Choking - infant under 1 year
Choking is when someone can't breathe because food, a toy, or other object is blocking the airway (throat or windpipe).
This article discusses choking in infants.
Choking may result from a complete or partial blockage of the airway.
- A complete blockage is a medical emergency.
- A partial blockage can quickly become life threatening if the person cannot breathe enough.
Permanent brain damage can occur in as little as 4 minutes when a person does not get enough air. Rapid first aid for choking can save a life.
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.
The danger signs of choking are:
- Bluish skin color
- Difficulty breathing - ribs and chest pull inward
- Loss of consciousness if blockage is not cleared
- Inability to cry or make much sound
- Weak, ineffective coughing
- Soft or high-pitched sounds while inhaling
Do NOT perform these steps if the infant is coughing hard or has a strong cry. Strong coughs and cries can push the object out of the airway.
If your child is not coughing forcefully or does not have a strong cry, follow these steps:
If the object does not come out of the airway after 5 blows:
IF THE INFANT LOSES ALERTNESS
If the child becomes unresponsive, stops breathing, or turns blue:
- Shout for help.
- Give infant CPR. Call 911 after 1 minute of CPR.
- If you can see the object blocking the airway, try to remove it with your finger. Try to remove an object only if you can see it.
- Do NOT perform choking first aid if the infant is coughing forcefully, has a strong cry, or is breathing enough. However, be ready to act if the symptoms worsen.
- Do NOT try to grasp and pull out the object if the infant is alert (conscious).
- Do NOT do back blows and chest thrusts if the infant stops breathing for other reasons, such as asthma, infection, swelling, or a blow to the head. Do give infant CPR in these cases.
When to Contact a Medical Professional
If an infant is choking:
- Tell someone to call 911 while you begin first aid.
- If you are alone, shout for help and begin first aid.
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.
- Don't give children under 3 years old balloons or toys with fragile or small parts.
- Keep infants away from buttons, popcorn, coins, grapes, nuts, or similar items.
- Watch infants and toddlers while they are eating. Do not allow a child to crawl around while eating. Childproof your home.
- The earliest safety lesson is "No!"
Manno M. Pediatric respiratory emergencies: Upper airway obstruction and infections. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 166.
Last reviewed 7/20/2013 by Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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