergencies (Again, you have already researched this, haven’t you?)