"Children suffer quietly" What is the fear of choking accidents May 5 at 31:17

At a nursery school where safety is required, there have been a series of accidents that should not have happened.
Two children, both less than one year old, became choking and falling into a critical condition unconscious after eating apples served for school lunch and snacks.

The six-month-old girl died after just over a month of treatment.

Once, a woman who said her daughter choked on an apple testified that she "suffered quietly."
There are endless suffocation accidents. What is that fear?

Children who ate apples ... What to do in the nursery

On the 18th of last month, an accident occurred at a nursery school in Aira City, Kagoshima Prefecture, in which a six-month-old girl was transported by ambulance.

After eating a grated apple, which was served as a snack, the complexion suddenly deteriorated.
He lost consciousness.

The director of the nursery school explained in previous interviews, "After thinly cutting, the apples grated on a grater were served with barley tea."

After eating, the girl's clothes and the area around her mouth became dirty, so the staff tried to get a change of clothes out of the locker and put her on her back on her back.

In the few seconds between getting dressed and turning around, the girl's appearance had changed completely.

Treatment continued at the hospital, but on the 28th of this month, the girl died without regaining consciousness.

Will a grated apple get stuck in your throat?

The director told the interviewer, "We cannot deny the possibility that there were apples in a solid state that could not be fully grated, and that they got stuck in the throat."

About one month after this accident, an accident occurred at a nursery school in Niihama City, Ehime Prefecture, in which a child fell unconscious immediately after eating an apple.

The kindergarten child is an 1-month-old boy.
On the 8th of this month, immediately after eating the apples served at school lunch, I felt pale.

According to the kindergarten's explanation, the nursery teacher, who thought it was stuck in her throat, patted her on the back and tried to make her vomit, but her face turned pale.

The boy was taken to the hospital by ambulance and is being treated at a hospital, but remains unconscious.

What was served at the school lunch were apples cut into small dice shapes.

According to the description of the garden, it is about 7 mm long, 2 mm wide, and 3 mm thick. The nursery teacher would put it on a spoon and bring it to her mouth to feed it.

The boy had just entered the school one week ago, and this was the second day he ate lunch.

The kindergarten explained to previous interviews that it had confirmed that the boys had eaten apples in interviews with parents before providing them.
However, they did not explain how to cook and serve raw and solid food.

"Suffer quietly" Fear of suffocation

Choking accidents in which familiar ingredients can lead to life-threatening accidents.

"I, too, once had a child choke an apple in his throat,"

says Mika Kudo, who lives in Tokyo, about her experience.

One day, Mr. Kudo served apples as a snack to his eldest daughter, who was one year and several months old.

The eldest daughter liked the crunchy texture and had already eaten rice crackers for babies.
Thinking that he would be able to eat enough, he cut it into thin wedges and handed it to him.

The eldest daughter began to nibble deliciously.
However, her lips gradually turned blue and she showed a touch of her chest.

"You choked it in your throat?!"
said Kudo, who was
flustered, and hurriedly picked her up from her chair and patted her on the back with her head down.

But apples do not come out.

At that time, I remembered the "Heimlich method" (which I will introduce later in the article), which I had learned in nursing school, and when I tried it, I saw a "piece" of an apple from my mouth.
Fortunately, it didn't turn out to be important.

In fact, Mr. Kudo experienced this experience more than 1 years ago. That's why he doesn't remember the exact time or the age of his eldest daughter.
However, the scene at that time still leaves a strong impression on me.

She told me that what scared her most was that her eldest daughter "suffered quietly."

Mika Kudo:
"When I stuck the apple in my throat, my eldest daughter didn't speak or lash out, and suddenly her lips turned blue. I barely took my eyes off my eldest daughter at the time, so I could notice her right away, but if I was talking to someone or watching TV, I don't think I would have noticed."

When we talked about the risks of playing in the water, we told you that children in particular "drown quietly."

Drown "quietly"? Risks lurking in summer vacation

Ms.
Kudo: "I had heard the story and thought it was the same: when a child chokes, he or she suffers quietly. I was keenly aware that when a small child is eating something, you should never take your eyes off them."

What are the rules to prevent choking in children?

There is no end to accidents in which children die due to choking on food.

According to an analysis by the Consumer Affairs Agency, 2019 children under the age of 6 died in the six years to 14. Seventy percent of them were under the age of two.

Looking at the 51 people whose causative food was revealed, the most common were breast milk and sweets.
Six children have died after choking on fruits such as apples and grapes.

In fact, in order to prevent accidents in educational facilities and childcare facilities, the guidelines established by the government in 2016 also describe how food should be prepared and served.

For example, about apples, it is described like this:

・ Even if fruits are chewed and fine, they are easy
to clog depending on the firmness and cutting method ・ Apples and pears are heated and served until the baby food is completed.

According to a person in charge of the Children and Families Agency, the contents of this guideline were made known to local governments nationwide when it was created.

In addition to the recent cases in Ehime and Kagoshima, there have been a series of reports of suffocation after eating fruits such as apples, so last month they called for thorough efforts.

However, the guidelines are only positioned as "for reference" and are not enforceable. In fact, in the accidents that occurred in Ehime and Kagoshima prefectures, both apples were served unheated.

It is said that the government does not know the actual situation to what extent the contents stipulated in the guidelines are thoroughly implemented in the field.

Searching for a site to prevent accidents

In response to a series of accidents that have come to light, some nursery schools are searching for ways to provide safer food.

Izumi Nursery School in Matsuyama City.
We take care of 10 children from 5 months to 131 years of age.

At this kindergarten, what the children eat is cooked and served in accordance with the national guidelines.

As for apples, children up to about one and a half years old after baby food are not given raw or solid, but grated and then heated.

Other guidelines stipulate in detail how to handle ingredients and how to cook them properly, such as "avoid using" grapes and cherries, and "finely mix with something" for boiled eggs.

A nationwide shortage of childcare workers has been pointed out, and childcare sites are busy. However, at this kindergarten, we are thoroughly implementing measures to prevent us from following the guidelines, saying, "You should not be unable to follow the guidelines because you are busy."

Izumi Sagawa, Director
of Izumi Rengekai Izumi Nursery School: "If it is difficult to make apples according to the age of the month, for example, I think it is possible to give them grated apples according to younger children when they can eat them in the form of heated dice.

そして、今回の事故を受けて、この保育園では新たな対応も始めます。

この園では、園児が子どもが給食を食べ始める前、アレルギーの有無を確認するため、これまでにどんな食材を食べたことがあるかを、保護者に報告してもらっています。

その確認にあたって、今後は、園で提供している給食の写真を見てもらったうえで、家庭での食事の状況を踏まえて、どんな形で提供するか、保護者の了承を得ることにしました。

佐川園長
「同じ愛媛県の保育園で事故が起き、決してひと事ではありません。『大丈夫』と思って続けていたことが、危険な事故を引き起こすこともあるということを、痛感させられました。大変な面もありますが、子どもたちの周りに潜む危険を見逃さないようにしていきたいです」

家庭で気をつけることは 万が一の時どうすれば

家庭では、どんなことを気をつければよいのでしょうか。

According to Tatsuhiro Yamanaka, a pediatrician and president of Safe Kids Japan, a nonprofit that works on child safety, young children are less likely to chew and swallow so what they eat enters their respiratory tract than adults.

In addition, they often cry or speak out with food in their mouths, and when they inhale, they inhale food with them.

He also wants people to be aware that "suffocation occurs suddenly" and that "it is not easy to notice."

Tatsuhiro Yamanaka:
"Even if you watch over them all the time, it is difficult to determine whether you are swallowing well.

So, what can be done to prevent accidents?

Here are some of the ideas for "how to eat" that Mr. Yamanaka raised.

・ Do not
let them eat while playing, do not talk with food in their mouths, do not surprise them while eating, do not


force them to eat, always observe by their side while eating

Still, if your food gets choked, what should you do?

The first aid method that Mr. Yamanaka introduced is the "back slapping method" and the "Heimlich method" performed by Mika Kudo, whose daughter once choked an apple in her throat.

In the "back slapping method", the child is held with one arm and the child is laid face down so that the head is down.
And the method is to hit the middle of the back forcefully and continuously.

The "Heimlich method" involves putting both arms around the child from behind and clenching a fist with one hand. Then, it is a method of squeezing between the navel and the solar plexus and thrusting upwards. It is considered to be a first aid measure for children over 1 year old.

If there is anyone around, ask for an ambulance before performing these first aids.

Ingredients needing attention

National guidelines for kindergartens and other facilities stipulate in detail foods that can easily lead to suffocation and cooking methods.

Please use it as a reference when making meals at home.

Ingredients
to avoid using ▽ Spherical shape is dangerous (can block the airway by inhaling) Cherry tomatoes (can be divided into 4 equal parts) Dried nuts and legumes, quail eggs, candy, ramune, round cheese (can be used if heated) Grapes and cherries (dangerous because not only the shape but also the skin remains in the mouth)



▽ When mixed with broth, the stickiness increases, and dangerous
rice cakes, white ball dumplings
▽ Is it too hard (it
becomes hard when cut into small pieces and heated)

Ingredients
to avoid serving for 0 and 1 year olds ▽ Hard and chewy
shrimp and shellfish
▽ Grilled rice balls that are difficult to
chew

Ingredients
that are creative in cooking and cutting ▽
Elastic and hard fiber yarn konjac, shirataki (cut into 1 cm pieces), sausage (cut in half lengthwise), enoki, shimeji, maitake (cut into 1 cm pieces),

wakame (cut into small pieces)


Hard-to-swallow minced
chicken (used with pork or thickened with cake flour), boiled eggs (finely mixed with something),

boiled fish (soft and thoroughly simmered)

Foods
that require special consideration when feeding ▽
Hard-to-swallow rice, bread, fluffy and baked potatoes, castella (drink water and moisten your throat before eating, chew well without overstuffing)

Fruits
▽ Apples and pears (served heated until the completion of baby food) Persimmons (substituted with apples
until the completion of baby food)

Matsuyama Bureau Reporter Maho ArakawaJoined
Nagasaki Bureau in 2008, Osaka Bureau
, and Social
Affairs DepartmentMother raising a 2-year-old child

Kagoshima Bureau Reporter Tomohiro
SumiyamaJoined the Bureau
in 2022Originally from Kagoshima, covering mainly incidents and accidents

Network News Department Reporter Kotomi

FujimeAfter joining the
Tokushima Bureau and Social Affairs Department in 2008, my
current sons, ages
3 and 1, entered nursery school this spring.

Naoya Saito, a reporter
in the Network News Department, joined the Okayama Bureau, Fukuoka Bureau, and Science and Culture Department in 2010,
and was in charge of digital investigations for the
NHK special "School Accidents" to which he currently belongs
.

Network News Department Reporter Shie

Kanazawa joined Sendai Bureau
in 2011 After working in the Political Department, etc., he is currently a member