When helping a choking child you should give a series of five back blows followed by five abdominal thrusts (Heimlich maneuver), alternating until the object is dislodged or the child becomes unconscious. This sequence is recommended by leading safety organizations for children age 1 year and older. Acting quickly and correctly can save a life while waiting for emergency medical help.
Choking occurs when a foreign object blocks the airway, preventing oxygen from reaching the lungs. For elementary-aged children, common choking hazards include food items like hot dogs, grapes, and hard candy, as well as small toys or coins. Recognizing the signs of choking—such as inability to cough, speak, or breathe—is the first critical step.
Immediate steps for a choking child
If a child is choking and cannot cough, cry, or breathe, call 911 immediately. Then begin the following steps while help is on the way. Do not perform these actions if the child can cough forcefully—encourage them to keep coughing instead.
Administer back blows
Stand or kneel behind the child and place one arm across their chest for support. Lean the child forward so they are parallel to the ground. Use the heel of your other hand to deliver five firm back blows between the shoulder blades.
Check the child’s mouth after each set of blows. If you see the object, remove it carefully with your fingers. Never perform a blind finger sweep, as this can push the object deeper into the airway.
Perform abdominal thrusts
If back blows do not work, move to abdominal thrusts. Stand behind the child, make a fist with one hand, and place the thumb side just above the navel. Grasp your fist with the other hand and give five quick inward and upward thrusts.
Alternate between five back blows and five abdominal thrusts until the object comes out or the child becomes unresponsive. Each cycle should be smooth and controlled. Avoid excessive force, especially with smaller children.
When to modify the technique for younger children
For children under 1 year old, the procedure is different. Instead of abdominal thrusts, use chest thrusts. Place the infant face-down on your forearm, support the head, and give five back blows. Then turn the infant face-up and give five chest thrusts using two fingers on the lower breastbone.
For children between 1 and 8 years old, the standard back blows and abdominal thrusts apply. However, adjust your force based on the child’s size. A smaller child may require gentler thrusts to avoid internal injury.
| Age Group | Technique | Key Points |
|---|---|---|
| Under 1 year | Back blows + chest thrusts | Use forearm support; no abdominal thrusts |
| 1 to 8 years | Back blows + abdominal thrusts | Adjust force to child’s size |
| 8 years and older | Heimlich maneuver (abdominal thrusts) | Same as adult technique |
What to do if the child becomes unconscious
If the choking child becomes unresponsive, lower them gently to the ground. Call 911 if you haven’t already. Begin CPR starting with chest compressions. After each set of 30 compressions, open the mouth and look for the object.
If you see the object, remove it. Then give two rescue breaths. Continue the cycle of 30 compressions and two breaths until help arrives or the child starts breathing. Do not stop to check for a pulse unless you are trained to do so.
Common mistakes to avoid
- Performing the Heimlich maneuver on a child who can still cough or speak—this can worsen the blockage.
- Using blind finger sweeps to remove an object—this can push it deeper into the airway.
- Slapping the child’s back while they are upright—this can lodge the object further down.
- Delaying the call to 911—always call for emergency help immediately if the child is choking and cannot clear the object on their own.
Prevention tips for parents and teachers
Supervise children during meals and snack times. Cut food into small, manageable pieces, especially round or hard items like grapes, cherry tomatoes, and hot dogs. Teach children to chew thoroughly and avoid talking or laughing with food in their mouths.
Keep small toys, coins, and other choking hazards out of reach of younger children. Regularly inspect play areas for items that could fit through a toilet paper roll—a common measure for choke risk. Encourage children to sit while eating and avoid running or playing with food.
Practice and training
Take a certified first aid and CPR course to build confidence in your skills. Many community centers and schools offer classes for parents and educators. Refresher courses every two years help you stay current with updated guidelines.
Practice the steps on a mannequin if possible. Muscle memory can make a difference in a real emergency. Share what you learn with other caregivers, including babysitters and grandparents.
In summary, when helping a choking child you should give five back blows followed by five abdominal thrusts, repeating the cycle until the object is removed or the child becomes unconscious. Always call 911 immediately and avoid common mistakes like blind finger sweeps. With prompt action and proper technique, you can significantly increase the child’s chance of a positive outcome.
Frequently Asked Questions
What should I give when helping a choking child?
You should give five back blows followed by five abdominal thrusts, alternating until the object is dislodged or the child becomes unconscious.
Can I give water to a choking child?
No, do not give water or any liquid to a choking child, as it can make the blockage worse and cause aspiration into the lungs.
What if the choking child is under 1 year old?
For infants under 1 year, give five back blows on the back and then five chest thrusts using two fingers, not abdominal thrusts.
When should I call 911 for a choking child?
Call 911 immediately if the child cannot cough, speak, or breathe, or if the object does not come out after your first attempts.
Do I need training to help a choking child?
While you can help without formal training, taking a certified first aid and CPR course is strongly recommended to learn proper technique and build confidence.
