Dealing with a choking infant requires assessing the situation to determine what is causing the obstruction, then proceed with 5 back blows and 5 chest thrusts. This is to be performed on a conscious child. If the choking infant goes unconscious, begin infant CPR. Always call 9-1-1 in emergency situations.

Anytime you are dealing with a child or any emergency situation, you will need to first check the scene for safety. This means assessing whether or not it is safe to remain (i.e. do you smell gas?). Then check the infant to see if there are other visible injuries or symptoms. Get consent (with infants, this is with a parent or guardian if you are a third-party).

Quick List for Conscious Infant Choking First Aid

Remember these 5 steps when assisting an infant who is choking.
1. Check the Airway
2. Give 5 Stern Back Blows
3. Give 5 Chest Thrusts
4. Repeat Back Blows and Chest Thrusts
5. Continue Until Object is Dislodged or Infant Becomes Unconscious.

If the infant becomes unconscious, you will need to begin Infant CPR.

Detailed Steps to Help a Conscious Choking Infant

Step 1: Check the Airway of Infant Choking

Lay the infant down on his or her back. Lightly lift the chin up and open the mouth. Look inside, checking to see if you can see an object and confirm the infant in choking. Do NOT try to perform a finger swipe to remove the object. This can push it farther down.

Proceed with giving back blows that should dislodge the object.

Step 2: Give 5 Back Blows

Back blows are performed with the heel of your hand between the shoulder blades. To get the infant in the proper position, position the infant on your forearm, face-up. Use your hand to cradle the infant’s head and your forearm to support the body.

Sandwich the child with your other arm, using your thumb and forefinger to hold the child’s jaw. Flip the infant over so he or she is facedown being supported by your forearm. Use your leg to help maintain balance and support.

The infant’s head should be lower than his or her feet, allowing gravity to assist with dislodging any object obstructing the airway.

Deliver 5 back blows. Make each blow separate and distinct, aiming for the space between the shoulder blades.

Step 3: Give 5 Chest Thrusts

Performing chest thrusts requires the infant is turned face up. Sandwich him or her once again between both hand and arms and flip him or her belly-up. Maintain control on your thigh.

With the free hand, place the index and middle finger on the center of the infant’s chest. Make sure you are aligned just below the nipple line. With the pads of the fingers, press firmly down on the breastbone. Compress approximately 1 ½ inches and allow the chest to return up before compressing again. Repeat these 5 times.

Step 4: Repeat Back Blows and Chest Thrusts

Continue to perform back blows and chest thrusts by alternating the two methods. Continue to use both hands to sandwich the baby and support his or her entire body.

By alternating from back blows to chest thrusts, you give the body a slightly different dynamic that might help dislodge an obstructing object.

Step 5: Continue with Care Until Object is Dislodged or Infant Becomes Unconscious

Don’t stop alternating 5 back blows and 5 chest thrusts until either:
• The infant starts forcibly coughing.
• The object becomes dislodges and is forced out.
• The infant becomes unconscious.

If the infant choking is not breathing and is unconscious, begin infant CPR until the paramedics arrive.

Note that back blows are firm but not as hard as you would do for a child or an adult. The goal with emergency response is to help and not create more injuries whenever possible.

Signs of Infant Choking

Because infants are not yet able to effectively communicate, determining if an infant is choking requires attentive assessment. Not whether the child was playing with something or eating food. A choking infant will cough or hack, sometimes without any sound coming out if the obstruction is big enough. If there is no air getting in, the infant’s lips will begin to turn blue.

Allergic Reactions and Infant Choking

It is possible that an infant is not choking on something ingested. Instead, the infant could be having an allergic reaction. Bee stings, bug bites and certain foods can lead to anaphylactic shock, an allergic reaction in some infants causing the throat glands to swell and close. This cannot be resolved with back blows or chest thrusts.

Checking the scene and the infant are imperative. Look for anything that could have lead to an allergic reaction such as a bee or bug in the area. Scan the infant’s skin for bites. Make note of any new foods introduced. If the infant is having an allergic reaction, immediate medical attention is needed. Proceed to an emergency room or wait for paramedics to arrive.

Common Infant Choking Hazards

Children are notorious for putting things in their mouth. It is one way they explore the world. Many things are not suitable for ingestion and can become serious choking hazards.

Common objects and foods that are infant choking hazards are:
• Marbles
• Rocks
• Grapes
• Carrots
• Coins
• Pen caps
• Bottle tops
• Batteries
• Baby powder

Always be aware of what infants are doing. It only takes a moment for something to get swallowed and start a choking incident. Most people don’t think about something like baby powder as a choking hazard, but it becomes thick with mucus and prevents airflow. Never assume something is safe for an infant to play with, even something as innocuous as baby powder to occupy him or her while you sleepily change a diaper at 1 am.

Final Checklist to Prevent Infant Choking

You can’t always prevent a choking infant scenario but you can reduce the chances that you will deal with one.
• Keep choking hazards away from infants
• Always monitor your infant when eating
• Cut food into small, manageable portions
• Learn infant CPR and first aid just in case you need it.

Looking for more information on Child Choking or Infant CPR or Children CPR? Visit of our resource center. Be Safe Smart!