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How to Save a Choking Child

FIRST AID: Under 1 Year
Conscious Baby

1. Lay the infant facedown on your forearm, resting your arm on your thigh to hold her steady. Support her chin firmly with one hand, and be sure her head and neck are lower than her torso.

2. Using the heel of your free hand, deliver five quick blows right between her shoulder blades.

3. If she doesn't cough up the object, turn her onto her back. Rest her on your forearm, using your thigh to support her body and your hand to steady her head and neck. Make sure that both her head and her neck are lower than her torso.

4. Using two fingers, deliver five quick thrusts to the center of her chest, right on the breastbone, about one finger-width below the nipples. Stop if she starts to cough so she can cough up the object.

5. If she still can't breathe, continue to alternate five back blows with five chest thrusts until the airway is unblocked. If this doesn't work or she loses consciousness, go to Unconscious Baby section at right.

Unconscious Baby

1. Lay her on her back. To open her airway, tilt her head back and lift her chin. If you can see the object, remove it.

2. Seal your mouth over her nose and mouth; give two slow breaths; feel to find out if her chest rises and falls.

3. Reassess. Put an ear to her mouth to listen for breathing; feel for chest movement. If there's no rising or falling, redo steps 1 and 2. If she breathes with your help, give one breath every three seconds (count "one one-thousand, two one-thousand...") until she breathes on her own or help comes.

4. If there are still no signs of normal breathing, begin chest compressions: Place two fingers in the center of her chest, over the breastbone. Deliver five compressions one-half to one inch deep. Follow with one breath.

5. Continue cycles of five compressions/one breath for one minute  -- then call 911 if no one has yet. If the baby doesn't regain consciousness, continue with rescue breathing and chest compressions until help arrives. Every minute, check for signs of normal breathing, coughing, and movement.

FIRST AID: Ages 1-8
Conscious Child

1. Stand or kneel behind him and wrap your arms around his waist.

2. Make a fist with one hand and place the thumb side on the child's abdomen. Your fist should be positioned just above the navel  -- and well below the child's breastbone.

3. Grasp the fist with your other hand and give five quick inward and upward thrusts. Each thrust should be a separate, distinct movement. Continue with a series of five thrusts until the object is expelled. If this doesn't work or the child loses consciousness, see section at right.

Unconscious Child

1. Lay him on his back. Open his airway by tilting his head back and lifting his chin. If you can see the object, remove it. If you can't see it, don't try.

2. With his head still tilted back, seal your mouth over the child's mouth (but not his nose), then pinch his nose. Give two slow breaths.

3. Reassess. Put your ear to his mouth and listen for breathing; feel for chest movement. If he's still not breathing, repeat steps 1 and 2. If he begins to breathe with your help, give one breath every three seconds (count "one one thousand, two one thousand...") until he starts to breathe on his own or help arrives.

4. If there are still no signs of normal breathing, begin chest compressions: Place the heel of one hand in the center of his chest over the lower half of the breastbone. Deliver five compressions one-half to one inch deep, then one breath.

5. Continue cycles of five compressions/one breath for about one minute  -- then call 911 if no one has done so yet. If the child doesn't regain consciousness, continue with rescue breathing and chest compressions until help arrives. Every minute, check for signs of normal breathing, coughing, and movement.

When Not to Step In
If your infant or child is choking but can do any of these:

  • cough

  • talk

  • cry

  • breathe

    These signs mean her airway is only partially blocked; trying to unblock it could make matters worse.

    When to Step In
    Call 911 and start rescue steps if she shows any sign of:

  • blue lips or skin

  • inability to swallow, talk, cry, or make noise

  • inability to breathe (chest not rising up and down)

  • loss of consciousness

    Prevention
    Keeping Babies and Kids Safe

  • Once your infant can sit up or pull up, remove crib gyms or mobiles with small parts that could break off.

  • Check all toys for small parts that could break off.

  • If an object can fit through a toilet paper tube, it's a danger until your child knows not to put objects in his mouth  -- which may occur at age 3, 4, or even later.

  • Don't let him walk, talk, laugh, or run around with food  -- or any object  -- in his mouth.

    Take-Care Food Rules
    Babies

  • Mash or puree all foods.

  • Stay close and watch.

  • When riding in the car, don't allow a toddler-age sibling to eat bite-size snacks  -- he might hand one to the baby.

  • Tell older siblings not to give the baby pieces of food.

    Toddlers and up

    Until your child is 4, don't give him:

  • popcorn

  • nuts

  • hard candy

    And be careful with:

  • hot dogs  -- slice lengthwise twice, then crosswise to make tiny pieces.

  • carrots  -- cook until mushy.

  • grapes  -- slice into quarters.

  • peanut butter  -- spread thin.

    The top reason for failure to get a breath into a choking child: The child's head is positioned wrong.

    Common Hazards
    Watch out for things lying around the house as well as in your purse, wastebaskets, jewelry box, and toolbox:

  • coins

  • rings

  • pen caps

  • nails

  • balloons (inflated or not)

  • safety pins

  • pop tops

  • gum
  • comments