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Infant First Aid for Choking and CPR: An Illustrated Guide
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, , 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.
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.
• 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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