Child Choking Relief: Learn the Critical Skills for Rapid Response

Choking is a leading cause of injury and death among children, especially those aged 3 and under. This guide provides a comprehensive understanding of the steps involved in BLS for a choking child, equipping caregivers, parents, and bystanders with the tools needed to respond effectively in this high-stress situation. 

Choking poses a grave and immediate threat to a child's life, occurring when an object obstructs their airway, impeding their ability to breathe. In such critical moments, having the knowledge and skills to perform Basic Life Support mean the difference between life and death. Here are the BLS steps that you should follow when helping a child who is choking:

  1. Assess the Situation: Stay calm and assess the child's condition.
  2. Call for Help: If you're alone with the child, call 911 immediately. If someone else is available, ask them to call for help while you provide assistance.
  3. Positioning: Place the child in a standing or sitting position. Stand or kneel behind the child, ensuring they are stable and supported.
  4. Administer Abdominal Thrusts (Heimlich Maneuver): When helping a choking child you should perform the heimlich maneuver or abdominal thrusts until the object blocking the airway is expelled, or the child breathes again.
  5. Continue Until Successful or Unresponsive: If the child becomes unresponsive (stops breathing or loses consciousness), you must initiate CPR.
  6. Checking the Airway: After every 30 compressions in CPR, open the child's mouth and look for the object causing the obstruction. If you see the object, remove it carefully using your fingers. Do not perform a blind finger sweep.
  7. Repeat Steps:  Repeat the cycle until the object is removed, the child starts breathing, or professional medical help arrives.
  8. Monitor the Child: Once the child starts breathing and responsive, monitor their condition until emergency medical help arrives.

Assess the Situation

Before taking any action, quickly assess the severity of the situation. Determine if the child is able to cough, speak, or breathe, albeit with difficulty. If the child cannot make any sounds or is struggling to breathe, immediate intervention is needed. This assessment is crucial in determining the appropriate course of action.


Call for Help

If you are alone with the choking child, call for help before proceeding with any maneuvers. If someone else is present, instruct them to call emergency services while you assist the child. Remember, every second counts in a choking emergency, and having someone on the line with professional medical expertise provides guidance and reassurance.



Proper positioning plays a significant role in the effectiveness of your intervention. The child's posture impacts the force with which you dislodge the obstructing object:

  • Position the child in an upright manner while standing or kneeling behind them.
  • Ensure the child's head is slightly tilted downward to allow gravity to aid in dislodging the obstructing object.
  • This positioning optimizes the mechanics of the rescue maneuver and increases the likelihood of successful intervention.


Administer Abdominal Thrusts For Children Over 1 Year

For children over 1 year of age, the abdominal thrusts, commonly known as the Heimlich maneuver, are the primary technique to remove the obstruction. Follow these steps carefully:

  1. Assess the Situation: If you notice a toddler choking and unable to breathe, act quickly.
  2. Position Yourself: Kneel or stand behind the child, ensuring they are facing away from you.
  3. Wrap Your Arms: Wrap your arms around the toddler's waist, positioning them just below the child's shoulder blades.
  4. Locate the Navel: Find the child's navel (belly button) using your thumb side.
  5. Make a Fist: Make a fist with the thumb side of your hand against the child's abdomen, just above the navel.
  6. Perform Quick Abdominal Thrusts: Using the heel of your hand, push inward and upward with quick, forceful movements.
  7. Repeat If Necessary: Continue with abdominal thrusts until the object is expelled or the child becomes unconscious.

Remember, the Heimlich maneuver is performed to dislodge an object blocking the child's throat, potentially saving their life. If the child makes a high-pitched sound or shows signs of choking, act promptly and perform the maneuver to clear the airway.


Continue Until Successful or Unresponsive

Repeat abdominal thrusts until the object is dislodged or if the child becomes unconscious. If the child loses consciousness, lay the child face down on your forearm, supporting their head and neck and start cardiopulmonary resuscitation (CPR) with chest compressions and rescue breaths. Be prepared to shift to CPR if the situation warrants it, as maintaining oxygen flow to the brain is critical.


Checking the Airway

After performing each abdominal thrust, check the child's mouth to see if the obstruction has been removed. If you see the foreign object, carefully try to remove it using your fingers. Be cautious not to push the object further down. This step helps prevent inadvertently lodging the object deeper into the airway.


Repeat Steps

Continue alternating between abdominal thrusts and checking the airway until the object is successfully removed or medical professionals arrive. This cycle maximizes your chances of success while preventing panic or confusion. Stay composed and follow the steps diligently.

Monitor the Child

Even if the object is successfully dislodged, closely monitor the child's breathing and overall condition. Seek medical attention to ensure there are no residual issues. The effects of a choking incident linger, and professional assessment is essential to rule out any potential complications. Your prompt action and ongoing vigilance contribute to the child's well-being.


Signs and Symptoms of a Choking Child

Recognizing the signs of a choking child is crucial for prompt action. Symptoms include:

  • Inability to breathe or difficulty breathing
  • Ineffective coughing
  • Panicked gestures
  • Clutching the throat
  • Bluish skin color (cyanosis)

Understanding Child Development Stages

When it comes to performing Basic Life Support on a choking child, the approach must be tailored to the child's age and developmental stage. Infants, toddlers, and preschoolers have distinct physical and developmental differences that directly impact the effectiveness of BLS techniques. Understanding these differences is essential to providing appropriate and timely assistance in a choking emergency.


Infants have smaller airways and narrower throats than older children and adults. Their tongue takes up a larger proportion of the oral cavity. The trachea (windpipe) is softer and more flexible, making it more susceptible to collapse when obstructed.

Infants explore the world around them by using their mouths as a sensory tool. Their innate curiosity leads them to put various objects in their mouths, which inadvertently leads to choking hazards. 


Impact on BLS Techniques:

  • Abdominal thrusts is not effective for infants due to their underdeveloped abdominal muscles and the risk of causing harm.
  • Back blows and chest thrusts are preferred for infants to dislodge an obstruction.
  • Techniques must be gentle yet forceful to avoid injuring the delicate structures of the airway.
  • Careful positioning and support are critical to ensure the infant's head and neck are aligned properly during interventions.



Toddlers have a larger airway and more developed oral cavity compared to infants. Their trachea is less flexible but still relatively soft compared to adults. Their teeth are erupting, affecting oral space and alignment.

At this age, toddlers are more mobile and have improved gross and fine motor skills. They chew and grind food, but their swallowing reflex is still developing. Their fascination with objects of all shapes and sizes often leads to them investigating items by tasting or mouthing them. Supervision becomes crucial to prevent them from accessing small items or foods that could become lodged in their airways.


Impact on BLS Techniques:

  • Abdominal thrusts become more effective due to the development of abdominal muscles.
  • Techniques such as back blows and chest thrusts still be suitable for toddlers.
  • Care must be taken not to push an obstruction deeper with excessive force.


Pre-schoolers' airways and throats continue to grow in size. Their trachea becomes more rigid and less prone to collapse. Oral cavity and teeth development progress.

Pre-schoolers have improved motor skills, including more refined hand-eye coordination. They chew, grind, and manage a wider range of foods. Their developing independence leads them to rush through meals, attempting to swallow larger bites than they manage.


Impact on BLS Techniques:

  • Abdominal thrusts become more reliable due to improved muscle development.
  • Techniques like back blows and chest thrusts still be effective.
  • Pre-schoolers responds better to verbal instructions and calming reassurance during interventions.

Get CPR Certified in Minutes for as low as $19.95

Join thousands of professionals that have been certified online with us
100% Online Certification
Fast & Convenient
Instant Certification Card
Nationally Accepted
Get Started
5 star
from 259,205 reviews


Tailored for the community and workplace
Offer Expires:
Comprehensive CPR Training Across All Ages
Choking response training
Recovery position technique course

Importance of Basic Life Support (BLS) for Child Choking

Basic Life Support is a crucial intervention in saving a choking child's life. Swift and accurate BLS techniques quickly remove obstructing objects, restore normal breathing, prevent oxygen deprivation, and avoid complications.

Delayed or inadequate BLS, on the other hand, leads to oxygen deprivation, brain injury, cardiac arrest, and even fatal outcomes. Recognizing the importance of prompt BLS and understanding potential outcomes emphasizes the need for proper training and preparedness to respond effectively to choking emergencies involving children.


Preventing Choking Incidents

The World Health Organization (WHO) highlighted that choking on food and small objects is among the top 10 causes of injury and death for children under the age of 5. Here are practical tips to minimize choking hazards and keep common objects out of reach:

  1. Keep small objects like buttons, coins, marbles, and small toys out of reach. Regularly scan the floor, furniture, and play areas to ensure no small items are left behind.
  2. Select toys that are suitable for the child's age and do not have detachable small parts. Follow age recommendations on toy packaging.
  3. Cut food into small, manageable pieces, especially for infants and toddlers. Avoid giving children foods that are hard, round, or easily break into small parts.
  4. Keep balloons and deflated or torn plastic bags away from children. Discard them properly. Supervise children while playing with balloons, and ensure they don't put them in their mouths.
  5. Keep devices with button batteries securely closed and out of reach. If a device requires a button battery, ensure it's child-resistant and locked.
  6. Store jewelry, hair accessories, and small adornments in a secure location. Avoid using or wearing these items around infants and young children.
  7. Use age-appropriate art supplies and avoid materials that are easily swallowed, like small beads or buttons.
  8. Store medications in child-resistant containers and keep them out of children's reach. Never take medications in front of children, as they mimic the behavior.
  9. Empty pockets and bags when children are around to prevent them from accessing coins, keys, or other small objects.
  10. Use a small parts tester or a toilet paper roll to assess whether an object poses a choking risk. If it fits inside the tester or roll, it's a hazard.
  11. Inform babysitters, family members, and caregivers about choking hazards and safety measures.
  12. Regularly inspect the environment for potential choking hazards, especially as children grow and explore more areas.


How choking in children be prevented?

Choking in children is prevented by supervising them during meals and snacks, encouraging them to sit upright while eating, cutting food into small, manageable pieces, and avoiding giving young children hard, round, or slippery foods like whole grapes, nuts, popcorn, or chunks of raw vegetables. Additionally, keeping small objects and toys out of reach of young children helps prevent choking incidents.

Performing BLS on a Child Who Becomes Unresponsive

When a choking child goes from being awake and responsive to not responding, it's a serious point that needs quick action to keep the child safe. If the child becomes unresponsive, place them on a firm surface and initiate CPR:

  • Lay the Child Down: Place them on their back with their head lower than their body.
  • Begin CPR: If unresponsive, start chest compressions (pushes on the chest) to help remove the obstruction and get air into their lungs.
  • Check Airway: After each set of chest compressions, check if you see and remove the object if it's visible in the mouth.
  • Keep Alternating: Do 30 chest compressions, check the airway, and repeat until the object is out, they start breathing, or help arrives.
  • If They Breathe: If they start breathing, lay them on their side, monitor their breathing, and wait for help.


Choking Maneuvers for Special Circumstances

Adapting techniques for specific situations, such as assisting a choking child with disabilities, requires a thoughtful and individualized approach. Children with disabilities have unique physical, sensory, or cognitive challenges that influence their response to choking and the effectiveness of certain interventions. Here's how to adapt techniques in such situations:

  • Communication: Use communication methods that the child is comfortable with. This could include gestures, facial expressions, or assistive communication devices. If the child is nonverbal, pay close attention to signs of distress like changes in facial color, breathing patterns, or body language.
  • Gentle Techniques: Be cautious with forceful abdominal thrusts or chest compressions, especially if the child has fragile bones or is susceptible to injury. Opt for gentle back blows or modified chest thrusts that are appropriate for the child's physical condition.
  • Positioning: Ensure the child is in a comfortable and safe position that supports their disabilities. Adjust the positioning as needed to aid in dislodging the obstruction.
  • Assistive Devices: If the child uses medical devices, braces, or assistive equipment, carefully work around them during interventions. Remove or adjust devices if they hinder effective assistance.

What are the risks of improper intervention when a child is choking?

Improper intervention during a choking incident leads to further blockage of the airway or injury to the child. Techniques like back blows or abdominal thrusts should be performed correctly to avoid harm.

How can caregivers be prepared to handle a choking incident?

Caregivers can be prepared to handle a choking incident by taking a CPR and first aid training course that includes choking rescue techniques. They should familiarize themselves with the Heimlich maneuver for children and infants.

What should you do if a child begins to choke while lying down or sleeping?

If a child begins to choke while lying down or sleeping, caregivers should immediately call for emergency medical assistance and perform appropriate first aid techniques like the Heimlich maneuver. It's important to carefully move the child into a position that allows for effective intervention while being mindful of any potential spinal injuries.

How do allergies contribute to choking risks, and how they are managed?

Allergies contributes to choking risks if a child ingests an allergen that causes throat swelling or constriction. Caregivers should be aware of a child's allergies and take precautions to prevent exposure to allergens. In case of an allergic reaction, prompt administration of medication such as an epinephrine auto-injector (e.g., EpiPen) and seeking immediate medical attention is crucial.

What role do toys and small household items play in choking, and how the risks be minimized?

Toys with small parts or household items like coins, buttons, or batteries pose choking hazards to children. Risks are minimized by selecting age-appropriate toys and ensuring small items are kept out of reach. Regularly inspecting toys and household items for potential hazards and providing appropriate supervision during playtime are important measures.

How schools and childcare centers prepare for and prevent choking incidents among children?

Schools and childcare centers prepares for and prevent choking incidents among children by having staff trained in CPR and first aid, conducting regular safety assessments of their environment and equipment, and implementing protocols for preventing and responding to choking incidents. They should ensure that age-appropriate foods are served, and children are supervised during meal and snack times.

What are the legal implications and responsibilities of caregivers and institutions if a child chokes under their supervision?

Caregivers and institutions are held legally responsible for negligence if a child chokes under their supervision. They have a duty to provide a safe environment and appropriate supervision to prevent accidents. This includes implementing safety protocols, providing proper training to staff, and ensuring that choking hazards are minimized.

How technology or products help in preventing or addressing choking in children?

Technology and products helps prevent or address choking in children by providing childproof packaging, designing food cutters specifically for children, producing age-appropriate toys with safety features, and offering clear labeling and warnings for choking hazards. Additionally, advancements in medical technology leads to improved devices for addressing choking incidents, such as automated external defibrillators (AEDs) that provide instructions for CPR.

Seeking Medical Help and Emergency Contacts

Seeking medical attention after successful BLS for a choking child is crucial due to potential hidden risks and complications, such as internal injuries, swelling, delayed symptoms, and hidden obstructions. While not every successful BLS intervention requires immediate emergency services, scenarios like unsuccessful BLS, breathing problems, cyanosis, vomiting, behavior changes, and persistent symptoms warrant calling for professional help. Prioritizing the child's safety and well-being and consulting healthcare professionals ensure comprehensive care and prevent potential complications.


Emotional Aspects and Staying Calm

When faced with a choking child, staying composed is essential for an effective response. Remember, your calmness and focus directly impact the child's safety. Take a deep breath to steady yourself and quickly assess the situation. Recognize that your immediate action makes a critical difference. Stay present in the moment, focusing on the steps you need to take. Prioritize your actions and follow the appropriate BLS techniques. Trust your instincts and training. While the situation is undoubtedly stressful, maintaining composure helps you think clearly and act swiftly, giving the child the best chance for a positive outcome.


Having a clear understanding of child choking and being trained in Basic Life Support make a significant difference in preventing tragic outcomes. By following the outlined steps, recognizing the signs, understanding developmental stages, and maintaining composure, caregivers are better prepared to respond promptly and effectively in the event of a child choking emergency.