Do you know what to do if your baby is choking? While it’s something no caregiver wants to think about, even seconds count if your child’s airway is obstructed. Knowing the basics can help you potentially dislodge an object or know what to do until help arrives. Here’s more about how you can help a baby (under 12 months old), what you definitely shouldn’t do, and some tips to prevent choking accidents in your home.
Steps to take if your baby is choking right now
Things can happen very quickly in emergencies, so we’ve kept our descriptions clear and to the point.
Step 1: Verify that your baby is actually choking
Your baby may be coughing or gagging. This can sound and look scary, but if they’re making noise and able to take breaths, they’re likely not choking. Choking is when a baby is unable to cry or cough. They also won’t be able to make any noise or breathe because their airway is completely obstructed.
Step 2: Call 911
Ideally, you can have a friend or family member call 911 or local emergency services while you take care of your baby. Explain the steps you’re following to the operator and provide updates. It’s especially important that you tell the operator if your child becomes unconscious at any point during the process.
Step 3: Place your baby face down on your forearm
Use your thigh for support. With the heel of your free hand, deliver five blows to the area between their shoulder blades. These blows should be both quick and strong to be effective. This action creates vibrations and pressure in your baby’s airway that will hopefully force the object out.
Step 4: Turn baby over onto their back
Rest your baby on your thigh, keeping their head lower than their chest. With your index and middle fingers, find your baby’s breastbone (between and slightly below the nipples). Press down five times with enough pressure to press the chest down about one-third. This action helps to push air from the lungs into the airway to potentially force the object out.
Step 5: Repeat
If the object still hasn’t dislodged, return to back blows following the same instructions above. Then repeat the chest thrusts. Again, tell the 911 operator immediately if your baby loses consciousness.
What babies can choke on
It’s beyond scary to think about this whole scenario playing out in real life. But it happens. You may or may not be surprised to learn that food is the most common cause of choking with infants. That’s why it’s important to introduce only age-appropriate foods — usually purees — to your child after they turn 4 months old. Watch out for these foods in particular:
- grapes (If giving these to your older baby — they’re not appropriate until closer to a year of age — peel off the skin and cut in half first.)
- hot dogs
- chunks of raw fruits or vegetables
- chunks of meat or cheese
- nuts and seeds
- peanut butter (While perhaps technically a puree, the thickness and stickiness makes it a hazard.)
- hard candies
- chewing gum
Of course, we know you’re likely not giving chewing gum or hard candy to an infant — but consider if your baby found some on the ground. Even the most careful caregiver may miss certain objects that land places where little eyes end up seeing them. Other choking hazards found around the home include:
- toys with small parts
- latex balloons (uninflated)
- button batteries
- pen caps
- other small household items
Young babies may also choke on liquids, like breast milk, formula, or even their own spit-up or mucus. Their airways are particularly small and easily obstructed. This is one reason that you hold your baby with his head below his chest when attempting to help. Gravity may allow the liquid to drain out and clear the airway.
What not to do
While it’s tempting, resist the urge to reach in your baby’s mouth and grab an object out unless it’s visible and easy to grasp with your fingertips. Grasping around something that you can’t see in their throat may be harder than you think. And you may actually push the object farther down into the airway.
Also, don’t attempt to do the Heimlich maneuver (abdominal thrusts) with an infant. While abdominal thrusts can help children and adults move objects in their airways, they can be damaging to a baby’s developing organs. You may also have heard to turn your baby upside down and hold them by their feet. This isn’t a good idea because it may force the object deeper into the throat — or you could accidentally drop your child in the process.
If your baby does lose consciousness, the 911 operator may instruct you to do CPR until help can arrive. The goal of CPR isn’t necessarily to bring your baby back to consciousness. Instead, it’s to keep the blood and oxygen circulating to their body and — even more importantly — to their brain. One set of CPR includes 30 chest compressions and 2 rescue breaths:
- Place your infant on a flat, firm surface, like the ground.
- Look for an object in your baby’s mouth. Remove it only if it’s visible and easy to grasp.
- Place two fingers on your baby’s breastbone (the area where you applied pressure for chest thrusts). Apply pressure that compresses their chest about one-third (1 1/2 inches) at a rhythm of around 100 to 120 compressions each minute. Complete 30 chest compressions in all.
- Tilt your baby’s head back and lift their chin to open the airway. Give two rescue breaths by making a seal around the baby’s mouth and nose. Blow each breath in for 1 full second.
- Then repeat this process until help arrives.
You may not be able to prevent all choking accidents. That said, you can take measures to make your home as safe as possible for your baby.
Pay attention at mealtime
Especially as the foods you offer get chunkier, it’s important to keep good watch on your little one as they eat. And be sure to have your child sitting at meals versus walking or running around.
Provide age-appropriate foods
“Age-appropriate” means starting with purees at first and then progressively offering larger pieces of soft foods that can mash in your baby’s mouth. Think boiled sweet potatoes versus raw carrots or bits of avocado versus chunks of orange. That said, if you do choose to do the baby-led weaning approach to feeding your infant, you don’t necessarily need to worry. Multiple studies (like research from 2016 and 2017) have shown no significant difference in risk with spoon feeding and feeding soft finger foods.
Speak with your doctor
Before offering high-risk foods, like grapes and peanut butter, check in with your pediatrician. They can help you decide when the best time is to introduce these foods and the best way to present them so they aren’t as much of a choking risk.
Read labels on toys
Check toy labels to ensure you’re buying ones that are age appropriate for your baby. And examine other toys in your home that might belong to older siblings. Consider creating a special spot for toys with small parts so they stay off the ground.
Create a safe space
Keep other hazards, like batteries or coins, out of your baby’s reach. If babyproofing your entire home seems overwhelming, you might try creating a dedicated “safe space” that’s gated off while you work on babyproofing the rest.
If you’re still feeling a bit uneasy about your ability to help your baby in an emergency, consider taking an infant first aid class that covers both choking and CPR skills. You may be able to find classes near you by calling your local hospital. A 2019 study showed that practicing on mannequins can help with learning and confidence in executing these procedures. Otherwise, do your best to keep choking hazards out of your baby’s play areas and pay close attention to anything you see in your baby’s mouth that shouldn’t necessarily be there.