"What do I do if my baby is choking?" It's the question I get more than any other in my classes, and it makes sense. Between the coughing, gagging, and wheezing a baby can make on a normal day, choking is always somewhere in the back of a parent's mind. The good news: a real choking emergency is one of the most preventable and treatable emergencies out there, as long as you know what to look for and what to do next.

Common Choking Hazards

The best way to avoid a choking emergency is to prevent it. Here are a few things to look out for  that are commonly choked on:

1. Latex balloons: They coat the airway if a piece is inhaled, which makes them uniquely dangerous; a mylar balloon is a much safer choice for a party

2. Small foods: uncut grapes, blueberries, strawberries, peanuts

3. Small items: batteries, marbles, pebbles, hair barrettes 

4. Starchy and sticky foods: french fries, peanut butter 

5. Dog food: If you have a pet, a crawling or toddling baby getting into the food bowl is more common than you'd think

Choking Emergency Prevention Strategies

• Cut food into small pieces

• Or, if practicing Baby Led Weaning, make sure you research how to do it safely

• Watch your child while they eat

• Have them sit while eating, no eating on the move, in the car seat, or in the stroller until they are better at the skill of chewing and swallowing: roughly two

• Be especially vigilant with starchy and sticky foods

When to Respond

If your baby has a forceful cough, let them keep coughing. Coughing is the body's own airway-clearing tool, and it's more effective than anything you can do by hand. Stay close, stay calm, and resist the urge to reach into their mouth (unless you can see it!); a blind finger sweep can push an object deeper.

Signs of choking

1. Changes in skin color (a bluish hue around the lips or face)

2. Inability to cry, cough, or make noise

3. Loss of consciousness

The moment the cough goes silent, or your baby can't cry, breathe, or make noise, that's your signal to act.

How to Respond: Under 12 Months

Current guidance calls for alternating back blows and chest thrusts, not abdominal thrusts, on an infant, since their organs sit higher and are more easily injured.

1. Sit or kneel, and lay your baby face-down along your forearm, supporting the jaw and chest, head lower than the body.

2. Give 5 firm back blows between the shoulder blades with the heel of your hand.

3. Flip baby face-up along your other arm, still head-down.

4. Give 5 chest thrusts in the center of the chest, just below the nipple line, about 1½ inches deep.

5. Keep alternating 5-and-5 until the object comes out, your baby starts crying or breathing, or they become unresponsive.

If your baby becomes unresponsive, lower them to a firm, flat surface and begin infant CPR immediately, and have someone call 911 (or call yourself on speaker if you're alone and haven’t done so already).

How to Respond: 12 Months and Up

Similar to an infant, we want to start with five back blows, then transition to five abdominal thrusts (Heimlich):

1. 5 back blows between the shoulder blades.

2. 5 abdominal thrusts (the classic Heimlich), hands above the belly button, below the ribs, thrusting inward and upward.

3. Keep alternating until the object clears or the child becomes unresponsive.

If they go unresponsive, start CPR and get emergency services on the way.

With Competence Comes Confidence

So, what do you do if your baby is choking? Now you know: watch for the signs, act fast the moment the cough goes silent, and trust the steps. They're simple, and they're proven. I hope this leaves you feeling more confident in your ability to respond if a choking emergency ever happens. Happy Parenting!

Ryan is the owner of Baby Safe CPR, teaching in-home CPR and baby safety classes across the Salt Lake Valley. If in-home classes aren't an option for you, he also offers an on-demand infant CPR class you can take from home, at your own pace.

*This post was written by Ryan Wirth, certified CPR instructor and owner of Baby Safe CPR. This content is for educational purposes only and is not a substitute for hands-on CPR training. In any emergency, call 911 immediately. The Little Milk Bar is not responsible for outcomes resulting from the use of this information.