Signs of choking

These are signs of choking in a baby:

• Weak, ineffective coughing

• A high-pitched sound when breathing in (stridor)

• Your baby can’t cough, breathe, or cry

• Face turns pale and blue

What to do

The steps to take when a baby is choking will vary. The instructions for each situation are below.

If the baby is awake, has trouble breathing, and can’t make sounds:

1. Don't put your finger into the baby’s mouth to remove the object. Your finger could push the object down into the baby’s throat.

2. Shout for someone nearby to call 911.

3. Sit down. Then lay the baby’s body face-down along your forearm. Support the baby’s face (head) and neck in your hand. If you need to, support your arm with the baby on your thigh. Make sure the baby’s head is slightly lower than the rest of their body. This will help free the object from the throat.

4. Use the heel of your free hand to give 5 quick thumps on the baby’s back between the shoulder blades.

5. If the object is still stuck, turn the baby face up on your forearm. Support the head. Place 2 or 3 fingers in the middle of the baby’s breastbone. Push down about 1/2 inch to 1 inch. Do this 5 times fast.

6. Check the baby’s mouth to see if the object is out. If not, repeat steps 3, 4, and 5 until the baby’s airway is clear and the baby is breathing normally.

7. If the baby becomes unresponsive (unconscious), lay them on a firm, flat surface and start infant CPR (see below).

If a baby is not breathing and not awake:

1. Shout for someone nearby to call 911.

2. Lay the baby on a firm, flat surface, such as a table, the floor, or the ground.

3. Start infant CPR (see below). If you are alone, do CPR for 5 cycles. Call 911 after the 5th cycle.

4. Continue CPR until emergency service arrives or your baby starts breathing.

If you are alone, not trained in CPR, and are near a phone, call 911 right away.

How to do CPR on a baby

To do infant CPR (cardiopulmonary resuscitation):

1. Start with 30 chest compressions. To do this, use 2 fingers to gently push down on the center of the baby’s chest, just below the nipple line. Push in about 1.5 inches. Let the chest return to its normal position after each compression. Do this 30 times fast. It should take about 20 seconds.

2. Tilt the baby’s head back and chin down. Check inside their mouth for an object. If you see it, carefully try to sweep it to the side. Be very careful to not push it down into the throat.

3. Give 2 rescue breaths. To do this, gently lift the chin up with 1 hand and tilt the head back. Cover your baby’s mouth and nose with your mouth. Gently give 2 puffs of air into your baby’s mouth and nose. Each breath should take about 1 second. Watch to see if the baby’s chest rises.

4. This is one cycle. If the baby doesn’t start breathing, repeat chest compressions and rescue breaths.

Preventing choking in a baby

A baby may choke if:

• They swallow breastmilk or formula too quickly

• They have too much mucus

Any object small enough to go into your baby's airway can block it. Common choking hazards include:

• Small food items, like nuts, grapes, beans, or pieces of hot dogs

• Any food that hasn’t been chewed well

• Small objects (see below)

Objects like these are a choking risk:

To help prevent choking:

• Watch your baby closely during feeding. Watch how they swallow liquids.

• If they are eating food, make sure to cut food into very small pieces.

• Check floors and tables at home every day for small objects.

• Choose large, sturdy toys that don’t have sharp edges. Make sure they don’t have small, removable parts. Toys that can fit in a toilet tissue roll are too small and not safe.

• Check toys often for loose or broken parts.

• Remove drawstrings from clothing. Don't tie balloons, long strings, or ribbons near a crib.

Special note for parents

Anyone caring for a baby should learn infant or child CPR. Ask your baby’s healthcare provider about CPR classes in your area.

Call 911

Call 911 if any of these happen:

• Continued choking or trouble breathing

• Whistling sound when breathing (wheezing) or any odd breathing noises after choking. An airway that is partly blocked can become fully blocked.

• Skin, lips, and nails look blue or darker than normal

• The baby is not alert or awake