Sunday, July 8, 2012

Würstchen!!!! OMG!! Würstchen!!!

       I remember the first time I learned.  I was 23 and a grad student who wanted to earn a little extra cash, so I started babysitting.  There was the mother, cutting up a hot dog in the kitchen.  She cut it up so small, each piece was about the size of half a tic tac.  Tiny.  "Hot dogs are a huge choking hazard," she said, so it's always important to cut them up.  So, I started my babysitting career of cutting up hot dogs.  I cut up tons of hot dogs.  They are a CHOKING hazard for little kids, after all.  You can read about the hazard here.  Hot Dogs are one of the 10 most dangerous foods.  Read all about it from TIME here.  The American Academy of Pediatrics wants parents to cut up hot dogs before kids eat them, because kids chould choke.  Maybe even hot dogs should be labeled as choking hazards!  Some groups have pushed for that too.  They cause 17% of all choking deaths for children under the age of 10.  At least that's the statistic we read.
       But now, I'm older and live in Germany, and I have several wonderful German women friends who have small children.  They are all awesome mothers.  Their homes are full of picture books and toys, and their baby bags are full of organic apple slices and sunscreen.  They breastfeed and read parenting manuals and research kindergartens and have the pediatrician's number in their cell phones.  They have college degrees and involved husbands and grandma is sending along a few too many princess crowns.  They are moms anybody would be lucky to have.
       And they feed their children würstchen.  Dearest friends, a würstchen is just a German hot dog.  My friends feed their children hot dogs, and they don't cut them up.  I have a friend who gives her daughter a würstchen almost every day.  Her daughter is not yet 2, couldn't be a happier child and just loves loves loves her sausages.
       How could this be?  How could such awesome moms not know to cut up their children's hot dogs?  Aren't those children going to choke?  Something didn't add up.  So I looked into it.  It turns out that the 17% choking figure came from a paper published in 1984, based on a study done from 1979 to 1981.  It was long before cutting up hot dogs came into common practice, and we honestly have no way of knowing if the widespread cutting up of hot dogs decreases the number of deaths by hot dog asphyxiation.
       So, I looked into it.  How dangerous are hot dogs, really?  It turns out that children do choke, they choke on lots of things.  They choke on nuts, raisins, all kinds of food, non-food objects, and balloons.  They also choke on hot dogs.  But children don't often die of choking.  In fact, very few do.  In the oft cited study, around 5 children - in the entire United States - died of choking on hot dogs every year.  That's horrible, and every death is a very sad.  But really, 5 is not very much compared to many other illnesses and childhood accidents.  To put it in perspective, around 550 children drown every year in swimming pools. 
       Additionally, I have problems with the 17% figure.  Ok, so 17% of childhood choking deaths are from hot dogs.  Ok.  But that doesn't take into effect how often children eat hot dogs. Which is quite a bit for many of them.  Hot dogs are delicious, easy to cook, and inexpensive.  Say a child eats hot dogs for 2 meals a week - and that would be EASY.  That's just about 10% of all meals.  The problem with the percentage, is it doesn't tell us if children choke more on hot dogs than they do on anything else they eat.  Perhaps they choke on more hot dogs than duck a l'orange simply because they eat more hot dogs than duck a l'orange.
       It seems like, and please tell me dearest readers if you disagree, that it is easier for a child to choke on a hot dog than on most other foods.  But, that the risk of a young child dying from choking on a hot dog is vanishingly small.  It may be so vanishingly small that it's never really been mentioned in the German media, so it would never occur to my friends to cut up their children's hot dogs.  I'm not the best at searching German media for moms, but a search on my part didn't come up with anything particular about children choking on würstchen.  There are articles about children, choking, and Heimlich maneuvers, but nothing about würstchen being a special hazard.  My guess is, it's not really a public health concern, so the German public isn't really concerned about it.
       Instead of worrying about not cutting up hot dogs, or not cutting them up small enough, or cutting them up too small, or should they have warning labels or be redesigned, perhaps we should be more concerned as to why we blow insignificant risks out of proportion.  Why do we worry about hot dog choking when any one child has an infinitesimal chance of dying of hot dog asphyxiation?  Is it because hot dogs are inexpensive and thus associated with lower economic status?  Is it because hot dog slicing is something we can control in an uncontrollable world?  Is it because it never hurts, so why not?  Is it because 5 American children a year demands a redesign of an age old food and countless warning labels, media appearances, and 10,000 children in Africa dying of malaria is a tragedy that just can't be helped? 
      I wonder all these things.  But I do know that it wouldn't hurt us to look at the real statistics and do our best to measure the real world risks.


  1. Good advice. However, my 2 year old will have nothing to do with hot dogs.

  2. I think it's often the case that what gets people in a rage has more to do with what excites the imagination than with context and substance. I remember an NPR story a few years ago about the top five fears parents have for their kids (Kidnapping/ School snipers/ Terrorists/ Dangerous strangers/ Drugs) versus the top five actual causes of death and injury in children (Car accidents/ Homicide/ Abuse/ Suicide/ Drowning). When I lived in Belize I was forever getting yelled at for stepping out in light rain because everyone was convinced it would give me a cold or pneumonia.

    We're odd creatures, we humans. Interesting post :-)

    (The NPR story can be found here: