If your child puts something in her mouth like a piece of candy, seed, or grape and it gets lodged in her throat, follow these steps:

If she is coughing noisily and is able to speak or make sounds

• Stay by her side and watch her. Do not interfere as long as she is coughing noisily. This means she is trying to dislodge the object herself.
• If you are worried about her breathing, call 9-1-1.

If your child cannot breathe, is coughing but not making any noise, or cannot speak or make sounds

• Call for help and ask someone to call 9-1-1.
• Begin first aid choking technique appropriate for your child’s age. The technique is different for babies under age one than it is for children over the age of 1.

Baby under the age of 1 who is choking

1. Quickly lay her face down over your forearm. Use your thigh for support. Make sure her head is lower than her body. Hold her head and jaw in one hand.
2. With the palm of your other hand, give up to 5 forceful blows between her shoulder blades.

If the object is not expelled

3. Turn her over onto her back. Continue to hold her head and keep it lower than the rest of her body.
4. Place two fingers in the middle of her chest, just below an imaginary line between the nipples. Give 5 quick, forceful thrusts. Compress the chest at least 4 cm (1.5 in.), avoiding the tip of the sternum.
5. Continue giving 5 forceful back blows followed by 5 chest thrusts, and repeat until your child is breathing, coughing, or crying, or until she loses consciousness.

If a choking baby under the age of 1 loses consciousness

1. Lay the infant face up on a hard, flat surface (e.g., a table).
2. Gently tap her foot and yell her name. If she does not react, she is unconscious.
3. Call for help and ask someone to call 9-1-1.
4. Check her breathing: if your unconscious baby is not breathing, follow the steps below.
5. Give 30 chest compressions:
   • Place two fingers in the middle of her chest, just below the imaginary line between the nipples. Avoid touching the tip of the sternum.
   • Push down the chest 30 times. Push hard and fast. Push straight down about 4 cm (1.5 in.) at a frequency of at least 100 times per minute. Let the chest return to its normal position after each push.
6. Open the airways and remove the object from her mouth if you can:
   • To open the airways, place one hand on her forehead to tilt her head back slightly and use two fingers to lift her chin.
   • Look in her mouth. If you see something that you can remove easily, take it out. Do not try a blind finger sweep (try to remove something you can’t see) because you could push it in further.
7. If she is still not breathing, give 2 breaths:
   • Keeping her airways open, take a breath, cover her mouth and nose with your mouth, and give 2 breaths (one second per breath). Your baby’s chest should rise with each breath.
8. Repeat series of 30 compressions and 2 breaths, checking to see if you can remove the object from her mouth after each series of compressions.
9. After two minutes or 5 series of 30 compressions and 2 breaths, call 9-1-1 if no one has done so already.
10. Repeat steps 5 through 7 until your baby regains consciousness or the ambulance arrives.

Child age 1 or older who is choking

1. Kneel down behind the child and wrap your arms around her waist.
2. Make a fist with one hand and put the thumb side against your child’s abdomen, just above her belly button.
3. Grasp your fist with your other hand and give quick inward and upward thrusts into your child’s abdomen.
4. Repeat the abdominal thrusts (Heimlich manoeuvre) until the object is expelled and your child can breathe, cough, or speak, or until she loses consciousness.

If a choking child age 1 or older loses consciousness

1. Lay her face up on a hard surface.
2. Give her a gentle tap and yell her name. If she does not react, she is unconscious.
3. Call for help and ask someone to call 9-1-1.
4. Check her breathing. If your unconscious child is not breathing, follow the steps below.
5. Give 30 chest compressions:
   • Place the palm of one or both of your hands (one over the other) in the middle of your child’s chest, over the lower half of her sternum.
   • Push down the chest 30 times. Push hard and fast. Push straight down forcefully and quickly about 5 cm (2 in.) at a frequency of at least 100 times per minute. Let the chest return to its normal position after each compression.
6. Open the airways and remove the object from her mouth if you can:
   • To open the airways, place one hand on her forehead to tilt her head back slightly and use two fingers to lift her chin.
   • Look in her mouth. If you see something that you can remove easily, take it out. Do not try a blind finger sweep (try to remove something you can’t see) because you could push it in further.
7. Give 2 breaths:
   • Keeping the airways open, pinch your child’s nose closed.
   • Take a breath, cover her mouth with your mouth, and give 2 breaths (one second per breath). Your child’s chest should rise with each breath.
8. Repeat series of 30 compressions and 2 breaths, checking to see if you can remove the object from her mouth after each series of compressions.
9. After two minutes or 5 series of 30 compressions and 2 breaths, call 9-1-1 if no one has done so already.
10. Repeat steps 5 through 7 until your child regains consciousness or the ambulance arrives.

Sternum: Flat bone in the middle of the chest.