Choking First Aid: What to Do If Your Child is Choking

When a child is truly choking, every second counts. This is not a time to panic—it's a time to act. Every parent and caregiver should know these techniques before an emergency happens. Reading this guide is a good start, but taking a certified first aid course provides hands-on practice that builds the muscle memory you need.

Recognizing True Choking AAP

First, determine if your child is actually choking:

Choking (airway blocked—ACT NOW):

• Cannot cry, speak, or make sound
• Cannot cough or cough is very weak
• Making high-pitched sounds or no sound when trying to breathe
• Skin, lips, or nails turning blue
• Hands clutching throat (universal choking sign)
• Losing consciousness

NOT choking (airway partially open—WAIT):

• Coughing forcefully
• Crying or talking
• Making gagging sounds
• Face may be red but breathing is occurring

Critical rule: If your child can cough forcefully, cry, or speak, do NOT interfere. Encourage them to keep coughing. Only intervene if they cannot breathe, cannot cough effectively, or are turning blue.

Choking First Aid for BABIES Under 12 Months American Red Cross

For infants, use back blows and chest thrusts (NOT abdominal thrusts):

### Step 1: Position the Baby

• Sit down and rest your forearm on your thigh
• Hold baby face-down on your forearm, supporting their head and jaw with your hand
• Keep baby's head lower than their body
• Support the head and neck firmly without pressing on the throat

### Step 2: Give 5 Back Blows

• Using the heel of your free hand, give 5 firm back blows between the shoulder blades
• Each blow should be a separate, distinct strike
• Use enough force to dislodge the object

### Step 3: Give 5 Chest Thrusts

• Turn baby face-up on your forearm, supporting the head
• Place 2 fingers on the center of the chest, just below the nipple line
• Give 5 quick chest thrusts, pressing down about 1.5 inches
• Allow chest to return between thrusts

### Step 4: Repeat

• Continue alternating 5 back blows and 5 chest thrusts
• Keep doing this until:
• The object comes out
• Baby starts breathing or coughing
• Baby becomes unconscious

### If Baby Becomes Unconscious:

1. Call 911 immediately (or have someone else call)

2. Place baby on a firm, flat surface

3. Begin infant CPR:

• Give 30 chest compressions (push hard and fast, 1.5 inches deep)
• Open the airway (head tilt-chin lift)
• Look in the mouth—only remove object if you can SEE it
• Give 2 rescue breaths
• Continue CPR until help arrives or baby recovers

NEVER do blind finger sweeps in an infant's mouth—you could push the object deeper.

Choking First Aid for Children Over 12 Months American Red Cross

For children over 1 year, use abdominal thrusts (Heimlich maneuver):

### Step 1: Position Yourself

• Stand or kneel behind the child
• Wrap your arms around their waist
• For small children, you may need to kneel

### Step 2: Give Abdominal Thrusts

• Make a fist with one hand
• Place the thumb side of your fist against the middle of the child's abdomen, just above the navel and below the breastbone
• Grasp your fist with your other hand
• Give quick, upward thrusts into the abdomen
• Each thrust should be a separate, distinct motion aimed at dislodging the object

### Step 3: Repeat

• Continue abdominal thrusts until:
• The object comes out
• Child starts breathing or coughing
• Child becomes unconscious

### If Child Becomes Unconscious:

1. Lower child to the ground

2. Call 911 immediately

3. Begin child CPR:

• Give 30 chest compressions
• Open the airway
• Look in mouth—only remove object if visible
• Give 2 rescue breaths
• Continue until help arrives

What to Do If YOU Are Alone AAP

If you're alone with a choking child:

1. Perform rescue techniques first for about 2 minutes
2. Then call 911 (bring your phone to the child)
3. Continue rescue efforts until help arrives

If the object is dislodged and the child is breathing, still call for medical evaluation.

After the Object is Dislodged

Even after successful rescue:

Seek medical attention if:

• The child was unconscious at any point
• You had to perform abdominal thrusts
• The child has persistent coughing, difficulty swallowing, or throat pain
• You're unsure whether the entire object came out
• The child has any breathing difficulties afterward

Monitor for:

• Continued coughing or wheezing
• Drooling or difficulty swallowing
• Complaints of something stuck in throat
• Changes in voice

What NOT to Do AAP

Common mistakes that can make things worse:

• Don't pat a coughing child on the back if they're effectively coughing—this can lodge the object deeper
• Don't do blind finger sweeps—only remove an object if you can clearly see it
• Don't use abdominal thrusts on infants under 1—their organs are too delicate
• Don't give up—continue until help arrives or the child recovers
• Don't try to give water to a choking person—it won't help and could make things worse

Special Situations

Choking while alone (older children/teens):
Teach children who are old enough: thrust your own abdomen against a chair back or countertop edge.

Child with known disabilities:
Children with developmental disabilities, feeding difficulties, or neuromuscular conditions may need modified approaches. Discuss with your pediatrician and consider specialized training.

After a near-miss:

Even if the child seems fine, a close call is a good reminder to:

• Review prevention strategies
• Check for hazards in the home
• Refresh your first aid knowledge

Getting Proper Training American Red Cross

Reading about choking first aid is important, but hands-on training is essential:

Take a course:

• American Red Cross: offers in-person and online courses
• American Heart Association: infant, child, and adult CPR/first aid
• Local hospitals: many offer community classes
• Many pediatricians can recommend local training

What you'll learn:

• Practice on infant and child manikins
• Proper hand placement and technique
• How much force to use
• Full CPR training

Refresh regularly:

• Retake courses every 2 years
• Review techniques at least annually
• Practice positioning (without actually compressing) periodically

Emergency Preparedness

Post these numbers visibly:

• 911 (emergency)
• Poison Control: 1-800-222-1222
• Pediatrician's number

Ensure all caregivers are trained:

• Babysitters
• Grandparents
• Daycare providers
• Older siblings (age-appropriate training)

Keep a first aid kit accessible that includes:

• Instructions for choking rescue
• Emergency contact numbers
• Phone to call 911

The Bottom Line

Knowing choking first aid can save your child's life. Learn the difference between infants (back blows + chest thrusts) and children over 1 (abdominal thrusts). Take a hands-on course to practice these skills before you need them. Remember: a choking child who can cough forcefully should be allowed to cough. Only intervene when they cannot breathe, speak, or cough effectively.

Clara strongly encourages every parent to take a certified infant and child CPR/first aid course. It's one of the most valuable things you can do for your family.