On December 6, 2024, in Newark, New Jersey, a police sergeant saved a 1-year-old girl choking on a peppermint candy by using the Heimlich maneuver correctly. This method is suitable for children over 1 but not for infants, where back blows and chest thrusts are safer. His quick action cleared her airway just in time for hospital care. This close call shows how fast choking can turn deadly and why knowing what to do matters. Babies often explore by putting things in their mouths, and small objects or food can silently block their airways. So, read on to learn the signs of baby choking, the exact steps to take, and the CPR procedure if they lose consciousness.
How Can You Identify a Choking Infant?
Infants under 12 months have much narrower airways and a less developed gag reflex than older children, so even a small blockage can escalate fast. Here are some clear signs to watch for if you think a baby might be choking:
- The Baby Is Unable to Cry or Make Sounds
If a baby can’t cry, laugh, or make any noise, it may mean their airway is completely blocked. This is a sign of severe infant choking. You must act quickly to clear the airway because the baby will not be able to breathe without help.
Remember: no sound also means no breathing or air exchange.
- Ineffective Cough
A baby with a weak cough or no cough at all may not be able to clear the blockage in their throat. This means they need your help immediately. A strong cough can remove the object, but a weak one is a warning sign.
- Skin, Lips, or Face Turning Blue or Pale
When a baby’s skin, lips, or face turns pale or blue, they aren’t getting enough oxygen. Pallor may appear first, especially in lighter-skinned infants, but dusky or mottled coloring is a danger sign in all skin tones. Begin baby CPR right away to restore airflow and prevent the situation from becoming fatal.
- Shortness of Breath
If a baby is unable to breathe, is frantic, or is having difficulty breathing, his airway could be blocked. This is a critical indication that the baby must be treated immediately to clear the blockage and start breathing normally.
- Silence or Squeaky Noise When Trying to Breathe
Sometimes a choking baby will make squeaky, high-pitched, or stridor-like sounds while trying to breathe, or may go completely silent. This suggests a partial blockage that can worsen rapidly. Immediate action must be taken to dislodge the blockage and have them breathe once more.
How to Tell if a Baby’s Airway Is Partially or Fully Blocked?
The following table outlines the difference between the usual signs of partial airway obstruction in an infant:
| Partial Blockage – Monitor Closely | Severe Blockage – Act Immediately |
| Baby is coughing strongly → air is still moving. | Cough is weak or gone → airway fully blocked. |
| Baby is crying loudly → breathing is happening. | Baby is silent → no air exchange. |
| Baby coughs effectively → don’t interfere, just watch. | Baby can’t cough, cry, or breathe → begin first aid. |
| Skin looks normal → stay alert for changes. | Skin turns pale, blue, or dusky → start choking first aid/CPR. |
What Are the 5 Steps to Help a Choking Infant?
Every parent, caregiver, or babysitter should know what to do if a baby starts choking. Staying calm, acting quickly, and using the right steps can save their life. Never use the Heimlich maneuver on infants under 1 year. Use back blows and chest thrusts instead. So, here are the key steps to follow when you are dealing with a choking infant:
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What Are the 5 Steps to Help a Choking Infant?
- Stay calm and act quickly
- Check if the baby is truly choking
- Call for help (911)
- Give 5 back blows + 5 chest thrusts
- Continue until the airway clears or help arrives
1. Stay Calm and Act Quickly
Stress can cause caregivers to shake or mishandle the baby. Stability is important because infants have fragile neck muscles and airways. Breathe deeply and concentrate on saving the baby. Acting quickly and firmly will be the turning point in saving his/her life. Remember that every single second counts in the case of a choking crisis.
2. Make Sure the Baby is Actually Choking
Ensure the baby can cough, breathe, or cry. If yes, then it is a partial obstruction. Encourage coughing and monitor closely. If the baby can’t cry, is gasping, or turning blue, then it is a complete obstruction. Administer first aid as soon as possible to dislodge the object and continue normal breathing. Always check the mouth quickly, but don’t sweep blindly with the finger. It can push the object deeper.
3. Call for Help
If someone is with you, ask them to call 911 right away while you give care. If you are alone, give two minutes of care (cycles of 5 back blows and 5 chest thrusts) before calling for help. Emergency responders can guide you and arrive with the equipment needed to save the baby’s life.
4. Give Back Blows and Chest Thrusts
A combination of 5 back blows and 5 chest thrusts can help push the object out of the baby’s airway. Support the baby’s head, keep it angled downward, and use firm but gentle force. Repeat this cycle until the blockage is cleared or the baby becomes unresponsive. You should begin CPR immediately when you are waiting for help to arrive.
5. Keep Going Until the Airway Is Clear or Help Arrives
Do not stop trying to help until one of three things happens: the object comes out, the baby starts breathing on their own, or trained emergency responders arrive to take over. Persistence is key; every attempt gives the baby a better chance of survival. Do not attempt the Heimlich maneuver (abdominal thrusts) on infants under 1 year old, as it can cause serious internal injuries.
How to Give Back Blows to a Baby
Back blows are the initial step to assist a baby’s airway if the baby is choking and unable to breathe, cry, or make any sound. To provide a baby with back blows correctly, follow these steps:
- Hold the baby’s head and neck with one hand, supporting them gently.
- Always support and stabilize the baby’s head and neck. Infants have fragile neck muscles, and improper support can cause injury.
- Hold the baby on your forearm, face down, with your arm supported on your thigh.
- Make sure that the baby’s head is below their chest.
- Using the heel of your second hand, give 5 hard blows between the shoulder blades.
- These must be of a force sufficient to cause force in the airway but not hard enough to be harmful.
- Immediately after every strike, re-check whether the object has been pushed out.
- If not, continue until you’ve completed all 5 back blows before moving to chest thrusts.
How to Give Chest Thrusts On An Infant
If the blows to the back do not clear the blockage, the rescuer proceeds to give chest thrusts. The technique is used to build up pressure in the chest of the baby that will push the object out of the airway. Techniques to give chest thrusts include:
- After the back blows, roll the baby face up, still supporting his or her head and neck.
- Place two fingers (index and middle) on the lower half of the sternum (breastbone), not just below the nipples.
- Deliver 5 firm but gentle thrusts, pressing about 1.5 inches deep each time.
- Maintain strong and forceful movement to avoid causing injury. Repeat 5 back blows following the end of 5 chest thrusts.
- Continue to repeat this process until the airway is cleared, the baby starts to breathe, or they become unresponsive and you need to perform infant choking CPR.
Read More: How to Perform CPR on a Choking Infant
What Should You Do for an Unresponsive Choking Infant?
Choking infant CPR is used when a baby’s airway is blocked and they become unresponsive. In this situation, the baby is not breathing normally and needs immediate help to restore airflow. The steps on how to provide CPR to the choking infant are:
1. Check Responsiveness
Gently tap on the baby’s foot and call out their name to test if they are responding or not. If the baby is not moving, crying, or awakening, they might require CPR right away. Testing for responsiveness will inform you if and when you need to provide immediate life-saving interventions.
2. Call for Help
If you have a person with you, have them call emergency services, and you begin CPR. If you are alone, do two minutes of CPR before you call. Emergency services will guide you over the phone and send trained professionals quickly to where you are.
3. Put the Baby on a Firm Flat Surface
Lay the baby on its back on a firm, flat surface like the floor or a sturdy table. This stable position lets you perform chest compressions effectively and makes it easier to open the airway during CPR
4. Perform 30 Chest Compressions
Use two fingers, press on the lower half of the sternum, just below the nipple line. Push about 1.5 inches deep at a rate of 100–120 compressions per minute. Let the chest rise fully after each push. These compressions help circulate blood and oxygen through the baby’s body. This is a critical step in CPR as recommended by the American Heart Association (AHA) 2020 guidelines.
5. Open the airway
Tilt the baby’s head back and lift the chin in order to open the airway. Look for any object in the mouth or throat and take it out only if you are able to see it. Don’t try to feel around with your fingers.
6. Administer 2 Rescue Breaths
Cover the baby’s nose and mouth with your mouth. Give two soft puffs of air, just enough to make the chest rise. Do not blow too hard. Watch closely to discover whether the chest rises, which means the air has entered the lungs.
7. Continue CPR Until Help Arrives or Baby Breaths
Just keep repeating the 30 compressions and 2 breaths. Don’t stop unless the baby is breathing on his own, you can’t keep going, or trained emergency personnel arrive and take over. Consistent effort will save the baby’s life.
Read More: How to Give Rescue Breaths for a Child: Step-by-Step + Suctioning Guide
How Can You Prevent Choking in Infants?
Many choking cases happen at home during eating or playtime. However, following a few steps can help you prevent choking and keep your baby safe. The most effective strategies are discussed as follows:
- Food Safety Tips
Cut your baby’s food into very small, bite-sized pieces to make swallowing easier. Avoid dangerous foods like nuts, popcorn, whole grapes, and hard candy, as they can easily block the airway. Always cook vegetables until they are soft enough to mash with a fork. In fact, a recent study of infant feeding found that roughly 26.2% of infants experienced at least one choking episode between 6–12 months old.
- Toy and Object Safety
Keep small items such as coins, buttons, batteries, and tiny toys far from your baby’s reach. Choose toys that are age-appropriate and free from detachable small parts. This reduces the risk of your baby putting dangerous objects in their mouth and choking.
- Supervision Tips
Always keep a close watch on your baby when they are eating or playing. Never leave them unattended with food or small objects. Teach older siblings to keep their toys and other small items away from the baby to prevent choking hazards. Preventive education helps. A national public campaign in Israel achieved a 35% reduction in baby choking incidents.
Be Ready to Save a Baby’s Life
Baby choking is a serious emergency, but with the right knowledge and quick action, you can save a baby’s life. By learning to identify the signs, such as difficulty breathing, silence, or skin turning blue, you can act before the situation becomes worse. Remember the steps: 5 back blows and 5 chest thrusts, repeated until the airway is clear or help arrives.
If the baby becomes unresponsive, start CPR right away and continue until they begin breathing again or emergency responders take over. Being prepared means you won’t waste precious seconds in a crisis. Take the next step by enrolling in a certified CPR training course today. The knowledge you gain could one day save a child’s life.
