ELK GROVE VILLAGE, ILL. — In a policy statement issued Feb. 22, The American Academy of Pediatrics (A.A.P.) identified hot dogs among the foods considered to be a choking hazard for children that are three years of age and younger.

In its statement, “Prevention of Choking Among Children,” published in the March issue of Pediatrics, food, including hot dogs, hard candies, peanuts, nuts and peanut butter; toys; and coins were linked to causing the most choking-related events in young children. The A.A.P. recommends issuing a recall for food that pose high choking risks in addition to requiring labeling on the products. The design of the high-risk foods should also be required under the recommendations (see the statement by clicking here: http://www.aap.org/advocacy/releases/feb2210studies.htm).

The shapes, sizes and consistencies of foods posing the greatest risk for choking in children are known and food manufacturers should design or redesign foods whenever possible, to avoid those characteristics to reduce the choking risk, said Dr. Gary Smith, immediate-past chairman of the American Academy of Pediatrics' Committee on Injury, Violence and Poison Prevention and lead author of the organization's new policy statement on preventing choking.

"If you were to take the best engineers in the world and asked them to design a perfect plug for a child's airway, you couldn't do better than a hot dog," Mr. Smith said in a recent HealthDay News article. "It's the right size, right shape. It's compressible so it wedges itself in.”

Janet Riley, vice-president of public affairs for the American Meat Institute, said the choking risks associated with small children who eat hot dogs is not new. “For more than a decade, we have echoed the American Academy of Pediatrics recommendations that hot dogs should be cut into small pieces before serving to young children; that casings, if present, should be removed; and that parents should carefully supervise their young children’s eating at all times,” she said.

She also addressed the issues of labeling and redesigning hot dogs. “Several companies who manufacture hot dogs – representing roughly half the market share –have chosen to include choking prevention advice on packages and have done so for years," she said. "It is important to evaluate the impact the presence of those warning labels has had on choking incidents associated with hot dogs and whether or not those labels have been effective in preventing choking incidents. Despite the fact that this has not yet been evaluated, our members are carefully considering A.A.P.'s new policy on this issue."

In terms of a call for a redesign of hot dogs, these are an iconic food known for their distinctive shape, she said.

"However, I can say that as a mother, I redesign many foods – from hot dogs to grapes to carrot sticks – in my own kitchen when I serve them to toddlers. I simply use a knife and cut them into small, bite-sized pieces," she added. "We support the Academy's efforts to advise consumers on how to prepare food for young children to prevent choking. In joining that effort, we are committed to creating a Web video and companion brochure this year that will advise parents of the importance of cutting hot dogs in very small pieces when serving to young children."

The A.A.P. recommendations include:

* Warning labels on foods that pose a high choking risk.
* A recall of food products that pose a significant choking hazard.
* The establishment of a nationwide, food-related choking-incident surveillance and reporting system.
* Food manufacturers should design new food and redesign existing food to minimize choking risk.
* CPR and choking first aid should be taught to parents, teachers and child-care providers.
* Pediatricians should continue to provide guidance to parents on safe and appropriate food and toy choices, as recommended by the A.A.P.