Foods considered a choke-risk could be banned in early childhood centres next year, following more than five choking instances since 2016.
High choke-risk foods are considered to include seeds, lollies, crisps or chips, rice crackers, dried fruit, sausages, popcorn, and marshmallows.
The Ministry of Health's deputy director of public health, Dr Harriette Carr, said public consultation is being held proposing the new guidelines for early childhood centres.
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They would be required to follow new advice from the ministry - which is currently being drafted - focusing on either "removing or altering the texture of a range of foods considered to be high risk for choking".
The advice was developed by the Nutrition and Physical Activity Team at the Ministry of Health with technical support from an independent Speech Language Therapist with expertise in child eating and swallowing.
Dr Carr said the advice seeks to balance safety, practicality, nutrition and developmental requirements of food in early learning service settings.
She said it's consistent with the nutrition criteria in the Healthy Active Learning Toolkits being developed for early learning services and ngâ kohanga reo.
The advice will be made into a "user-friendly resource" for these organisations.
The Ministry of Education's acting deputy secretary for sector enablement and support, Coralanne Child, said children under five are at a higher risk of choking.
She said that's because they have small air and food passages and are still developing their biting, chewing and food-grinding skills.
"Since the beginning of 2016, we have been alerted to seven instances of children choking at early learning services," she told Newshub.
One of the cases was a 22-month-old who suffered from brain damage after choking on an apple.
But not all of these instances have involved food.
"The ministry is making changes that will make it mandatory for early learning services to follow the Ministry of Health guidelines on preparing and serving food for young children to reduce the risk of choking."
She said early childhood centres currently have to ensure children are supervised while eating.
But under the proposed changes, they will be required to follow specific guidance on preparing and serving food to small children to minimise the risk of food-related choking.
"We expect that most early learning services already follow the guidelines for minimising food-related choking risks. But some may need to make changes to the way they do things to meet the new minimum standards."
Child said the ministries want to hear from educators, parents, caregivers and whānau on these proposed changes through the survey.
The survery can be found here.
The consultation ends on November 15, 2019 and the ministries expect any changes to come into effect in the first half of 2020.
The Ministry of Health's draft guidance can be found here.