Grapes are often larger than a young child's airway, and unlike small hard objects, such as nuts, the smooth surface of the fruit enables it to create a tight seal in an airway, blocking this completely and also making it more difficult to remove without specialist equipment.
Doctors writing in the Archives of Disease in Childhood, explain that foods account for over half the episodes of fatal choking among the under 5s, with grapes the third most common cause of food related choking behind hot dogs and sweets.
But they claim public awareness of this potential hazard is not widespread.
“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,” the authors write. “But knowledge of the dangers posed by grapes and other similar foods is not widespread.”
While small toys come with warnings about the potential choking hazard they represent, no such cautions are available on foodstuffs, such as grapes and cherry tomatoes, the doctors point out.
Therefore, they advise that grapes and cherry tomatoes "should be chopped in half and ideally quartered before being given to young children (5 and under)." They also stress "the importance of adult supervision of small children while they are eating."
The experts cited several cases whereby young children required emergency treatment after eating whole grapes. One tragic case involved a boy, aged five, 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 later died.
“The airways of young children are small; they don't have a full set of teeth to help them chew properly; their swallow reflex is underdeveloped; and they are easily distracted, all of which puts them at risk of choking,” added the report authors.
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