FULL REFERENCE: Young, L., Agar, S., Chiwawa, B., and Gerritsen, S. (2024). Impact of food-related choking prevention guidance on the food environment in early childhood education. NZ International Research in Early Childhood Education Journal, 26, pp. 1-13.
ABSTRACT: Young children are at risk of choking on food. In 2020, the New Zealand Ministry of Education mandated food-related choking guidance for licensed early childhood education (ECE) services. Prior to implementation there was concern about the guidelines from some parts of the ECE sector. A survey was conducted to assess the impact on food access and nutrition practices in centres. Survey data was collected from centre managers using an online questionnaire in four regions across New Zealand. Responses are presented using descriptive statistics and thematic analysis of open-ended questions. Survey responses were received from centre managers of 179 centres (17%). The survey showed that changes were made in response to the new guidance to food provision, staff duties and supervision of children, and to the centre’s connection with whānau (family) through events and celebrations. The guidelines raised awareness of choking prevention and resulted in changes aligned with the recommended actions. However, some changes adversely impacted the food environment e.g., less access to onsite vegetable gardens, removal of fresh fruit and vegetables from menus, and learning opportunities about food. There is a need for education on how to adopt food safety practices within the context of growing food onsite and continuing family/cultural celebrations. The guidelines need to be clear and practical for ECE services to implement.
KEY WORDS: Food-related choking prevention; early childhood education; food environment, young children; food policy, food, kaupapa-policy; whānau-family group; kai-food; māra kai-gardening for food; tikanga-practices; tamariki-children; kanohi ki te kanohi-face to face.
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INTRODUCTION
Young children (0-5 years), especially children under one year of age, are at higher risk of choking on food due to their body’s immature physiology (narrow airways), chewing, swallowing and coughing ability (Sidell et al., 2013). In New Zealand (NZ) choking on food was responsible for eight deaths (4.9%) during the period 2006-2010 and was the leading cause of hospitalisations within the category of injury from unintentional suffocation, strangulation and choking in children aged 0-14 years from 2008 to 2012 (N=134, 45%) (Safekids Aotearoa, 2015). Foods associated with child deaths from choking in NZ were meat/sausage, peanuts, apple, and grapes (Ministry of Health, 2012). Furthermore, non-fatal choking can result in acute and chronic health issues including hypoxic brain damage (Ministry of Health, 2012).
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