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  1. Conscious Infant Choking

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Show full transcript for Conscious Infant Choking video

This conscious infant choking lesson is for situations where you can see that an infant is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including:

  • They cannot cough
  • They cannot breathe
  • They cannot speak or babble or make any noise
  • Their lips are beginning to show signs of circumoral cyanosis – a blue ring around the lips that indicates early signs of oxygen starvation

Signs that the infant is conscious include:

  • The baby is still moving around
  • The baby's eyes are open

Remember to only worry about calling 911 and activating EMS if doing so is quick and easy, or there is another person nearby that can call. Otherwise, don't waste time calling 911 and go right into assessing and helping the infant.

How to Provide Care

Helping a conscious choking infant is significantly different than helping a child or an adult. You'll be performing a combination of back slaps and chest thrusts to try and dislodge the airway obstruction.

If there is a parent or legal guardian present, make sure to get permission before beginning the following procedure.

Back Slap and Chest Thrust Technique for Infants

  • Place your thumb and index finger over the baby's cheekbones and around the face. Make sure you're supporting the infant's head and neck.
  • Turn the infant over so they are facing down. Rest the infant's body on your forearm, so their legs are straddling your bicep.

Pro Tip #1: Hold the baby at about a 30-45-degree angle, so the head is lower than the feet. This will allow gravity to assist, rather than hinder, your efforts.

  • Using your other palm, perform five back slaps between the infant's shoulder blades.
  • Using the same hand that you just used to perform the back slaps, hold the back of their head and neck and turn the baby over so they are facing up.
  • Draw an imaginary line across the infant's nipples and place two fingers on the sternum in the center of the infant's chest. Your fingers should be perpendicular to the chest, meaning your knuckles are directly above your fingers.
  • Make sure the head is lower, just like before, at around a 30-45-degree angle.
  • Perform five chest thrusts, much like you would when performing CPR on an infant.

Pro Tip #2: It's important that you keep the infant's body stabilized when doing the back slaps and chest thrusts. If you allow the infant's body to move downward with each slap or thrust, you'll minimize the effects necessary to force enough air up the trachea to remove the obstruction.

  • Continue to perform a combination of back slaps and chest thrusts until the object comes out and the infant is breathing normally again.

If you called 911, let them come anyway, so the infant can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. And they can do a quick assessment for internal bleeding or other damage.

Pro Tip #3: If you did not call 911, it's always a good idea for you or someone else to take the infant into an urgent care center, hospital, or to see their physician to determine if more care is necessary.

This conscious infant choking procedure is around 80 percent effective if you perform the back slaps and chest thrusts properly.

If you weren't able to remove the obstruction, the infant will go unconscious pretty quickly. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious infant choking procedure.

A Word About Pediatric Considerations

Young children are more prone to choking on small objects like toys, buttons, coins, and balloons. Food, too, is a bigger threat for children under four years old because they don't have a full set of teeth at that age, which means they aren't able to chew their food as well as older children.

The American Academy of Pediatrics (AAP) recommends not giving any firm, round food to children under four years old unless it is cut into smaller pieces – ideally smaller than half an inch. They also recommend keeping the following food items away from younger children:

  • Hot dogs
  • Nuts and seeds
  • Chunks of meat or cheese
  • Whole grapes
  • Hard, gooey or sticky candy
  • Popcorn
  • Chunks of peanut butter
  • Raw vegetables
  • Raisins
  • Chewing gum

According to the Consumer Product Safety Commission (CPSC), balloons represent the greatest threat to young children, as more have suffocated on non-inflated balloons and pieces of broken balloons than any other type of toy.

It's also important to remember to get permission from a parent or legal guardian, if present, before helping a choking infant or child.