Choking In Infants


Choking in infants is usually caused by breathing in a small object that a baby has placed in their mouth (button, coins, balloon, toys, etc.)

Key Facts:

  • Each year approximately 18,000 suffocation injuries are sustained by children each year
  • Choking accounts for 44% of all toy-related fatalities
  • Each year, cribs and playpens are responsible for half of all nursery product-related deaths among children ages 5 and under.
  • Cribs, often older or used cribs, are responsible for 26 strangulation and suffocation deaths each year.
  • The majority of childhood suffocation, choking and strangulation incidents occur in the home.
  • 60% of infants suffocate in the sleeping environment as a result of pillows/cushions blocking their airway while sleeping.
  • Common items that strangle children include clothing drawstrings, pacifier strings, and window blind and drapery cords.
  • Children 4 and under, especially under age 1, are 15 times more likely to experience a suffocation death.


  • Choking
    • Supervise your baby when he/she is eating and playing
    • Avoid giving your baby small, hard, or round foods
    • Use a small parts tester to ensure toys are not too small so that they pose a choking hazard 
    • Learn CPR for infants
  •  Suffocation 
    • Actively supervise babies at all times
    • Remove pillows, blankets, and stuffed animals from your baby’s sleeping area
    • Don’t allow babies to sleep on couches, chairs, or regular beds or other soft surfaces
    • Don’t allow babies to play with plastic bags, or in and around poorly ventilated spaces
  •  Strangulation
    • Keep cords and strings out of your child’s reach
    • Remove hood and neck drawstrings from your baby’s clothing
    • Don’t allow babies to wear hanging jewelry, purses, scarves, or loose clothing
    • On older or used cribs, make sure all crib-railing slats are secure and no more than 2 and 3/8 inches apart (size of soda can)

Symptoms: (If an infant is choking more attention must be paid to an infant’s behavior. They cannot be taught the universal choking sign.)

  • Bluish skin color (as well as lips and nails)
  • Difficulty breathing or noisy breathing
  • Loss of consciousness if blockage is not cleared
  • Inability to cry or make much noise
  • Weak and ineffective coughing or gagging
  • Soft or high-pitched sounds while inhaling

First Aid:

  • Do not perform these steps if the infant is coughing forcefully or has a strong cry because it can push the object out of the airway
  • If the child is not coughing or crying forcefully, follow these steps:
    • Lay the infant face down along your forearm and use your thigh or lap for support.  Hold the infant’s chest in your hand and jaw with your fingers, while pointing the head downward lower than the body.
    • Give up to 5 quick forceful bows between the infant’s shoulder blades using the palm of your free hand.
    • If the object does not come out of the airway after 5 blows turn the infant face up and place two fingers on the middle of the breastbone, just below the nipples.
    • Give up to 5 quick thrusts down, compressing the chest to about 1/2 to 1 inch and then allow the chest to come back to normal position.
    •  Continue the sequence of 5 back blows and 5 chest thrusts until the object is forced out or the baby starts to cough.
    • If the infant loses alertness then shout for help and give the infant CPR (cardiopulmonary resuscitation)

Video for Choking:



What is CPR?   

  • The lifesaving measure you can take to save your baby if he/she shows no signs of life.
  • The purpose of CPR is to circulate blood that contains oxygen to the brain and other vital organs.
  • By keeping the oxygenated blood circulating if can prevent brain damage and even death.
  •  Important to continue CPR until medical personnel arrive at the scene.

Steps to Perform CPR

  •  Step 1: Check your baby’s condition
    • Determine consciousness of your infant by gently tapping the shoulder, flicking their foot, and shouting to gain their attention.
    • If there is no response gently place your baby on their back on a flat surface and begin CPR. 
  •  Step 2: Open your baby’s airway
    • To open the airway gently tilt your baby’s head back slightly with one hand and lift their chin slightly with the other.
    •  Check for signs of life, such as movement and breathing, but for no more than ten seconds.
    • Put your head next to the baby’s mouth to determine if the baby is breathing.
    • Look to see if the chest is rising while listening for breath sounds.  
  • Step 3: Give you baby two gentle breaths
    • Give your baby two gentle breaths, lasting about one second per breath.
    • Cover your baby’s nose and mouth with your mouth and gently exhale into their lungs.
    • Observe the chest wall rise and fall.
    • Babies’ lungs are smaller than the average adult, so be sure to not breathe too hard or to fast because air can be forced into the stomach or damage the lungs.
    • If the chest does not rise then the airway is blocked and you should give the baby first aid for choking.
    • If the breaths do go in, give your baby two breaths in a row, pausing in between rescue breaths to allow the air to flow back out.
  •  Step 4: Give 30 chest compression
    • After giving the two rescue breaths, place the pads of two or three fingers just below an imaginary line running between your baby’s nipples.
    • With the pads of your fingers compress the chest ½” to 1” by pushing straight down smoothly, avoiding jerky movements.
    • Give the baby 30 chest compressions at a rate of 100 compressions per minute.
    • After completing the 30 chest compressions return to rescue breathing.
  • Step 5: Repeat compressions and breaths
    • Continue to repeat the cycle of 2 breaths and 30 compressions until help arrives.
    • If you are alone give the baby two minutes of care and then call 911.  If you are with someone have then call 911 as soon as your realize the child is unconscious.
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