An infant choking incident can quickly become a life-threatening emergency, especially when the baby becomes unresponsive. A blocked airway rapidly cuts off oxygen to the brain, potentially causing damage within minutes. This guide provides clear, actionable steps for responding to an unresponsive choking infant, aiming to equip caregivers with life-saving knowledge.
Initial Choking Response
If an infant is choking but remains responsive (coughing, crying, or making sounds), it indicates a partial airway obstruction. The infant’s own cough can be the most effective way to dislodge the object. However, if the cough is weak or ineffective, or if the infant cannot cry or make sounds, immediate intervention is necessary.
For infants under one year old, first aid involves a sequence of five back blows followed by five chest thrusts. Support the infant face-down along your forearm, using your thigh for support, ensuring their head is lower than their body. Use the heel of your free hand to deliver five firm blows between their shoulder blades.
If the object does not dislodge after back blows, turn the infant face-up, supporting their head and neck, and rest them on your thigh with their head still lower than their chest. Place two fingers in the center of their chest, just below the nipple line, and give five quick chest thrusts about 1.5 inches deep. Repeat these cycles of five back blows and five chest thrusts continuously until the object is expelled, the infant can breathe or cry effectively, or they become unresponsive.
Responding to an Unresponsive Choking Infant
If the infant becomes unresponsive while choking, indicated by a loss of consciousness, cessation of breathing, or turning blue, the priority immediately changes to initiating cardiopulmonary resuscitation (CPR). If you are not alone, instruct someone to call for emergency medical help (e.g., 911 in the U.S.) immediately while you begin care. If you are alone with the infant, shout for help, but begin CPR first, and then call for emergency services after two minutes of continuous CPR.
Place the unresponsive infant on a firm, flat surface. Begin chest compressions by placing two fingers in the center of the infant’s chest, just below the nipple line. Deliver 30 rapid and firm compressions, pushing down about 1.5 inches (approximately one-third the depth of the chest) at a rate of 100 to 120 compressions per minute.
After 30 compressions, open the infant’s airway by performing a slight head tilt-chin lift. Give two rescue breaths, creating a complete seal over the infant’s nose and mouth. Deliver a gentle breath lasting about one second, observing for a visible rise of the infant’s chest. If the chest does not rise, reposition the head and attempt the second breath.
Before delivering each set of rescue breaths, briefly open the infant’s mouth and check for the foreign object. If you can clearly see the object and it is easily removable, attempt to retrieve it. However, do not perform a blind finger sweep if the object is not visible, as this risks pushing the obstruction deeper into the airway.
Continue cycles of 30 chest compressions followed by two rescue breaths without interruption. Maintain this continuous sequence of CPR until emergency medical professionals arrive or until the infant shows obvious signs of life, such as crying, moving, or breathing normally. Consistency in performing CPR is vital in sustaining oxygen flow to the brain and other organs.
Post-Emergency Steps
After a choking incident, even if the object has been successfully dislodged and the infant appears to have recovered, seeking professional medical evaluation is important. There could be internal injuries, such as damage to the throat or lungs, that are not immediately apparent. Medical professionals can assess for any residual obstruction or complications.
Caregivers should monitor the infant for any lingering physical signs, such as persistent coughing, wheezing, or difficulty swallowing. Observing for signs of emotional distress, like increased anxiety or changes in feeding behavior, is also important. Providing comfort and reassurance to the infant and ensuring a calm, safe environment can help mitigate any lasting psychological impact.
Preventing Choking
Proactive measures are the most effective way to prevent choking incidents in infants. Food accounts for a significant number of choking events, so careful selection and preparation of foods are necessary. Avoid common choking hazards for infants and young children:
Whole grapes
Hot dogs
Nuts
Seeds
Popcorn
Hard candies
Large chunks of meat or cheese
Always cut foods into small, manageable pieces, no larger than one-half inch, and thin slices. For instance, grapes and cherry tomatoes should be quartered, and hot dogs should be cut lengthwise and then into small pieces, not rounds. Sticky foods like peanut butter should be spread thinly on crackers or toast, rather than offered in large lumps.
Beyond food, many household items and toys pose choking risks. Keep small objects out of an infant’s reach:
Coins
Buttons
Marbles
Small toy parts
Deflated or broken balloons
When selecting toys, ensure they are age-appropriate and large enough that they cannot be swallowed or lodged in the windpipe. A simple test is to see if an object can fit through a standard toilet paper roll; if it can, it is generally considered a choking hazard for young children. Additionally, check toys for securely attached parts, such as eyes or buttons, and avoid those with long strings that could pose a strangulation risk. Constant supervision during feeding and playtime is the most effective prevention strategy.