If the baby can cough or make sounds, let him or her cough to try to get the object out. If you are worried about the baby's breathing, call.

WARNING: Do not begin the choking rescue procedure unless you are certain that the baby is choking.

If a baby can't breathe, cough, or make sounds, then:

• Put the baby facedown on your forearm so the baby's head is lower than his or her chest.
• Support the baby's head in your palm, against your thigh. Don't cover the baby's mouth or twist his or her neck.
• Use the heel of one hand to give up to 5 back slaps between the baby's shoulder blades. See picture A.
• If the object does not pop out, support the baby's head and turn him or her faceup on your thigh. Keep the baby's head lower than his or her body.
• Place 2 or 3 fingers just below the nipple line on the baby's breastbone and give 5 quick chest thrusts (same position as chest compressions in CPR for a baby). See picture B.
• Keep giving 5 back slaps and 5 chest thrusts until the object comes out or the baby faints.
• If the baby faints, call (if you haven't called already). Then:
  • Do not do any more back slaps or chest thrusts.
  • Start CPR. If you do rescue breaths, look for an object in the mouth or throat each time the airway is opened during CPR. If you see the object, take it out. But if you can't see the object, don't stick your finger down the baby's throat to feel for it.
  • Keep doing CPR until the baby is breathing on his or her own or until help arrives.

Picture A

Picture B

Illustration copyright © 2002 Nucleus Medical Art, Inc. All rights reserved. www.nucleusinc.com