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When Your Child Has an Object in the Airway

Small children tend to put objects, such as food or toys, into their mouths. The object can then be breathed into the trachea (airway). A blocked airway causes choking and can be serious, even deadly. This sheet can help you prepare for a choking emergency at home. You can also learn steps to help prevent your child from choking.

For a baby

 

For a child

Closeup of person holding baby on one arm, face down. Arrow shows heel of hand striking baby's back. Another image shows baby, face up, head supported. Adult places two or three fingers in the middle of baby's breastbone and thrusts downward 5 times.

 

Toddler boy standing with woman kneeling behind him. Woman's fist is on boy's abdomen with other hand on top of fist. Arrow shows woman pushing in on boy's abdomen with fist.

 

Step 1:

Turn the baby onto his or her stomach. Use the heel of your hand to give five quick, forceful blows on the baby’s upper back, between the shoulder blades.

 

Step 2:

Hold your baby in one hand, supporting the head. Place two or three fingers in the middle of the baby’s breastbone and give 5 thrusts downward.

 

Make a fist and grab it with your other hand. Place your fist right above the bellybutton. Then use fast, short motions to thrust inward and upward.

 

How does the airway become blocked?

Choking happens when an object gets lodged in the throat or airway. This can block the flow of air and cut off oxygen to the brain. Young babies may choke if they swallow breast milk or formula too quickly or if they have excessive mucus.

Any object small enough to enter your child's airway can block it. This includes small food pieces, such as nuts, grapes, beans, popcorn, hotdogs, or food that hasn’t been chewed well. Household objects, such as buttons, marbles, coins, latex balloons, and beads are also common choking hazards. Small toy parts can cause your child to choke, too.

First aid should be given immediately to clear the airway so the baby can breathe.

Signs of a blocked airway

The following are signs of choking:

  • Violent coughing

  • A high-pitched sound when breathing in

  • Inability to cough, breathe, cry, or speak

  • Face that turns pale and bluish

  • Clutching at his or her throat

At the first sign of choking

Infants (up to age 1)

If the baby has trouble breathing and cannot cry or make sounds:

Start "first aid" for choking immediately to clear the airway if a baby has trouble breathing. Do NOT put your finger into the baby’s mouth to remove the object. Your finger could push the object further into the baby’s throat. 

  1. Have someone call 911 if you're not alone.

  2. Sit down. Then lay the baby stomach down along your forearm, with the baby’s face (head) and neck supported in your hand. If you need to, support your arm (with the baby) along your thigh. Make sure the baby’s head is slightly lower than the rest of his or her body, so the object can be dislodged from the throat more easily.

  3. Use the heel of your free hand to give 5 quick thumps (back blows) between the baby’s shoulder blades.

  4. If the object is still lodged, turn the baby over and give 5 chest compressions (thrusts). This is done by placing your middle and ring (3rd and 4th) fingers on the baby’s breastbone on the imaginary line that runs between the nipples.

  5. Check the baby’s mouth to see if the object is dislodged. If not, repeat steps 3 and 4 until the baby’s airway is clear and the baby is breathing normally.

If the baby is not breathing, becomes unconscious or unresponsive:

If you are not alone:

  1. Have a person call 911 immediately

  2. Lay the baby on a firm, flat surface such as a table or the floor or ground.

  3. Start infant cardiopulmonary resuscitation (CPR).

    • Give 30 chest compressions

    • Tilt the infant's head back and chin down and then check inside the mouth for a foreign object. If an object is visible, sweep the mouth with your fingers and remove the object.

    • Give 2 rescue breaths.

  4. Continue CPR (repeat step 3) until emergency service arrives or the baby starts breathing

If you are alone:

  1. Lay the baby on his or her back on a firm, flat surface such as a table or the floor or ground.

  2. Start CPR for 2 minutes (5 cycles)

    • Give 30 chest compressions

    • Tilt the infant's head back and chin down and then check inside the mouth for a foreign object. If an object is visible, sweep the mouth with your fingers and remove the object.

    • Give 2 rescue breaths

  3. 3. Call 911 (after the 5th cycle)

  4. 4. Continue CPR (repeat step 2) until emergency service arrives or the baby starts breathing

 

Please note: If you are alone, not trained in CPR, and a phone is nearby, call 911.

Children (age 1 to puberty)

If a child is having trouble breathing but is able to talk and has a strong cough:

  1. Don't give back blows or abdominal thrusts. The child's cough is better than any back blows or abdominal thrusts.

  2. Call 911 because the airway can become completely blocked

If the child has trouble breathing and cannot talk, cry, or make sounds:

Start "first aid" for choking immediately to clear the airway if a child has trouble breathing. Do NOT put your finger into the child’s mouth to remove the object. Your finger could push the object further into the child’s throat.

  1. Have someone call 911 if you're not alone.

  2. Get behind the child. Kneel if you need to.

  3. Give abdominal thrusts (inward and upward):

    • Wrap your arms around the child’s waist.

    • Make a fist with one hand. Place the thumb-side of your fist directly above the child’s bellybutton.

    • Grab your fist with your other hand.

    • Do short, quick thrusts, pulling the hands inward and upward. Do not lift the child off floor while thrusting.

  4. Continue giving abdominal thrusts until the object is dislodged or the child becomes unconscious, unresponsive, or stops breathing.

If the child stops breathing, becomes unresponsive, or unconscious:

If you are not alone:

  1. Have a person call 911 immediately

  2. Lay the child down on a hard, flat surface such as a table, floor, or ground.

  3. Start cardiopulmonary resuscitation (CPR)

    • Give 30 chest compressions

    • Tilt the child's head back and chin down and then check inside the mouth for a foreign object. If an object is visible, sweep the mouth with your fingers and remove the object. Take care not to push the object further into the throat.

    • Give 2 rescue breaths

  4. Continue CPR (repeat step 3) until emergency services arrives or the child starts breathing

If you are alone:

  1. Lay the child down on his or her back on a hard, flat surface such as a table, floor, or ground.

  2. Start CPR for 2 minutes (5 cycles) before calling 911

    • Give 30 chest compressions

    • Tilt the child's head back and chin down and then check inside the mouth for a foreign object. If an object is visible, sweep the mouth with your fingers and remove the object. Take care not to push the object further into the throat.

    • Give 2 rescue breaths

  3. Call 911 after the 5th cycle

  4. Continue CPR (repeat the steps) until emergency services arrives or the child starts breathing

 

 

To help prevent your child from choking:

  • Keep an eye on children as they eat or play.

  • Keep food or objects that are easily choked on, such as grapes or marbles, away from small children.

  • Do not allow small children to play with toys with small parts.

  • Safety proof your home.

  • Check for recalls on toys. Visit the U.S. Consumer Product Safety Commission’s website:

 

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