Choking: Infants, Children, Adults
In 15 minutes you'll know how to help someone who's choking, and why babies need a different technique.
Print this course — or save it as a PDF from the print dialog. Good for a fridge, a glovebox, or a waiting room.
Why this matters
Choking blocks the airway completely, and without oxygen a person can lose consciousness within minutes. It can happen mid-bite at a family dinner or mid-bounce with a toy in a toddler's mouth, and the person choking usually cannot call for help — they cannot make a sound. What you do in the next few seconds, before anyone dials 911, is what clears it.
Know the signs
The universal sign of choking
Someone who is truly choking grabs at their throat with one or both hands. That is the universal signal, and it crosses every age and language.
Ask them: "Are you choking?" If they cannot answer, cannot cough, and cannot breathe, act immediately. A person who can still cough forcefully or speak, even a little, is not yet at the emergency stage — the next section covers what to do for them.
Let a strong cough do the work
If the person can cough forcefully, cry, or speak, their airway is not fully blocked. Encourage them to keep coughing — a strong cough moves more air than anything you can do from the outside. Stay close, stay calm, and do not slap their back or reach into their mouth while they can still cough.
Step in only if the cough goes silent, gets weaker, or they cannot breathe at all.
Adults and children over 1: back blows and thrusts
This course teaches the American Red Cross method for a bystander helping an adult or a child over age 1. Other organizations teach the steps in a different order — trained methods vary, so if you learned it differently, use what you know.
Stand behind the person and lean them forward. Give 5 firm back blows between the shoulder blades. If that does not clear it, give 5 abdominal thrusts: make a fist above their navel, grab it with your other hand, and pull sharply inward and upward. Alternate 5 and 5 until the object clears.
If they become unconscious, lower them to the ground, call 911 if needed, and begin CPR — compressions can also help dislodge the object.
Infants under 1 are different: never abdominal thrusts
For a baby under 1 year old, the method changes completely, and this is the most important difference in this whole course: never use abdominal thrusts on an infant. Their organs sit too close to the surface, and thrusts can injure them.
Instead: sit down and lay the baby face-down along your forearm, supporting the head and jaw, head lower than the chest. Give 5 firm back blows between the shoulder blades with the heel of your hand. Then turn the baby face-up along your other arm, still head-down, and give 5 chest thrusts with two fingers on the center of the breastbone, just below the nipple line. Repeat 5 and 5 until the object clears. If the baby becomes unconscious, call 911 and begin infant CPR.
Pregnant or large-bellied: use chest thrusts
If the person choking is pregnant, or too large around the middle for you to reach around, use chest thrusts instead of abdominal thrusts. Place your fist at the center of their breastbone and pull straight back, alternating with 5 back blows the same way you would for anyone else.
After it clears, and how to prevent it
Once the object comes out, get a medical check the same day, even if the person seems completely fine — thrusts can occasionally cause minor injury, and a piece of food can still be lodged lower down.
Most choking is preventable. Cut grapes, cherry tomatoes, and hot dogs lengthwise and into small pieces for young children. Skip whole nuts, popcorn, and hard candy for children under 4, and have everyone sit down to eat instead of running or playing with food in their mouth.
How it really looks
A grape, and a suddenly silent birthday party
Bettina is cutting cake when she notices her granddaughter, almost 2, has gone silent, both hands at her throat. No cough, no cry, nothing. Bettina kneels behind her, tips her forward, and gives 5 firm back blows between the shoulder blades. Nothing yet. She makes a fist above the little girl's navel, covers it with her other hand, and gives 5 quick abdominal thrusts. On the third one, a whole grape pops free and the toddler starts wailing, furious and breathing. Bettina calls the pediatrician's after-hours line anyway, just to be safe, and cuts grapes into quarters from then on.
Silent and standing up at Sunday dinner
Sunday dinner is loud until it suddenly isn't. Aaron looks up to see his grandfather on his feet, both hands at his throat, face reddening, making no sound. Aaron asks, "Are you choking?" and gets a frantic nod instead of an answer. He stands behind his grandfather, gives 5 sharp back blows between the shoulder blades, then wraps his arms around him for 5 abdominal thrusts, fist above the navel, pulling in and up. On the fourth thrust, a piece of steak flies out onto the tablecloth. His grandfather sits down and finally coughs out a real breath. The family still gets him checked at urgent care that evening, and cuts his meat smaller from then on.
What to do until help arrives
- Ask if they're choking. If they can cough, speak, or breathe, encourage coughing and wait.
- If they cannot cough, speak, or breathe, act immediately — do not wait or run for water.
- Adults and children over 1: give 5 back blows between the shoulder blades, then 5 abdominal thrusts. Repeat.
- Infants under 1: give 5 back blows, then 5 chest thrusts — never abdominal thrusts.
- Pregnant or large-bellied: use chest thrusts instead of abdominal thrusts.
- If they become unconscious, lower them to the floor, call 911, and begin CPR.
- Once the object clears, get them checked by a medical professional the same day.
Myths & mistakes
People often think you should only slap a choking person's back, or only do abdominal thrusts, not both.Actually the taught sequence alternates 5 back blows with 5 abdominal thrusts (or chest thrusts for infants), repeating both until it clears, not just one or the other.
People often think abdominal thrusts are safe to use on a choking baby.Actually never use abdominal thrusts on an infant under 1. Their organs sit too close to the surface. Infants get back blows and chest thrusts only.
People often think a choking person who can still cough needs back blows right away.Actually a forceful cough is doing more than you could do by hand. Encourage the coughing and step in only if it goes silent or weak.
What you learned
- Hands at the throat, no cough, no speech, no breath — that's the signal to act now.
- A strong cough is doing its job. Encourage it and step in only if it stops.
- Adults and children over 1: 5 back blows, then 5 abdominal thrusts, repeated.
- Infants under 1 get 5 back blows and 5 chest thrusts — never abdominal thrusts.
- Once it clears, get checked the same day, and cut food safely to prevent a repeat.
Sources
- American Red Cross — Choking first aid for adults, children, and infants
- American Academy of Pediatrics — Choking prevention and first aid for children
Spot an error? Tell us — accuracy matters more to us than being fast.
Common questions
Why does this course teach back blows and abdominal thrusts together instead of just one?
Different organizations teach slightly different sequences, and trained methods vary. This course follows the American Red Cross bystander method: 5 back blows, then 5 abdominal thrusts, repeated until the object clears. If you were trained differently, use the method you know — the goal is the same either way.
Why can't I use abdominal thrusts on a baby?
A baby's organs, especially the liver, sit close to the surface of a small abdomen, and abdominal thrusts can injure them. Instead, infants under 1 get 5 back blows followed by 5 chest thrusts with two fingers on the breastbone, gentler and just as effective for a baby's size.
The object came out and my child seems fine. Do we still need a doctor?
Yes, the same day. Back blows and thrusts can occasionally cause minor internal injury, and a piece of food can still be lodged lower in the airway even after the choking stops. A quick medical check confirms everything is clear and is worth the peace of mind.
Check what you know
Five questions. Four correct to pass. Retake as many times as you like — this is practice, not a test.
Keep going
This course belongs to Everyday Emergencies · Caring for Aging Parents · Protecting Young Kids. Courses that pair well with it:
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