Infant First Aid for Choking
and CPR: An Illustrated Guide
It may seem scary, but babies choke all the time. They're constantly putting
objects in their mouths, and they have trouble swallowing certain foods until
they're over a year old. Once a baby starts choking she can lose consciousness
within a matter of minutes, so it's important to learn how to clear a blocked
airway and to administer CPR (cardiopulmonary resuscitation) if necessary.
We've compiled this basic step-by-step guide to show you what to do in an
emergency, but please don't rely on it as your sole source of CPR information.
Set aside a day to take an Infant / Child CPR course
— it's one of the most important things you can do to protect your baby from
harm. Airway obstruction injuries (choking, suffocation, and strangulation) are
a leading cause of accidental death in children under age 14. You can find a
class in your area by calling your local chapter of the American Red Cross (check the white pages).
The following instructions are for children under age 1. To find out what to
do when a toddler chokes, see our illustrated guide to toddler
CPR.
 Choking
• Step 1: Figure out what's causing the
problem
If your baby is suddenly unable to cry or cough she probably has
something blocking her airway, and you will need to help her get it out.
She may make odd noises or no sound at all while opening her mouth, and
her skin may turn bright red or blue. If she is coughing or gagging, her airway
is only partially blocked, most likely because some food or liquid has
gone down her windpipe instead of her esophagus, the tube that leads to
the stomach. In this case, let her continue to cough; this is the most
effective way of dislodging the blockage. (If you suspect that an allergic reaction
or an infection, such as croup, has closed
off your baby's airway by causing her throat to swell up, call 911
immediately. You will not be able to clear her airway yourself.) If your
baby cannot clear her airway on her own and you believe something is
trapped there, begin Step 2.
• Step 2: Give back blows and chest
thrusts
Sit on a chair with your baby face down on your lap and her head
pointing away from you. Slide one arm under her body, and support her face
and neck with one hand. Use the heel of your other hand to gently but
firmly thump her five times in the middle of her back, between the
shoulder blades. Then turn her over on your arm, supporting the back of
her head with one hand. Find her sternum by imagining a line between her
nipples, position two fingers about one finger-width down from the middle
of that line, and press on this spot five times. Stop if the baby starts
to cough and let her try to cough up the obstruction. Otherwise, call for
help and then continue blows and thrusts until the airway is cleared. If
the object comes out but your baby is still not breathing, check her
pulse, and start rescue breathing or CPR. Ask someone to call 911 right
away. If you're alone, give your baby rescue breathing or CPR for one
minute before you stop to call for assistance.
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Rescue Breathing and CPR 
• Step 1: Check your baby's breathing and
pulse
Swiftly but gently place your baby on her back on a firm surface. Make
sure her airway is open by lifting her chin gently, tipping her head back
slowly. For at least five seconds, look, listen, and feel for signs of
breathing. To check for a pulse, lift your baby's arm above her head.
Place your index and middle fingers firmly on the inside of her arm,
halfway between the shoulder and elbow. Feel for a pulse for at least five
seconds.
• Step 2: If your baby is not breathing but
has a pulse, begin rescue breathing
Cover her nose and mouth with your mouth and exhale into her lungs
until you see her chest rise. (If her chest doesn't rise, her airway is
blocked. Resume the back blows and chest thrusts.) Give one slow breath
every three seconds. Stop every 20 breaths and check her pulse. Continue
rescue breathing until she starts breathing on her own or until you can no
longer find a pulse. If you can't feel a pulse, begin Step 3 below.
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• Step 3: If your baby is not breathing and has no pulse,
begin CPR
With your baby still lying on her back, locate her sternum again:
Imagine a line between her nipples, and measure one finger-width
down from the middle of that line. Position two fingers on that
spot, and depress the chest between 1/2 and 1 inch. Repeat five
times within about three seconds. (Count "one and two and three.")
With your baby's head still tilted, cover her nose and mouth with
your mouth, and give one slow, gentle breath. Repeat the cycle of
compressions and breathing about 10 times, then stop and check for a
pulse. Call 911 now if no one has done so for you. Resume CPR,
checking for a pulse every few minutes, until help arrives or your
baby resumes breathing.
Once your baby does resume breathing, get her to an emergency
room as soon as possible. Even if she seems fully recovered, a
doctor needs to make sure that her airway is completely clear and
that she has not sustained any internal injuries.
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