Choking - infant under 1 year

Definition

Choking is when someone cannot breathe because food, a toy, or other object is blocking the throat or windpipe (airway).

This article discusses choking in infants.

Causes

Choking in infants is usually caused by breathing in a small object that the baby has placed in their mouth, such as a button, coin, balloon, toy part, or watch battery.

Choking may result from a complete or partial blockage of the airway.

When a person does not get enough air, permanent brain damage can occur in as little as 4 minutes. Rapid first aid for choking can save a life.

Symptoms

The danger signs of choking are:

First Aid

DO NOT perform these steps if the infant is coughing hard or has a strong cry. Strong coughs and cries can help push the object out of the airway.

If your child is not coughing forcefully or does not have a strong cry, follow these steps:

  1. Lay the infant face down, along your forearm. Use your thigh or lap for support. Hold the infant's chest in your hand and the jaw with your fingers. Point the infant's head downward, lower than the body.
  2. Give up to 5 quick, forceful blows between the infant's shoulder blades. Use the palm of your free hand.

If the object does not come out of the airway after 5 blows:

  1. Turn the infant face-up. Use your thigh or lap for support. Support the head.
  2. Place 2 fingers on the middle of the breastbone just below the nipples.
  3. Give up to 5 quick thrusts down, compressing the chest one third to one half the depth of the chest.
  4. Continue 5 back blows followed by 5 chest thrusts until the object is dislodged or the infant loses alertness (becomes unconscious).

IF THE INFANT LOSES ALERTNESS

If the child becomes unresponsive, stops breathing, or turns blue:

Do Not

When to Contact a Medical Professional

If an infant is choking:

Always call your doctor after a child has been choking, even if you successfully remove the object from the airway and the infant seems fine.

Prevention

To prevent choking in an infant:

References

Atkins DL, de Caen AR, Berger S, et al. 2017 American Heart Association focused update on pediatric basic life support and cardiopulmonary resuscitation quality: an update to the American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2018;137(1):e1-e6. PMID: 29114009 pubmed.ncbi.nlm.nih.gov/29114009/.

Rose E. Pediatric respiratory emergencies: upper airway obstruction and infections. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 167.

Thomas SH, Goodloe JM. Foreign bodies. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 53.


Review Date: 2/12/2021
Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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