5.2 Child and Infant Choking

Children and infants are at higher risk of choking due to smaller airways and a tendency to put objects in their mouths. Choking can escalate quickly into a life-threatening emergency, so immediate and age-appropriate intervention is critical.

Child and Infant Choking

Responsive Child (Age 1 to Puberty)

Signs of severe airway obstruction in children include inability to speak or breathe, high-pitched or no sounds, and panic. If the child is responsive but choking:

1. Ask: “Are you choking?” and get permission to help (from the child or guardian).
2. Perform abdominal thrusts (Heimlich maneuver):
   • Stand or kneel behind the child,
     ×

     Stand or kneel behind the child,

     

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     depending on their height.
   • Place your fist just above the navel, grasp with your other hand.
   • Deliver quick, upward abdominal thrusts.
3. Continue until the object is expelled or the child becomes unresponsive.

Unresponsive Child

If the child becomes unresponsive:

1. Lower them gently to the ground and call 911 or activate emergency response.
2. Begin CPR immediately, starting with chest compressions.
3. Check the airway after compressions. If you see the object, carefully remove it.
4. Do not perform a blind finger sweep—only remove visible obstructions.

Responsive Infant (Under 1 Year)

Infants may exhibit weak cries, ineffective coughing, or stop breathing altogether. If an infant is choking but responsive:

1. Hold the infant face-down along your forearm, supporting the head and neck.
2. Deliver 5 back slaps (sometimes called “back blows”)
   ×

   Deliver 5 back slaps (sometimes called “back blows”)

   

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   between the shoulder blades using the heel of your hand.
3. Turn the infant face-up, keeping the head lower than the chest, and give 5 chest thrusts
   ×

   give 5 chest thrusts

   

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   using two fingers just below the nipple line.
4. Alternate back slaps and chest thrusts until the object is expelled or the infant becomes unresponsive.

Unresponsive Infant

1. Place the infant on a firm, flat surface and call 911 or activate emergency response.
2. Begin CPR, starting with chest compressions.
3. Each time you open the airway, look for the object and remove it if visible.
4. Do not attempt a blind finger sweep in an infant.

Prompt recognition and age-appropriate intervention during choking emergencies can mean the difference between life and death. Always stay calm, act quickly, and call for help early.