Close Window
Library Search Go Advanced Search
Español (Inicio)

HealthSheets™

When a Child Is Choking (Age 1 and Up)

Young children often want to put things into their mouth. This includes toys and food. And it can include anything they find nearby, such as a pen cap or coin. Small objects can choke a child. This happens when the object slips into the child’s airway (trachea). A blocked airway can be very serious, even deadly. Choking can block the flow of air and cut off oxygen to the brain. This can cause permanent brain damage or death.

This sheet can help you prepare for a choking emergency. It will also help you take steps to prevent a child from choking.

What are choking hazards?

Any object small enough to enter a child'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

  • Button batteries, such as those used for watches, cameras, and small electronics

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 speak

  • Face that turns pale and blue-tinted

  • Clutching at his or her throat

Assessing the situation

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

  • If a child has trouble breathing, but can talk and has a strong cough

  • If a child has trouble breathing, but can’t talk or make sounds and is conscious

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

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

The instructions for each situation are below.

If a child has trouble breathing, but can talk and has a strong cough:

  1. Do NOT put your finger into the child’s mouth to remove the object. Your finger could push the object deeper into the child’s throat.

  2. Call 911. This is because the airway can become fully blocked.

  3. Encourage the child to cough until the object comes out. Don't do the Heimlich maneuver. The child's cough is better than the Heimlich maneuver.

  4. Watch the child closely to make sure the object comes out and doesn’t shift to fully block the throat.

If a child has trouble breathing but can’t talk or make sounds and is conscious:

  1. Do NOT put your finger into the child’s mouth to remove the object. Your finger could push the object deeper into the child’s throat.

  2. Tell someone nearby to call 911.

  3. Do the Heimlich maneuver (see instructions below).

  4. Keep doing the Heimlich maneuver until the object is out of the throat.

  5. Stop if the child becomes unconscious or stops breathing.

If a child stops breathing or is unconscious:

  1. Tell someone nearby to call 911.

  2. Lay the child down on his or her back on a hard, flat surface such as a table, floor, or the ground.

  3. If you can’t see the object and the child has not started breathing, place your mouth over his or her mouth. Pinch the nose shut and puff 2 breaths into the mouth. Each breath should last 2 seconds.

  4. Do the Heimlich maneuver with the child lying on his or her back. Kneel at her feet, place the heel of one hand in the middle of her body between the navel and ribs. Put one hand on top of the other and use gentle but firm pressure to give 6 to 10 rapid thrust upward and inward.

  5. If the child has no pulse, this means his or her heart has stopped beating. Start CPR (see instructions below). Repeat CPR until emergency services arrives, or the child starts breathing.

How to do the Heimlich maneuver

Woman doing choking rescue maneuver on toddler boy.

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

  • With the child in the upright position, bend the child forward while holding the child with one hand at the waist.

  • With your free hand, give the child 5 back blows between the shoulder blades with the heel of your hand.

  • If the object is not dislodged, put both hands together making a fist at the child's abdomen.

  • Place your fist right above the child’s bellybutton.

  • Then use fast, short motions to thrust inward and upward giving 5 quick abdominal thrusts. Don’t lift the child off the floor while doing this.

  • Continue 5 sets of back blows followed by 5 abdominal thrusts until the objects is dislodged, the child can cough and breath, the child becomes unconscious, or help arrives.

How to do cardiopulmonary resuscitation (CPR)

You may also need to use this method if a choking child has no pulse (heartbeat) and is not breathing:

  1. Use the heel of your hand to push down on the lower part of the child’s breast bone, just below the nipple line. Push in about 2 inches. Do this 30 times fast. This should take about 20 seconds. This is a rate of at least 100 compression per minute.

  2. Give 2 rescue breaths. Gently lift the child’s chin up with one hand and tilt the head back. Place your mouth over his or her mouth, pinch the nose shut and puff 2 breaths into the child’s mouth. Each breath should last 1 second. Watch to see if the child’s chest rises.

  3. If the chest does not rise, give 30 chest compressions. Look in the child's mouth for an object. Remove the object, being careful not to push it back into the throat. If you can't see an object, don't put your finger in the child's mouth.

  4. If the child does not start breathing, continue cycles of 30 chest pushes followed by 2 quick breaths. Do this until breathing starts, help arrives, you become too exhausted to continue, or the scene becomes unsafe.

Help prevent a child from choking

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

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

  • Don’t let young children play with toys with small parts.

  • Safety-proof your home by removing small objects that a child may reach.

  • Check for toys recalled for choking hazards on the Consumer Product Safety Commission’s website.

© 2000-2017 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.