What To Do When Your Baby Starts Choking, According To A Paramedic

by Shannon Evans

Like many parents, experiencing a serious first aid emergency with one of my small children is among my greatest fears. Babies in particular are so fragile that my husband and I sweat bullets when they begin to eat table food. Despite having sat through several safety trainings in my life, I never remember the protocol as well as I would like, and I know I'm not alone in my fears of infant choking, because most parents I've talked to echo the same feelings. So for all of us, here's a refresher on what to do when your baby starts choking, because there's no time to panic.

The first step, says Health and Wellness expert Caleb Backe, is to assess whether or not the episode of choking will require intervention. Backe explains that coughing or gagging sounds coming from your baby is actually a good sign, one that indicates her throat is not completely blocked. In this case, encouraging her to cough more by lightly patting her back can encourage the natural gag reflex. If the coughing or gagging continues, it may be because of an allergic reaction and it's best to call an ambulance while you continue patting her back.

But the real concern, says Backe, is when a choking child is not making any sounds at all, indicating the airway is completely blocked.

Mike Gnitecki, a paramedic and American Heart Association Basic Life Support instructor, says the first course of action when your baby is choking is to place him face-down on one of your arms (he suggests using your non-dominant arm) and deliver five firm blows on his back, being sure to keep his head supported and facing downward so that the food has a better chance of dislodging.

After performing the five back blows, flip the infant over onto his back and do five of what the medical community refers to as "two-finger chest compressions". Place your index and middle fingers in the middle of the chest — just below the nipple line — and push in towards the child's chest, mimicking an adult chest compression.

Repeat this "five and five" model of five back blows and five chest compressions, until the food item is dislodged or the baby becomes unresponsive. You may have already chosen to call 911, but if you haven't, and the child is unresponsive, now is definitely the time to do so. If someone else is present, have them make the phone call while you continue the "five and five".

If the infant becomes unresponsive, Gnitecki advises parents to initiate CPR. First, place the baby on a flat surface. Next, do 30 two-finger chest compressions. Third, open the child's airway, looking inside for any items in the child's mouth. If you see an item, you can remove it. If you do not see an item, Gnitecki does not advise performing a blind finger sweep. Instead, proceed to breathe into the child twice.

To administer these two safety breaths, tilt your baby's head back with a forefinger and use two fingers on her bottom jaw to hold her mouth open. Place your mouth over their nose and mouth, ensuring a tight seal, and then blow. If her chest is still not rising, do the two-finger chest compressions again, and repeat the sequence until the ambulance arrives.

Imagining such a scenario is the last thing most parents want to do, but being prepared beforehand is critical for all moms, dads, and caregivers. The importance of keeping a knowledgable and level head in the heat of the moment cannot be overstated, so all parents should educate themselves on the appropriate protocol for infant choking. Looks like I'd better get practicing.

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