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All we want for Christmas is safe consumption

The Christmas season is upon us, a season filled with presents, family and friends and way too much food. If you’re planning on having a family gathering with any young children or elderly members, there are specific Christmas foods to be aware of. A few wise decisions now can enhance safe consumption this Christmas day.


All we want for Christmas is safe consumption - Dysphagia swallowing from a Speech Pathologist

Who are you protecting this Christmas?

There are many people who will benefit from taking extra precautions with regards to swallowing safety at Christmas time. This could be looking out for your little cousin who is still introducing solid foods into their diet, or your grandpa whose dentures aren’t quite fitting well (therefore impacting his ability to chew foods safely).


Think of it like this:


Why babies and Toddlers are at a choking risk

Why babies and Toddlers are at a choking risk
  1. Teething: Small children and toddlers are still developing their teeth, which are very important for chewing and breaking down food.

  2. Developing coordination: The swallowing process involves a lot of coordination of breathing, chewing, breaking down food and going down the oesophagus safely. Children are still developing this coordination, and therefore are at a higher risk of choking.

  3. Anatomical differences: A smaller oesophagus and trachea (windpipe) makes it easier for food to get lodged or stuck in their throat when eating solid foods.


Why those with a Disability & the older population are at a choking risk

Why those with a Disability & the older population are at a choking risk
  1. Teeth and dentures: People living with a disability or in the aged care space are more likely to have poor dentition such as gaps, broken teeth, broken or ill-fitting dentures, or no teeth at all.

  2. Neurological progressive conditions: Dementia, or other conditions that impact both young and older adults can impact someone’s ability to swallow safely e.g. poor coordination, weakness in the muscles of swallowing.

  3. Older age: As all healthy adults age, they will experience some weakness in their muscles that contribute to safe swallowing.


How to serve food safely at Christmas

Here are some general considerations to think about if you have any little ones or elderly people at the dinner table.

  • Is the food too hard? Does it need to be a softer consistency?

  • Is the food too big? Can you cut it up into smaller pieces? E.g. 1.5cm bite-sized cubes for older-adults (or a minced-consistency), cutting in half or quartering other foods for small children

  • Is the food too “dry” e.g. roast meats. Can you moisten it with a gravy or sauce?

  • Is the food too chewy? For example, roasted meats can be over-cooked and very difficult to chew for young children, older adults or anyone with dysphagia.

  • Is the food too “crunchy” – e.g. avoiding raw vegetables such as that in salad that take a log time to chew.

  • Is there skin or an outer-shell on the food? E.g. peas, corn, nuts, seeds. Can these be removed or avoided altogether?


Let’s take a closer look at some of our Christmas favourites, and what to look out for.


Fruit-mince tarts – a classic Christmas delicacy

Fruit-mince tarts – a classic Christmas delicacy.

Fruit-minced tarts are usually made with a short-bread biscuit or pastry shell, and a filling inside such as dried cranberries, dates, sultanas and other dried-fruit varieties. Some varieties of fruit mince-tarts also have nuts including almonds inside the filling.


Why might this not be suitable for children or adults experiencing swallowing difficulties?

  • The pastry and/or shortbread biscuit is hard and crunchy. This can be difficult for vulnerable people (smaller children, older adults and people living with dysphagia due to a disability) to bite into and chew safely.

  • Similarly, dried fruits are very hard to bite into. Additionally, dried fruits such as sultanas have an ‘outer shell’ that can get stuck in parts of someone’s mouth or throat, leading to a potential choking hazard.

  • Many components – there are many different parts as described above that make up a fruit-minced tart. When there are different parts that make up the one food, it can be difficult for some people to manage the various components and consistencies.


Advice to modify/alternatives for Fruit-minced tart

It can be challenging to modify a fruit-minced tart so that it is suitable for everyone. We would recommend cutting it up into halves or quarters. Alternatively, replace fillings from hard-fruits to something else such as a soft and smooth custard-slice would be more suitable if you are concerned for someone’s swallowing safety.

Roast Meat and Vegetables - Another classic, Christmas roast and veggies.

Roast Meat and Vegetables - Another classic, Christmas roast and veggies.

Different meat varieties may be served such as chicken, beef, lamb, or turkey, as well as many different vegetables including pumpkin, potato, peas, corn, carrot and so-on.


Why might this not be suitable for children or adults experiencing swallowing difficulties?

  • There are several important things to consider with roast meat and vegetables. Firstly, meat can be very dry, over-cooked and chewy. For someone experiencing swallowing difficulties, or young/old age, they might find it very challenging to chew this and break it down. This might lead to them swallowing pieces that are too big and choking.

  • Roast meat is often served in larger pieces on a plate.

  • Some vegetables such as peas and corn have an outer shell that can get lodged in someone’s mouth or throat. Additionally, other roast vegetables have a skin (such as pumpkin or potato). Vegetables can also form a hard ‘crust’ once they are roasted.

Advice to modify/alternatives Roast Meat and Vegetables

  • Prepare meats to a soft and tender consistency, or if appropriate ‘minced and moist.’

  • Cut up meat and vegetables into smaller, bite sized pieces or mince it up on their plate.

  • Avoid any bones or gristle on meats.

  • Peel off skin on any vegetables before cooking such as pumpkin and potato. These vegetables can also be mashed after they are roasted.

  • Avoid vegetables such as peas and corn that have an outer shell.


Christmas desserts – cherries, ice-cream, cakes, biscuits, gingerbread

Christmas desserts – cherries, ice-cream, cakes, biscuits, gingerbread. . .

A variety of Christmas desserts always end up on the table at our Christmas, and it can be difficult to choose what to have.


Why might this not be suitable for children or adults experiencing swallowing difficulties?

  • Biscuits and gingerbread – are hard, crunchy, difficult to bite into, chew, and breakdown safely.

  • Cakes – can be too dry on their own for some individuals and may cause choking.

  • Cherries – have a seed in the middle, which is a significant choking hazard, as well as a stem that needs to be safely removed. The skin on the outside of a cherry may also be a risk of getting stuck in someone’s mouth or throat.

  • Ice-cream – is what we call a ‘dual’ or ‘mixed consistency’ food. Even though it appears to be a nice soft and smooth consistency, when moisture is added or the temperature changes, ice-cream will melt into a thin liquid. For individuals on thickened fluids, this is unsafe.


Alternative Christmas Desserts

There are many delicious and safe dessert alternatives for those at higher risk of swallowing issues this Christmas. This might include custard, smooth pudding (no lumps, seeds, nuts or bits), mousse, yoghurt, cheesecake filling (no base), soft meringues, and cakes or muffins moistened/softened with a sauce.


We hope this provides you with the information you need to stay safe and eat well this Christmas and holiday season.

If you do notice any particular swallowing difficulties, concerns or incidents over the Christmas period, please contact our OSCAR Care Group Speech Pathology team for further support.

 

Natalie Ceravolo, Certified Practising Speech Pathologist for OSCAR Care Group

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