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Choking in a conscious infant may occur when the upper airway, usually the throat or windpipe, is blocked by an object or irritation.
What are the signs and symptoms of the injury?
Signs and symptoms of choking in a conscious infant include:
If the choking episode is left untreated, unconsciousness or death may follow.
- inability to breathe or cry
- high-pitched voice or gurgling sounds
- ineffective cough
- bluish tint in face, hands, or feet
What are the causes and risks of the injury?
Choking is usually caused by things that the infant has placed in his or her mouth. These include toys, candy, popcorn, nuts, batteries, rocks, and buttons. Things that wrap around the throat and constrict it, such as strings or rope, can also cause choking.
What can be done to prevent the injury?
Some cases of choking can be avoided by:
How is the injury recognized?
- giving infants only age-appropriate toys
- avoiding toys that break easily, have small parts, or have batteries
- keeping foods such as popcorn, hot dogs, nuts, and seeds away from infants
- keeping buttons, watch batteries, coins, rocks, and any other small household items away from infants
- keeping strings and ropes away from infants. Never tie a pacifier with string to a baby's clothing. The string could get wrapped around the baby's neck.
Usually a person will notice that the infant is having difficulty breathing. There may be a shocked, anxious look on the infant's face, and the baby may begin to turn blue.
What are the treatments for the injury?
If choking is suspected in a conscious infant:
If the person performing first aid is alone, he or she should shout for help and begin first aid. If another person is there, he or she should contact local emergency medical services.
- Nothing should be done if the infant can still cough, breathe, or cry.
- If the infant is conscious, do not try to grasp any object lodged in the throat, because this may push it down further.
- No first aid steps should be started until it is certain that the infant is actually choking. If the infant is actually choking, coughing and crying will be very weak or impossible, and the infant's distress will be very obvious.
First aid in the choking infant includes the following steps:
If the child does lose consciousness, the procedures for choking in the unconscious infant should be followed.
- Lay the infant face down along the forearm with the baby's head lower than its body. The lap can be used to support the baby.
- With the infant lying face down, use the heel of the hand to give 5 sharp blows to the back between the shoulder blades.
- The infant is then turned over, again keeping the head lower than the body. Two fingers are placed on the breastbone just below the nipple line, and 5 thrusts are given. Depress the breastbone one half to one inch each time.
- This series of 5 back blows and 5 chest thrusts is continued until the airway is cleared or until the child loses consciousness.
What are the side effects of the treatments?
Back blows and chest thrusts can cause vomiting, injuries to internal organs, or broken ribs. Vomiting can be a problem if the vomited material is caught in the airway and inhaled into the lungs.
What happens after treatment for the injury?
It is important to obtain medical care from a healthcare professional for an infant who has choked. Occasionally, an object will enter the lung instead of being expelled. This can cause coughing, wheezing, or aspiration pneumonia.
Author: James Broomfield, MD
Reviewer: Eileen McLaughlin, RN, BSN
Last Updated: 23/07/2005
Potential conflict of interest information for reviewers available on request