Infants (Birth to Age One)
Infants, birth to age one, are treated differently than children when performing lifesaving techniques. Here are some important steps to follow.
If Conscious but Choking
In a matter of minutes, an infant can go from choking to loss of consciousness. It is crucial to act quickly to remove the obstruction in a choking baby.
To verify an obstruction, look for the following signs: blue skin, no crying, breathing problems, and the possibility of loss of consciousness. If the child begins to cry or makes sounds, this is a good sign.
If your infant is coughing or crying, most likely the airway is only partially obstructed. If this is the case, do not lay the child down or you might increase the obstruction. Coughing often helps remove the object.
Look to see if anything is in the mouth. If there is any object in the mouth, remove it. Do not remove objects in the airway. If you can't remove the object, turn the infant face down on your lap and do five back blows. Using a pushing motion with the heel of your hand, administer the blows to the middle of the infant's back. The blows should be followed by five chest thrusts, done using two fingers in the middle of the chest. To determine where in the chest you should push, imagine a line connecting the infant's nipples and push in the center. Check the airway to see if the object has been removed. If not, repeat until the object is removed or help arrives.
Give five back blows and five chest thrusts. Repeat blows and thrusts until object comes out.
Check the infant for responsiveness. Shout and gently tap the child on the shoulder. If there is no response, position the infant on his or her back.
You want to look, listen, and feel for signs of breathing. Put your ear over the mouth and your hand on the chest. In most infants it is more helpful to look at the baby's stomach rather than the chest, since infants often breathe with their bellies. Then check for a pulse; look for the brachial pulse, just above the elbow. Use your index and middle fingers to find the pulse. (Do not use your thumb because it has a pulse and may lead you to believe the infant has a pulse.)
If there is no response, call 911 and return to the victim. In most locations the emergency dispatcher can assist you with CPR instructions.
If Not Breathing
If you can't detect respiration, do the following:
- Tilt the infant's head back and lift the chin up to open the airway.
- If the baby is not breathing, give two small, gentle breaths.
- Cover the baby's mouth and nose with your mouth.
- Use gentle breaths to avoid over inflating the infant's lungs (use the strength of your cheeks to administer light puffs of air).
- Each breath should be about one second long.
- Check to see if the infant's chest or belly is moving to ensure that air has entered the body.
If Air Won't Go In
- Give two CPR cycles (a cycle consists of two breaths per 30 gentle chest compressions).
- Place two fingers on the infants's sternum, about one finger-width below the imaginary line connecting the nipples.
- Press down only one-half to one inch; about one-third to one-half of the depth of the baby's chest. Each completed cycle should take about two minutes.
- Repeat the 30 compressions and two rescue breaths cycle until help arrives or until the baby breathes normally, coughs, or moves.
- If you feel a pulse return, give one breath every three seconds and discontinue chest compressions.
- Take the baby to the ER or pediatrician. Even if the infant appears to be all right, you need to verify that there are not any internal complications.