Choking in an infant is a medical emergency requiring immediate intervention. Airway obstruction quickly deprives the brain of oxygen, making prompt action vital for survival. First aid for a conscious infant involves a specific sequence of back blows and chest thrusts designed to forcefully expel air and dislodge the blockage. This technique is distinctly different from the abdominal thrusts used for older children and adults because an infant’s internal organs are delicate. Understanding the precise location for back blows is foundational to this life-saving skill.
Recognizing Infant Choking
The initial step is assessing the obstruction. If the infant is coughing forcefully, crying, or making loud noises, the airway is only partially blocked, and intervention is unnecessary; the body is attempting to clear the object naturally. Intervention is required only when the infant shows signs of a severe or complete obstruction. These signs include an inability to cough, cry, or make any sound, often accompanied by a distressed look. As oxygen levels drop, the infant’s skin may turn pale or blue, especially around the lips, signaling the need for immediate action.
Proper Positioning for Safety and Effectiveness
Before administering any blow, the infant must be securely positioned to maximize the effectiveness of gravity. The caregiver should sit or kneel and lay the infant face-down along their forearm, using their thigh for a stable base of support. The infant’s head must be held lower than their chest, using the hand to cradle the jaw and neck without compressing the throat’s soft tissues. This head-down angle utilizes gravity to assist in drawing the foreign object out of the airway once it is dislodged.
Exact Location and Administration of Back Blows
The back blow must be delivered to a specific point on the infant’s back to generate the necessary force. The location is between the infant’s shoulder blades. The blow is administered using the heel of the caregiver’s free hand, ensuring the force is directed through a firm, flat surface. The technique involves delivering five separate, distinct, and forceful blows in a downward and forward direction. This combination creates a rapid compression of air in the lungs, generating a mechanical cough that propels the object out of the windpipe.
Alternating Care and When to Seek Emergency Help
If the five back blows do not successfully dislodge the object, the caregiver must immediately alternate to five chest thrusts. The infant is carefully turned face-up along the other forearm, maintaining the head lower than the chest. The chest thrusts are delivered using two fingers placed on the center of the breastbone, just below the nipple line. Each of the five thrusts should be sharp and compress the chest approximately 1.5 inches deep, aiming to create a pressure wave that forces the object out.
The cycle of five back blows followed by five chest thrusts must be repeated continuously until the object is expelled, the infant begins to cough forcefully or cry, or the infant becomes unresponsive. If the caregiver is alone, they should immediately begin care and then call the emergency number after two minutes or five cycles. If a second person is present, they should call for emergency medical help immediately while the caregiver begins the first aid sequence.