Children who cough forcefully or who have a strong cry should be allowed to try to expel the object on their own. However, basic first-aid steps should be applied if the child does not display these signs while choking. Treatment options to stop choking differ depending on the age of the child. It is very important for caregivers to learn first-aid techniques from a professional and to practice them than to try to apply them for the first time during an emergency. If performed incorrectly, these techniques could injure the child.

For infants under age 1, it is important to provide proper support to the head, as the neck muscles are not fully developed. The caregiver is urged to lay the child face down along the parent’s forearm. Using a thigh or lap for support, the caregiver should hold the infant’s chest in a hand and hold the child’s jaw with fingers. After pointing the infant’s head downward (lower than the body) the caregiver should use the heel of a free hand to give up to five quick, forceful blows between the infant’s shoulder blades.

If this fails to dislodge the object, the infant should be turned onto the back face up while firmly supporting the head and neck. Using a thigh or lap for support and cradling the baby’s head, the caregiver should place two or three fingers in the middle of the child’s breastbone (just below the nipples) and give up to five quick thrusts downward. The chest should be compressed up to one-third to one-half of its depth.

The back blows and chest thrusts should be alternated until the object comes loose or the child loses consciousness. As the child loses oxygen, air muscles begin to relax. This makes it easier to dislodge the object.

If the infant loses consciousness, the caregiver should yell for help and begin cardiopulmonary resuscitation (CPR). Another person should call 911 while CPR is administered. If no one else is present, the Centers for Disease Control and Prevention (CDC) recommends calling 911 one minute after performing CPR.

Children ages 1 and older should be treated with the Heimlich maneuver. First, the child should be asked whether he or she is choking. If the child is able to speak or coughs, nothing should be done. The child should be allowed to try to cough up the item that is blocking the airway.

If the child cannot respond, he or she should be reassured that help is forthcoming. At this point, the adult should stand or kneel behind the child and wrap arms around the child. After making a fist with one hand, the adult should place the thumb on the child’s abdomen so that it is just above the navel and well below the ribs.