Nutritionists have long warned of the perils of hot dogs: fat, sodium and preservatives to name a few.  Now, the American Academy of Pediatrics wants foods like hot dogs to come with a warning label — not because of their nutritional risks but because they pose a choking hazard to babies and children.  Better yet, the academy would like to see foods such as hot dogs “redesigned” so their size, shape and texture make them less likely to lodge in a youngster’s throat. More than 10,000 children under 14 go to the emergency room each year after choking on food, and up to 77 die, says the new policy statement, published online today in Pediatrics. About 17% of food-related asphyxiations are caused by hot dogs.

 “If you were to take the best engineers in the world and try to design the perfect plug for a child’s airway, it would be a hot dog,” says statement author Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio. “I’m a pediatric emergency doctor, and to try to get them out once they’re wedged in, it’s almost impossible.”

 The Consumer Product Safety Commission requires labels on toys with small parts alerting people not to give them to kids under 3. Yet there are no required warnings on food, though more than half of non-fatal choking episodes involve food, Smith says.

 “No parents can watch all of their kids 100% of the time,” Smith says. “The best way to protect kids is to design these risks out of existence.”

 Though Smith says he doesn’t know exactly how someone would redesign a hot dog, he’s certain that some savvy inventor will find a way.

 Janet Riley, president of the National Hot Dog & Sausage Council, supports the academy’s call to better educate parents and caregivers about choking prevention. “Ensuring the safety of the foods we service to children is critically important for us,” Riley says.

 But Riley questions whether warning labels are needed. She notes that more than half of hot dogs sold in stores already have choking-prevention tips on their packages, advising parents to cut them into small pieces. “As a mother who has fed toddlers cylindrical foods like grapes, bananas, hot dogs and carrots, I ‘redesigned’ them in my kitchen by cutting them with a paring knife until my children were old enough to manage on their own,” Riley says.

 The Food and Drug Administration, which has authority to recall products it considers “unfit for food,” plans to review the new statement, spokeswoman Rita Chappelle says.

 Given the health risks of obesity, pediatrician Alan Greene, author of Feeding Baby Green, says, “The last thing we need is to redesign candy and junk food with cool shapes, so we can give them to kids even younger.” APP