The following instructions are for babies younger than 12 months old.
Choking
• Step 1: Assess the situation quickly.
If your baby is suddenly unable to cry or cough, something may be blocking her airway, and you'll need to help her get it out. She may make odd noises or no sound at all while opening her mouth, and her skin may turn bright red or blue.
If she's coughing or gagging, her airway is only partially blocked. In this case, let her 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 her 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, like croup.
Also call 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 her airway on her own and you believe something is trapped there, carefully position her facedown on your forearm with your hand supporting her head and neck. Rest the arm holding your baby on your thigh.
Support your baby so that her head is lower than the rest of her body. Then, using the heel of your hand, give her five firm and distinct back blows between her 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 her spine. Carefully turn her over while supporting her head and neck. Support your baby faceup with your forearm resting on your thigh, still keeping her head lower than the rest of her 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 her try to cough up the object.
If your baby becomes unconscious at any time, she'll need modified CPR (see full instructions below).
Give her two rescue breaths. If the air doesn't go in (you don't see her chest rise), retilt her head and try two rescue breaths again.
If her chest still doesn't rise, give her 30 chest compressions. Look in her mouth and remove the object if you see it. Give her two more rescue breaths, repeat the chest compressions, and so on, until help arrives.
How to Give CPR
What is CPR?
CPR stands for cardiopulmonary resuscitation. This is the lifesaving measure you can take to save your baby if she shows no signs of life (breathing or movement).
CPR uses chest compressions and rescue breaths to circulate blood that contains oxygen to the brain and other vital organs until emergency medical personnel arrive. Keeping oxygenated blood circulating can help prevent brain damage — which can occur within a few minutes — and death.
Giving CPR isn't hard to do. Follow these steps:
• Step 1: Check your baby's condition.
Is your baby conscious? Flick her foot or gently tap on her shoulder and call out. If she doesn't respond, have someone call 911 or the local emergency number. (If you're alone with your baby, give two minutes of care as described below, then call 911 yourself.)
Swiftly but gently place your baby on her back on a firm surface.
Make sure she isn't bleeding severely. If she is, take measures to stop the bleeding by applying pressure to the area. Do not administer CPR until the bleeding is under control.
• Step 2: Open your baby's airway. Tilt your baby's head back with one hand and lift her chin slightly with the other. (You don't need to tilt an infant's head back very far to open her airway.)
Check for signs of life (movement and breathing) for no more than ten seconds.
To check for your baby's breath, put your head down next to her mouth, looking toward her feet. Look to see whether her chest is rising and listen for breathing sounds. If she's breathing, you should be able to feel her breath on your cheek.
• Step 3: Give her two gentle breaths.
If your baby isn't breathing, give her two little breaths, each lasting just one second. Cover your baby's nose and mouth with your mouth and gently exhale into her lungs only until you see her chest rise.
Remember that a baby's lungs are much smaller than yours, so it takes much less than a full breath to fill them. Breathing too hard or too fast can force air into the infant's stomach or damage her lungs.
If her chest doesn't rise, her airway is blocked. Give her first aid for choking, above.
If the breaths go in, give your baby two breaths in a row, pausing between rescue breaths to let the air flow back out.
• Step 4: Give her 30 chest compressions.
With your baby still lying on her back, place the pads of two or three fingers just below an imaginary line running between your baby's nipples.With the pads of these fingers on that spot, compress the chest 1/2 inch to 1 inch. Push straight down. Compressions should be smooth, not jerky.
Give her 30 chest compressions at the rate of 100 per minute. When you complete 30 compressions, give two rescue breaths (step 3, above).
• Step 5: Repeat compressions and breaths.
Repeat the cycle of 30 compressions and two breaths. If you're alone with your baby, call 911 or the local emergency number after two minutes of care. Continue the cycle of compressions and breaths until help arrives.Even if your baby seems fine by the time help arrives, you'll want to have her checked by a doctor to make sure that her airway is completely clear and that she hasn't sustained any internal injuries.
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