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Food and Nutrition Programs

Choking Prevention Policy: Nutrition for Young Children (Under the age of four)

To:Child Nutrition Program Operators
From:Robert M. Leshin, Director
Office for Food and Nutrition Programs (FNP)
Date:May 10, 2018

Child Nutrition Program (CNP) Operators participating in the Child and Adult Care Food Program (CACFP), National School Lunch Program (NSLP), School Breakfast Program (SBP), and Summer Food Service Program (SFSP) must not offer to children under four years of age foods that pose the highest risk for choking.

FNP's policy applies to CACFP Centers, Day Care Homes (DCH), School Food Authorities (SFA), and SFSP sites serving children under four years of age.

Choking Prevention: Nutrition for Young Children

Based on guidance from the USDA*, foods that pose the highest risk for choking are foods that possess the following characteristics: "round, tube-shaped, small, hard, thick and sticky, smooth, slippery, or easily molded to stick to the airway." In order to align with Massachusetts state licensing and USDA's recommendations, FNP's policy restricts the serving of the following foods to children under four years of age:

  • Hot dogs, sausages, sausage links or similar processed food items
  • Grapes, cherries, melon balls, or cherry and grape tomatoes
  • Specific berries - kiwi, raspberries, blackberries, goji berries
  • Peanuts, nuts, and seeds (for example sunflower or pumpkin seeds)
  • Peanut butter and nut butters
  • Dried fruit such as raisins or cranberries

There are many items that are not included in the above list, which may still pose a choking hazard due to their shape or texture. FNP asks CNP operators to consider the aforementioned characteristics when feeding children under the age of four; and alter any food items that may pose a risk. CNP operators shall alter food items so that they can be served in manageable bites, no larger than a nickel in size, to pre-school age, toddlers and infant age groups.

* View External Link
Supplement A: Practice Choking Prevention

To clarify, the foods listed in the bulleted list, are not to be served to children under the age of four, even using alternate food preparation methods. The information about alternate food preparation methods relates only to other foods not specifically identified.

Vended Meals or Contracts

Operators that enter into a contract to purchase meals from a food service vendor are responsible for ensuring that meals and snacks comply with FNP choking prevention policy.

Please share FNP's policy guidance ensuring that meals received meet the requirements for serving children under the age of four years old.

Implementation timeframe:

CACFP to implement in FY2018, NSLP and SBP to implement in FY2019 (July 1, 2018), and SFSP to implement in FY2018.

If you have any questions or need further assistance, please contact FNP at 781-338-6480 or email

This institution is an equal opportunity provider

Last Updated: May 11, 2018

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