The Ministry of Education is considering a ban on foods including sausages, chips and popcorn in early childhood centres because they pose a high choking risk.

The ministry has told centres it wants to make Ministry of Health guidelines on food preparation compulsory in order to reduce the risk of children choking on their food.

It said under-fives were at higher risk of choking because they had small air and food passages and were still learning how to chew food properly.

Since the start of 2016, the ministry had been alerted to seven cases of choking, including the case of a 22-month-old child who suffered severe brain damage after choking on an apple.

Ministry of Health guidelines said services should exclude foods that presented "the highest risk of choking and either would not be practical to alter in an early learning service, have no or minimal nutritional value, or both".

Those foods were whole or pieces of nuts, large seeds like pumpkin or sunflower, hard or chewy sweets or lollies, crisps or chips, hard rice crackers, dried fruit, sausages, saveloys and "cheerios", popcorn, and marshmallows.

Other high-risk foods could be altered.

For example, raw carrot, apple or celery were difficult for young children to bite into pieces small enough to swallow safely and should be grated for under-three-year-olds and cuts into sticks for older children.

Grapes, berries and cherry tomatoes should be quartered or finely chopped for the youngest children and halved or quartered for older children, while peanut butter should be spread thinly.

The guidelines also said small children should be supervised while eating.

They should sit appropriately without distractions and be asked not to talk with their mouths full.

Ensuring accountability

Early childhood advocate Dr Sarah Alexander investigated the 2016 choking incident that resulted in serious brain damage to a 22-month-old and has been lobbying for tighter rules.

She said the ministry's push for mandatory food regulations would ensure centres were held to account if they gave children food that choked them.

"They're making it crystal clear that if a service unnecessarily puts a child's life or wellbeing at risk through providing food that is dangerous for the child to eat, that it will now be a breach of regulations," Dr Alexander said.

"Until now that hasn't been the case, it's been accepted that dangerous food can be provided to children."

Choking incidents were relatively common in early childhood services and they needed to see food as a potential hazard, Dr Alexander said.

"Children - being children - will jump up and down, it's very hard sometimes to get them to sit down, to chew properly."

The proposed change would be reassuring for parents, she said.

"They don't have to check that their child is going to be placed at unnecessary risk because the ministry now is taking responsibility."

Dr Alexander, who is a senior researcher at ChildForum, told Morning Report it was good news because it was an indication the ministry had "finally accepted that it's got to take action to make things safe for children".

"There is a reason why we have baby food" - Dr Sarah Alexander duration 7′ :11″ from Morning Report Add to playlistPlaylist Download Download as Ogg Download as MP3 Play Ogg in browser Play MP3 in browser "There is a reason why we have baby food" - Dr Sarah Alexander

She said there was a high risk of choking if a child whose teeth weren't fully developed was given popcorn or a peanut.

"There is a reason why we have baby food. There is a reason for regulation for toys not to have small objects that break off easily. The same thing about food, it about keeping kids safe.

"The basic expectation that any parent has when they leave their infants in licensed early childhood education is that their child will still be alive and unharmed at the end of the day."