Choking phobia in children is a frightening but treatable condition. When left unchecked, it can develop into Avoidant/Restrictive Food Intake Disorder (ARFID). Parents often hear heartbreaking words such as:
“I want to eat this food, but I can’t”
” Do you want me to choke?”
These are not acts of defiance. They are the voice of a child who longs to eat but feels trapped by fear.
What Parents May Notice
You might see your child leaning toward liquids or very soft textures, like shakes, pudding, or blended foods, because solid textures feel unsafe after a choking scare. In response, it’s common to start supplementing with nutritional liquids to keep their intake sufficient. Over weeks or months, even the eagerness to eat can fade; children may tamp down their hunger altogether, out of fear. A clinical case illustrates this well: a 4-year-old, after a choking incident, subsisted on milk, shakes, and blended bananas for two weeks before parents sought help with supplemented nutrition PMC.
This pattern—reliance on soft/liquid foods, supplemented diet, reduced appetite—is increasingly recognized, echoing subtypes of ARFID where low appetite, early satiety, and food indifference, often driven by anxiety, are central features Psychiatric Times. When feeding becomes fearful, even hunger can be suppressed, underscoring the need for compassionate, structured intervention.
What Is ARFID and How Does Choking Fear Contribute?
ARFID is more than “picky eating.” It is a serious eating difficulty that may stem from lack of appetite, sensory sensitivities, or a fear of choking or vomiting.
When a child experiences choking, gagging, or a traumatic swallow, the memory can become locked into the nervous system as a danger signal. Over time, this develops into choking phobia in children, a form of phagophobia. Avoidance of eating may then spiral into ARFID, leading to malnutrition, weight loss, and distress for both child and family.
(Related reading: Understanding Swallowing Phobia in Adults)
Why We Cannot Dismiss Choking Phobia in Children
When a child says, “Do you want me to choke?”, they are not refusing out of stubbornness. Their nervous system is convinced food is dangerous. Avoidance brings temporary relief, but it makes the fear stronger in the long run.
Parents naturally want to protect their child, but accommodating fears by removing foods forever only deepens ARFID. The key is to validate the fear, while gently helping the child rebuild safety and trust with food.
Treatment Approaches: Hypnotherapy and Exposure
Hypnotherapy for Choking Phobia
Hypnotherapy addresses the subconscious fear of swallowing. In a calm and safe state, the child can release anxiety, reframe negative experiences, and create new associations of safety with eating.
For example, a case study described a 13-year-old girl with severe choking phobia. After several months of hypnotherapy, she returned to eating solid food, regained healthy weight, and maintained progress long term. I have worked with younger children, so always ask if your child is younger.
Hypnotherapy Combined with Exposure
My approach combines hypnotherapy with exposure, which mirrors the standard method used for phobias. Exposure therapy alone is a proven treatment for ARFID and choking phobia in children—it starts with very soft, low-risk foods and then carefully builds up to more complex textures. Hypnotherapy makes this process easier and often more effective by helping children feel calmer, safer, and more confident as they progress.
In one published case, a 4-year-old who had relied only on formula began structured exposure therapy. Within just two weeks, the child accepted over 30 new foods. When combined with hypnotherapy, this kind of progress can feel smoother and less distressing for both the child and their family.
A Two-Phase Path to Recovery
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Hypnotherapy creates a safe foundation by calming fear, releasing body tension, and reframing swallowing as safe.
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Gentle exposure therapy then rebuilds trust with food step by step, restoring variety and confidence at mealtimes.
Together, these methods support children in overcoming phobia, expanding diet, and reclaiming joyful eating.
For Parents: Practical Guidance
- Listen and acknowledge your child’s fear without dismissing it.
- Stay calm and consistent: avoid pressure, but also avoid long-term food restriction.
- Work with specialists trained in ARFID, hypnotherapy, and exposure-based feeding therapy.
For more information book an assessment here with me.
(Outbound link: NHS ARFID information)
References
- Anbar, R. D. (2016). Hypnosis for treating children and adolescents with functional disorders. American Journal of Clinical Hypnosis, 58(4), 382–393. PMID: 27003485
- Chatoor, I., et al. (1997). Hypnobehavioral treatment of functional dysphagia and phagophobia: A case series. Journal of Developmental & Behavioral Pediatrics, 18(4), 262–267. PMID: 8897222
- Katzman, D. K., et al. (2014). Avoidant/Restrictive Food Intake Disorder: A diagnosis at the intersection of feeding and eating disorders. International Journal of Eating Disorders, 47(5), 510–523.
- Zucker, N., et al. (2019). Cognitive-behavioral therapy for ARFID: Feasibility and proof of concept. Journal of the American Academy of Child & Adolescent Psychiatry, 58(9), 904–914. PMCID: PMC6813117
- Sharp, W. G., et al. (2016). Successful behavioral treatment of choking phobia in a young child. Clinical Case Studies, 15(5), 391–403. DOI: 10.1177/1534650115602065
