Toddler First-Aid for Choking and CPR

Toddlers choke all the time — because they’re constantly putting objects in their mouth and they often attempt to swallow too-big pieces of certain foods. Children can lose consciousness within a matter of minutes once they start choking, so it’s important to learn how to clear a blocked airway and to administer CPR (cardiopulmonary resuscitation) if it becomes necessary.

We compiled this basic step-by-step guide to show you what to do in an emergency, but please don’t rely on it as your sole source of CPR information. Set aside a day to take a child CPR course; it’s one of the most important things you can do to protect your toddler from harm. Airway obstruction injuries (choking, suffocation, and strangulation) are a leading cause of accidental death in children under age 14. You can find a class in your area by calling your local chapter of the American Red Cross (check the white pages).

The following instructions are for children ages 1 to 3. To find out what to do when a baby chokes, see our illustrated guide to baby CPR.


Step 1: Figure out what’s causing the problem
If your toddler is suddenly unable to cry, cough, or speak, she probably has something blocking her airway, and you will need to help her get it out. She may make odd noises or no sound at all while opening her mouth, and her skin may turn bright red or blue. If she is coughing or gagging, her airway is only partially blocked, most likely because some food or liquid has gone down her windpipe instead of her esophagus, the tube that leads to the stomach. In this case, let her continue to cough; this is the most effective way of dislodging the blockage. (If you suspect that an allergic reaction or an infection has closed off your baby’s airway by swelling her throat, call 911 immediately. You will not be able to clear her airway yourself.) If your child cannot clear her airway on her own and you believe something is trapped there, begin Step 2.

Step 2: Administer the Heimlich maneuver or give abdominal thrusts
If your child is conscious but can’t cough, talk, or breathe or is beginning to turn blue, put your arms around her from behind and use the Heimlich maneuver to try to dislodge the object in her airway. First clench one hand into a fist and rest it against your child’s abdomen, just over her navel. Then put your other hand over the first one and quickly thrust upward several times. Continue until the child starts to breathe or cough. If your child is unconscious, place her on her back and position yourself at her feet (kneel if she’s on the ground, stand if she’s on a table or other elevated surface). Put the heel of one hand on your toddler’s abdomen between her navel and breastbone. You can put your second hand on top of the first, but you don’t need to. Once your hand is in position, thrust inward and upward five times — the thrusts should be gentle but quick.

With either method, stop if your child starts to cough and let her try to spit out the obstruction. Otherwise, open her mouth — tilt her head backward while bracing her jaw with your fingers and holding her tongue down gently with your thumb — and look inside. If you can clearly see the object she’s swallowed, use your finger to try to sweep it out of the way. Don’t try this if you can’t see the object, though — you could end up pushing it further down her airway by accident. If you cannot see the object continue with the abdominal thrusts. If the object comes out but your child is still not breathing, check her pulse and start rescue breathing (see below). Ask someone to call 911 right away. If you’re alone, give your toddler rescue breathing or CPR for one minute before you stop to call for help.

Rescue Breathing and CPR

Step 1: Check your child’s breathing and pulse
Swiftly but gently place her on her back on a firm surface. Make sure her airway is open by lifting her chin gently, then tipping her head back slowly. For at least five seconds, look, listen, and feel for signs of breathing. To check for a pulse, gently place your first two fingers on your child’s neck and feel for the artery that’s under her ear and just below her jawbone. Feel for a pulse for at least five seconds.

Step 2: If your child is not breathing but has a pulse, begin rescue breathing
Pinch your child’s nose shut, place your mouth over hers, and exhale into her lungs until you see her chest rise. (If her chest doesn’t rise, her airway is blocked. Resume the abdominal thrusts.) Give one slow breath every three seconds. Stop every 20 breaths and check her pulse. Continue rescue breathing until she starts breathing on her own or until you can no longer find a pulse. If you can’t feel a pulse, begin Step 3 below.

Step 3: If your child is not breathing and has no pulse, begin CPR
With your toddler still lying on her back, put the heel of your hand on the lower third of her breastbone. Depress her chest between 1 and 1 1/2 inches. Repeat five times within about three seconds. (Count “one and two and three.”) With your child’s head still tilted, pinch her nose shut, put your mouth over hers, and give one slow, gentle breath. Repeat the cycle of compressions and breathing about 10 times, then stop and check for a pulse. Call 911 now if no one has done so for you. Resume CPR, checking for a pulse every few minutes, until help arrives or your child resumes breathing. Once your toddler does resume breathing, get her to an emergency room as soon as possible. Even if she seems fully recovered, a doctor needs to make sure that her airway is completely clear and that she has not sustained any internal injuries.


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