What are choking hazards?

Any object small enough to enter a baby's airway can block it. This includes:

• Small food pieces, such as nuts, grapes, beans, popcorn, hotdog pieces, or food that hasn’t been chewed well

• Small household objects, such as buttons, marbles, coins, balloons, or beads

• Small toy parts

• Breastmilk or formula swallowed too quickly

• Too much mucus in the throat

Signs of choking

The signs of choking can include:

• Violent coughing

• A high-pitched sound when breathing in

• Being unable to cough, breathe, cry, or make sounds

• Face that turns pale and blue-tinted

Assessing the situation

DO NOT perform thefollowing steps if the infant is coughing forcefully or has a strong cry, either of which can dislodge the object on its own.

The steps to take when a baby is choking will vary in these situations:

• If a baby has trouble breathing and can’t cry or make sounds

• If a baby stops breathing or is unconscious and you are not alone

• If a baby stops breathing or is unconscious and you are alone

The instructions for each situation are below.

If a baby has trouble breathing and can’t cry or make sounds

1. Check inside the baby's mouth for an object. If you see it, carefully try to sweep it to the side. Be very careful not to push it farther into the throat. If you cannot see the object, don't put your finger into the baby’s mouth. Your finger could push the object deeper into the baby’s throat.

2. Tell someone nearby to call 911.

3. Perform the maneuver below (see How to help the choking baby).

If a baby stops breathing or is unconscious and you are not alone

1. Tell someone nearby to call 911.

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

3. Start cardiopulmonary resuscitation (CPR) (see instructions below).

4. Repeat CPR until emergency services arrive, or the baby starts breathing.

If a baby stops breathing or is unconscious and you are alone

1. Lay the baby down on their back on a hard, flat surface such as a table, floor, or the ground.

2. Do CPR (see instructions below) for 2 minutes (5 cycles).

3. Call 911 after the 5th cycle.

4. Repeat CPR until emergency services arrive, or the baby starts breathing.

How to help a choking baby

You may need to use this method when a baby is choking:

1. Lay the baby stomach-down on your forearm. Gently support the baby’s face and neck in your hand. Make sure that the baby's head, neck, and back are supported. If needed, sit down and rest your arm on your thigh. Make sure the baby’s head is slightly lower than the rest of their body. This will help the object to be dislodged from the throat more easily.

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

3. If the object is still stuck in the throat, turn the baby face-up on your forearm. Support the head. Place 2 or 3 fingers in the middle of the baby’s breastbone just below the nipple. Push down about 1/2 to 1 inch. Do this 5 times fast.

4. Check the baby’s mouth to see if the object is dislodged. If not, repeat steps 2 and 3 until the baby’s throat is clear and the baby is breathing normally.

How to do cardiopulmonary resuscitation (CPR)

Chest compressions.

Rescue breaths.

You may also need to use this method if a choking baby is unresponsive, has no pulse (heartbeat), is not breathing or is only gasping.

1. Give 30 chest compressions. To do this, use two fingers to push down hard on the center of your baby’s chest, just below the nipple line.

2. Keep your other hand on the infant's forehead, keeping the head tilted back.

3. Push in about 1.5 inches (4 cm). Give 30 chest compressions. Each time, let the chest rise completely. These compressions should be FAST and hard with no pausing. It should take about 20 seconds. This is at a rate of 100 to 120 compressions per minute.

4. Check inside the mouth for an object. If you see it, carefully try to sweep it to the side. Be very careful to not push it farther into the throat.

5. Give 2 rescue breaths. To do this, gently lift the chin up with one hand and tilt the head back. Cover your baby’s mouth and nose completely with your mouth. Gently give 2 puffs of air into your baby’s mouth and nose. Each breath should take about 1 second. Watch to see if the baby’s chest rises. If the baby's chest doesn't rise, re-tilt the head and make sure you have a good seal with your mouth before giving the second breath.

6. If the baby doesn't start breathing, or if the chest doesn't rise, do another set of 30 compressions.

7. After the second set of compressions, check inside the mouth for an object. If you see it, carefully remove it. Be very careful to not push it farther into the throat. After the 30 compressions, give 2 more rescue breaths.

8. If the baby doesn’t start breathing, do another 30 chest compressions followed by 2 rescue breaths. Check for an object in the mouth after each set of compressions. Continue giving 30 chest compression and 2 rescue breaths until the baby starts breathing or help arrives.

Help prevent a baby from choking

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

• Keep problem foods and objects away from babies. This includes small foods and small household objects.

• Don’t let babies play with toys with small parts.

• Child proof your home for safety by removing small objects that a baby may reach.

• Check for toys recalled for choking hazards on the Consumer Product Safety Commission website, www.cpsc.gov .