What to do when baby is choking on food

infant under 1 year: MedlinePlus Medical Encyclopedia

URL of this page: //medlineplus.gov/ency/article/000048.htm

To use the sharing features on this page, please enable JavaScript.

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.

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.

  • A complete blockage is a medical emergency.
  • A partial blockage can quickly become life threatening if the baby cannot get enough air.

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.

The danger signs of choking are:

  • Bluish skin color
  • Difficulty breathing -- ribs and chest pull inward
  • Loss of consciousness (unresponsiveness) 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 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 child becomes unresponsive, stops breathing, or turns blue:

  • Shout for help.
  • Give infant CPR. Call 911 or the local emergency number 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 get worse.
  • 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 the infant CPR in these cases.

If an infant is choking:

  • Tell someone to call 911 or the local emergency number 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.

To prevent choking in an infant:

  • Do not give children under 3 years old balloons or toys with small parts that can break off.
  • Keep infants away from buttons, popcorn, coins, grapes, nuts, and other small items.
  • Watch infants and toddlers while they are eating. Do not allow a child to crawl around while eating.
  • The earliest safety lesson is "No!"
  • Choking first aid - infant under 1 year - series

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.

Updated 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.

What to Do If Baby Is Choking: Step-By-Step First Aid

Do you know what to do if your baby is choking? While it’s something no caregiver wants to think about, even seconds count if your child’s airway is obstructed. Knowing the basics can help you potentially dislodge an object or know what to do until help arrives.

Here’s more about how you can help a baby (under 12 months old), what you definitely shouldn’t do, and some tips to prevent choking accidents in your home.

Things can happen very quickly in emergencies, so we’ve kept our descriptions clear and to the point.

Step 1: Verify that your baby is actually choking

Your baby may be coughing or gagging. This can sound and look scary, but if they’re making noise and able to take breaths, they’re likely not choking.

Choking is when a baby is unable to cry or cough. They also won’t be able to make any noise or breathe because their airway is completely obstructed.

Step 2: Call 911

Ideally, you can have a friend or family member call 911 or local emergency services while you take care of your baby.

Explain the steps you’re following to the operator and provide updates. It’s especially important that you tell the operator if your child becomes unconscious at any point during the process.

Step 3: Place your baby face down on your forearm

Use your thigh for support. With the heel of your free hand, deliver five blows to the area between their shoulder blades. These blows should be both quick and strong to be effective.

This action creates vibrations and pressure in your baby’s airway that will hopefully force the object out.

Step 4: Turn baby over onto their back

Rest your baby on your thigh, keeping their head lower than their chest. With your index and middle fingers, find your baby’s breastbone (between and slightly below the nipples). Press down five times with enough pressure to press the chest down about one-third.

This action helps to push air from the lungs into the airway to potentially force the object out.

Step 5: Repeat

If the object still hasn’t dislodged, return to back blows following the same instructions above. Then repeat the chest thrusts. Again, tell the 911 operator immediately if your baby loses consciousness.

Related: Why every anaphylactic reaction requires a trip to the emergency room

It’s beyond scary to think about this whole scenario playing out in real life. But it happens.

You may or may not be surprised to learn that food is the most common cause of choking with infants. That’s why it’s important to introduce only age-appropriate foods — usually purees — to your child after they turn 4 months old.

Watch out for these foods in particular:

  • grapes (If giving these to your older baby — they’re not appropriate until closer to a year of age — peel off the skin and cut in half first.)
  • hot dogs
  • chunks of raw fruits or vegetables
  • chunks of meat or cheese
  • popcorn
  • nuts and seeds
  • peanut butter (While perhaps technically a puree, the thickness and stickiness makes it a hazard. )
  • marshmallows
  • hard candies
  • chewing gum

Of course, we know you’re likely not giving chewing gum or hard candy to an infant — but consider if your baby found some on the ground. Even the most careful caregiver may miss certain objects that land places where little eyes end up seeing them.

Other choking hazards found around the home include:

  • marbles
  • toys with small parts
  • latex balloons (uninflated)
  • coins
  • button batteries
  • pen caps
  • dice
  • other small household items

Young babies may also choke on liquids, like breast milk, formula, or even their own spit-up or mucus. Their airways are particularly small and easily obstructed.

This is one reason that you hold your baby with his head below his chest when attempting to help. Gravity may allow the liquid to drain out and clear the airway.

Related: Choking on saliva — causes and treatments

While it’s tempting, resist the urge to reach in your baby’s mouth and grab an object out unless it’s visible and easy to grasp with your fingertips.

Grasping around something that you can’t see in their throat may be harder than you think. And you may actually push the object farther down into the airway.

Also, don’t attempt to do the Heimlich maneuver (abdominal thrusts) with an infant. While abdominal thrusts can help children and adults move objects in their airways, they can be damaging to a baby’s developing organs.

You may also have heard to turn your baby upside down and hold them by their feet. This isn’t a good idea because it may force the object deeper into the throat — or you could accidentally drop your child in the process.

Related: Introduction to first aid for babies, children, and adults

If your baby does lose consciousness, the 911 operator may instruct you to do CPR until help can arrive. The goal of CPR isn’t necessarily to bring your baby back to consciousness. Instead, it’s to keep the blood and oxygen circulating to their body and — even more importantly — to their brain.

One set of CPR includes 30 chest compressions and 2 rescue breaths:

  1. Place your infant on a flat, firm surface, like the ground.
  2. Look for an object in your baby’s mouth. Remove it only if it’s visible and easy to grasp.
  3. Place two fingers on your baby’s breastbone (the area where you applied pressure for chest thrusts). Apply pressure that compresses their chest about one-third (1 1/2 inches) at a rhythm of around 100 to 120 compressions each minute. Complete 30 chest compressions in all.
  4. Tilt your baby’s head back and lift their chin to open the airway. Give two rescue breaths by making a seal around the baby’s mouth and nose. Blow each breath in for 1 full second.
  5. Then repeat this process until help arrives.

You may not be able to prevent all choking accidents. That said, you can take measures to make your home as safe as possible for your baby.

Pay attention at mealtime

Especially as the foods you offer get chunkier, it’s important to keep good watch on your little one as they eat. And be sure to have your child sitting at meals versus walking or running around.

Provide age-appropriate foods

“Age-appropriate” means starting with purees at first and then progressively offering larger pieces of soft foods that can mash in your baby’s mouth. Think boiled sweet potatoes versus raw carrots or bits of avocado versus chunks of orange.

That said, if you do choose to do the baby-led weaning approach to feeding your infant, you don’t necessarily need to worry. Multiple studies (like research from 2016 and 2017) have shown no significant difference in risk with spoon feeding and feeding soft finger foods.

Speak with your doctor

Before offering high-risk foods, like grapes and peanut butter, check in with your pediatrician. They can help you decide when the best time is to introduce these foods and the best way to present them so they aren’t as much of a choking risk.

Read labels on toys

Check toy labels to ensure you’re buying ones that are age appropriate for your baby. And examine other toys in your home that might belong to older siblings. Consider creating a special spot for toys with small parts so they stay off the ground.

Create a safe space

Keep other hazards, like batteries or coins, out of your baby’s reach. If babyproofing your entire home seems overwhelming, you might try creating a dedicated “safe space” that’s gated off while you work on babyproofing the rest.

If you’re still feeling a bit uneasy about your ability to help your baby in an emergency, consider taking an infant first aid class that covers both choking and CPR skills.

You may be able to find classes near you by calling your local hospital. A 2019 study showed that practicing on mannequins can help with learning and confidence in executing these procedures.

Otherwise, do your best to keep choking hazards out of your baby’s play areas and pay close attention to anything you see in your baby’s mouth that shouldn’t necessarily be there.

Child chokes on food | Lessons for moms

Skip to content

Previous Next

Why does a small child choke on solid food, and how to fix it?

Almost every mother, at least once in her life, has seen the moment when the child choked while eating or feeding.

Panic, fear, despair…

And you start to think that maybe you shouldn't give pieces, but stay for more puree? Someone does this, and then, at 1-2 years old, they come to me and complain that the child chokes on food, cannot eat solid food, and the mother still grinds everything.

How do you find the sweet spot between teaching your child to handle bits and minimizing choking situations? That's about it in the article.

Why does the child choke on food?

Imagine the changes a small child goes through in his first year of life in his diet. From liquid food, he moves on to chewing solid food, trying to feed himself.

For a baby, learning to chew is actually very difficult:

  • Now you need to work with your hands, taking food and sending it to your mouth, and not to miss it;
  • The work includes not only the tongue, as it was before, but also the jaws;
  • The brain now has to coordinate the actions of the hands, tongue, jaws, lips; at first, it may not be able to handle such a load properly.

In such tension, it is no wonder that the child sometimes chokes while eating. And yes, almost certainly, he will eat less dense food than pureed food. After all, chewing for him is a big job. This is learning a new skill and it will take time.

Read also about the development of a child by months to a year>>>

The main causes of nutritional difficulties

In most cases, we ourselves provoke situations in which the child often chokes on food:

  1. Hurry and fuss.

We are always in a hurry, we are sorely lacking time for all household chores. Therefore, we prepare food for the baby with a blender (it’s more convenient for us, and the baby will eat faster) or even buy store jars.

But it's more convenient for us, not for the little one. We do not teach a child to chew by constantly offering pureed food.

  1. Early introduction of complementary foods.

You can decide that 4 months is the time to switch to complementary foods (especially if the first early tooth has already arrived - sometimes this happens).

Read about complementary foods for babies by months with breastfeeding>>>

Because there is less milk, the baby is no longer enough. Because they decided to go to work and transfer the baby to mixtures and more adult food. Because grandma said so.

Important! Up to six months, the child has a protective reflex: any solid object that has fallen into the mouth is pushed out by the tongue.

When trying to give him even a tiny piece, the child constantly chokes on food.

Nature, unlike us and even our grandmothers, knows that it is still too early to introduce the little man to pieces of food. He just doesn't know what to do with her.

But from 6 months this reflex is replaced by chewing, the baby begins to make chewing movements with the jaws, lips, cheeks.

Read an interesting article How to teach a child to chew>>>

  1. Delay in introduction to solid food.

Due to the advice of the pediatrician, who said that it is useless to give solid food to a baby without teeth, we continue to give only mashed potatoes at 8–10 months.

First, let's wait for the teeth, and then we will conquer the "chewing peaks" - a fundamentally wrong attitude.

All children are different, and sometimes it happens that the first tooth erupts much later than six months. By this time, the natural chewing reflex, alas, fades away without being developed. Do not be surprised then that a child, even at 2 years old, constantly chokes on food.

For children over the age of one who have problems with nutrition, see the online course We eat with pleasure: we return a healthy appetite to the child>>>

  1. Fear.

You gave a child a piece of food and he choked. You were terribly frightened and violently expressed it in the presence of the baby. The baby now intuitively protects mom from worries by refusing to accept such food.

And if he eats, he chokes again from tension. Because the brain has learned a lesson: eating in pieces is dangerous.

Read the important article What to do if the child chokes>>>

  1. Separate feeding of the child.

You put the little one at a separate table, in a separate room, give him separate food, letting him know how big and important he is already.

In fact, you simply deprive him of the opportunity to learn by example: to see how other family members take food, what it is, how it smells, how it looks, how they chew it, how they like it, imitate them.

You deprive the baby of the necessary experience, family socialization, and then you wonder: why is this child choking while eating?

  1. Mix pureed food and hard pieces.

We decide that the most prudent thing is to mix small pieces of solid food with puree, which the baby swallows without chewing. Not expecting a dirty trick, he tries to swallow the mashed potatoes with a piece. But his brain is not ready for this. The child is choking.

How to teach a child to deal with pieces?

  • Remember: there is a time for everything.

Important! Do not rush the introduction of "piece" food, but do not delay beyond 9 months.

After this age, the child begins to be afraid of new sensations, he becomes not interested in learning to chew.

He won't be able to learn it easily even if he has teeth. Give solid foods very little, leaving breast milk as the main food.

  • Give small soft microdoses of foods.
  • Offer food in chunks without persuasion, cartoons, jokes and other "distractions".
  • If your child is choking on food even at 1 year of age, try giving him a few bites of food first until he gets tired of chewing, and then move on to more familiar foods.

But the most important thing that will help you teach your little one how to chew solid food without any problems is natural complementary foods, which I often talk about. He lays the very foundations, true and timely, which will unobtrusively and naturally lead the child to chew:

  1. The baby develops food interest in time: he is curious about what his father and mother eat, he wants to try it himself.
  2. He has the opportunity to feel like a member of the family, sitting at a common table, spending time with relatives.
  3. Nature itself tells the child when it's time to try something from the adult table.

Read also the article on the topic: Pedagogical complementary foods>>>


Important! With this approach, try to make sure that the child has an idea what kind of product he eats: specifically, meat, egg, fish, apple.

And one more thing, be patient. Any skill requires patience from you, and from the crumbs - effort and time to master. Give him this time, do not rush things.

If, nevertheless, your child is constantly choking on food, then it is worth re-evaluating all the principles of complementary foods, working on mistakes and teaching the child to cope with pieces.

For details, step by step, everything about complementary foods, see the online course ABC of complementary foods: safe introduction of complementary foods to babies>>>

Feed your baby correctly!

See also:

  • WHO Complementary Food Chart
  • At what age can a child be given fish?
  • How to teach a child to eat independently?

Author: Lyudmila Sharova

Subscribe and receive a recording of the seminar about the five main mistakes of complementary foods .

Enter your email and click on the "GET" button

*- By clicking on the button, I agree to the processing of personal data and receiving the newsletter.

Learn about complementary foods:

Search result:

Take the test

How many children will I have?

Would you like to have a crystal ball to see the future?