Step 1: Assess the situation quickly.
If your baby is suddenly unable to cry or cough, something may be blocking their airway, and you'll need to help your baby get it out. She may make odd noises or no sound at all while opening their mouth, and your baby’s skin may turn bright red or blue.
If your baby is coughing or gagging, the airway is only partially blocked. In this case, let the baby continue to cough. Coughing is the most effective way to dislodge a blockage.
If your baby isn't able to cough up the object, ask someone to call 911 or the local emergency number while you begin back blows and chest thrusts (see step 2, below).
If you're alone with your baby, give two minutes of care, then call 911.
On the other hand, if you suspect that your baby's airway is closed off because the throat has swollen shut, call 911 immediately. Your baby may be having an allergic reaction to something she ate or to an insect bite, for example — or she may have an infection.
Also, call 911 right away if your baby is at high risk for heart problems.
Step 2: Try to dislodge the object with back blows and chest thrusts.
If your baby can't clear their airway on their own and you believe something is trapped there, carefully position your baby facedown on your forearm with your hand supporting the head and neck. Rest the arm holding your baby on your thigh.
Support your baby so that the head is lower than the rest of the body. Then, using the heel of your hand, give the baby five firm and distinct back blows between the shoulder blades to try to dislodge the object.
Next, place your free hand (the one that had been delivering the back blows) on the back of your baby's head with your arm along the spine. Carefully turn your baby over while supporting the head and neck. Support your baby faceup with your forearm resting on your thigh, still keeping the head lower than the rest of the body.
Place the pads of two or three fingers just below an imaginary line running between your baby's nipples. To give a chest thrust, push straight down on the chest 1/2 inch to 1 inch, then allow the chest to come back to its normal position.
Give five chest thrusts. The chest thrusts should be smooth, not jerky.
Continue the sequence of five back blows and five chest thrusts until the object is forced out or your baby starts to cough. If she's coughing, let your baby try to cough up the object.
If your baby becomes unconscious at any time, they will need modified CPR (see full instructions below).
Give your baby two rescue breaths. If the air doesn't go in (you don't see the chest rise), retilt the head and try two rescue breaths again.
If your baby’s chest still doesn't rise, give 30 chest compressions. Look in the mouth and remove the object if you see it. Give two more rescue breaths, repeat the chest compressions, and so on, until help arrives.
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