Choking risks on the holiday table: grapes, nuts, rice cakes, glutinous rice balls and hard candy — how under-5s can eat them safely

The short answer: glutinous rice balls at the winter solstice, nuts and sweets at Christmas, the 12 grapes of Spanish New Year's Eve, rice cakes at New Year in Japan and Korea — the best holiday foods are also among the easiest for young children to choke on. The Spanish Association of Paediatrics (AEP) warns that choking risk rises over the holidays¹, and the Japan Pediatric Society names mochi rice cakes as the classic example of a sticky, hard-to-chew high-risk food². Japan's Consumer Affairs Agency reports that 43 children under 5 died from choking on food between 2018 and 2022³. Remember three rules: cut round, slippery foods small (grapes and cherry tomatoes into lengthwise quarters), give sticky foods in small, slow bites, and no hard nuts or beans under 5¹²³.

Why take extra care over the holidays?

More risky foods around: the AEP notes that over Christmas and New Year, children eat more turrón, nuts, sugared almonds, popcorn and especially grapes and sweets, so choking risk goes up¹
Young children can't chew well yet: children aged 1 to 5 are still developing their motor and swallowing skills¹; baby teeth are usually complete only at 3–4 years, bite strength is weaker than an adult's, hard foods may be swallowed whole, and children are less able to cough things back up²
It can be very serious: when a child chokes, breathing can stop and the heart can arrest within minutes²

Which foods are most dangerous?

The Japan Pediatric Society groups them by type²:

Type	Common examples
Round and slippery	Grapes, cherry tomatoes, cherries, quail eggs, round cheeses, sausages, konjac, shiratama dumplings (similar to glutinous rice balls), hard candy
Sticky, hard to swallow	Mochi rice cakes, rice, bread
Hard, need chewing	Peanuts and other beans, nuts

Mochi is the classic example: it needs strong chewing and is extremely sticky, so it can stick in the mouth and block the airway²
Hard candy: the AEP says hard, round sweets can block a child's airway completely in seconds, dissolve slowly and lodge easily in the throat; no sweets at 0–3 years, high risk at 3–5 even with supervision, and lower but not zero risk after 5¹
Hard beans and nuts: don't give them to children 5 and under³; small chewed fragments can also be breathed in and cause pneumonia or bronchitis³

How can children eat them more safely?

Grapes: the AEP advises no whole grapes until at least 4–5 years; cut them lengthwise into quarters, not into round slices, and peel them and remove the seeds, because the slippery skin can slide into the throat¹
Grapes and cherry tomatoes: the Japan Pediatric Society recommends cutting them into quarters before giving them to children 4 and under²
Mochi, rice and bread: keep bites small, tear them into pieces that fit easily in your child's mouth, check that each bite is chewed and swallowed, and have a drink first to moisten the throat²
Keep watching even when food is cut small: children may stuff several pieces in at once, so remind them to take small bites and chew well³
Sit down and focus on eating: children should be seated and calm, with an adult watching¹; no eating while running, playing, lying down or walking, and no talking with food in the mouth²
Don't feed a crying child³
Tidy up: pick up dropped beans and sweets, food wrappers and desiccant packets so little ones can't put them in their mouths³

For how to adjust food textures during weaning, see The solids texture roadmap.

What do I do if my child is choking?

First, check whether your child can still cough effectively¹⁴:

Coughing loudly, still able to cry or speak: encourage them to keep coughing, don't give back blows, and stay with them¹⁴
Silent cough, can't breathe in, or struggling to breathe: shout for help and call your emergency number right away¹⁴
- Under 1: sit down and lay your baby face down along your thigh or forearm, supporting the head and neck, and give up to 5 sharp back blows with the heel of your hand between the shoulder blades; if that doesn't work, turn your baby face up with the head lower than the feet, place 2 fingers in the middle of the chest just below the nipple line, and give up to 5 sharp chest thrusts⁴
- Over 1: give up to 5 back blows; if that doesn't work, stand or kneel behind your child, put your arms under theirs around the upper tummy, place a clenched fist between the belly button and ribs, grasp it with your other hand and pull sharply inwards and upwards, up to 5 times⁴
- Check after each blow or thrust whether the object has come out, and keep alternating the two methods until it does or help arrives⁴
If your child becomes unconscious: lay them on a firm, flat surface, call your emergency number on speakerphone, and start CPR⁴

What not to do:

Don't poke blindly with your fingers, which can push the object further in⁴¹
Don't hold your child upside down by the feet, which is both ineffective and dangerous¹

Get checked even if the object comes out: part of it may be left behind, or the first aid may have caused an injury⁴¹.

It's worth taking an infant and child first aid course before the holiday gatherings.

Frequently asked questions

Is cutting grapes in half enough? The AEP advises cutting them lengthwise into quarters, peeled and seedless, until age 4–5¹, and the Japan Pediatric Society also recommends quarters for children 4 and under².

At what age can children have whole nuts? Japan's Consumer Affairs Agency advises no hard beans or nuts for children 5 and under³.

My child is coughing. Should I start back blows straight away? If your child is coughing forcefully, let them keep coughing and don't give back blows¹⁴. Back blows and thrusts are for when the cough is silent or they can't breathe in⁴.

This article is based on public information from the Spanish Association of Paediatrics, the Japan Pediatric Society, Japan's Consumer Affairs Agency and the NHS. It describes general principles for preventing food choking. First aid is best learned on a proper course. If your child is choking, can't cough or becomes unconscious, call your local emergency number immediately.

References

Asociación Española de Pediatría, Comité de Soporte Vital. (2025, December 23). Cómo pelar las uvas y cortarlas en cuatro trozos longitudinales para prevenir atragantamientos 'navideños' en menores de 5 años. https://www.aeped.es/actualidad/atragantamientos-navidad ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵
日本小児科学会こどもの生活環境改善委員会. (2025, August 31). 食品による窒息子どもを守るためにできること (Ver.3). https://www.jpeds.or.jp/society-activities/column/proposals-assertions/50123.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰
消費者庁. (2024, January 22). 子ども安全メール Vol.644 硬い豆やナッツ類をはじめとする食品での窒息や誤嚥に注意! https://www.caa.go.jp/policies/policy/consumer_safety/child/project_001/mail/20240122/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸
NHS. (2024, October 28). How to stop a child from choking. https://www.nhs.uk/baby/first-aid-and-safety/first-aid/how-to-stop-a-child-from-choking/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹