First Aid for Infants and Children: CPR and Choking

It's a moment no parent ever wants to face. Your child suddenly isn't breathing. Or something has lodged in their throat and they can't cough it out. In those seconds, what you do can make the difference between life and death.

Fortunately, first aid for children is something anyone can learn. You don't need to be a healthcare professional to save your child's life. Here is a step-by-step guide to CPR and choking response — based on current guidelines from the American Red Cross and the American Heart Association (AHA).

Emergency Numbers to Know

Before the techniques — memorize these numbers:

CPR for Infants Under 1 Year

If your baby is unconscious and not breathing normally, begin CPR immediately.

Step 1: Check for Response and Breathing

1. Stimulate gently — tap the bottom of your baby's foot, speak loudly. Never shake an infant.
2. Call for help — ask someone to call 911. If you're alone, use speakerphone.
3. Check breathing — lay your baby on their back. Keep the head in a neutral position (do not tilt back as far as you would with an adult). Gently lift the chin. Look, listen, and feel for breathing for no more than 10 seconds.

Step 2: Give 5 Rescue Breaths

If your baby is not breathing normally:

1. Keep the head in neutral position with the chin lifted
2. Cover both your baby's mouth AND nose with your mouth
3. Blow gently — a small, calm puff of air over about 1 second
4. Watch for the chest to rise
5. Release and repeat — a total of 5 rescue breaths

Step 3: Chest Compressions

If your baby is still not breathing after the rescue breaths:

1. Place two thumbs in the center of the chest — just below the nipple line
2. Wrap both hands around the baby's chest for support
3. Press down about 1/3 of the chest depth — firm but controlled
4. Speed: 100–120 compressions per minute (think of the rhythm of "Stayin' Alive")
5. Allow the chest to fully recoil between each compression

Step 4: Continue 30:2

Alternate between 30 chest compressions and 2 rescue breaths (30:2). Continue without stopping until:

• Your baby begins to breathe on their own
• Emergency responders take over
• You are too exhausted to continue (switch with another person if possible)

CPR for Children Ages 1–8

For older children, the technique is slightly different:

Differences from Infant CPR

• Head position: Tilt the head back slightly (not neutral as with infants)
• Rescue breaths: Cover only the mouth, pinch the nose closed. Blow gently.
• Chest compressions: Use one hand placed in the center of the chest. Press down 1/3 of the chest depth.
• Same overall pattern: 5 rescue breaths first, then 30:2

For children from puberty onward, adult CPR technique with two hands is used.

Choking: When Something Is Stuck in Your Baby's Throat

Choking is one of the most common emergencies involving infants and young children. Pieces of food, small toys, or other objects can lodge in the airway.

Signs of Choking

• Sudden coughing or gasping
• No sound — the child tries to cry or cough but cannot
• Bluish color in the face
• Child grabs at their throat (older children)

Choking in Infants Under 1 Year

If your baby is coughing effectively: Let them cough. Don't interfere. Effective coughing is the body's best mechanism for clearing an obstruction.

If your baby cannot cough:

1. Lay your baby face down on your forearm — head lower than body, support the chin
2. Give 5 firm back blows between the shoulder blades with the heel of your hand
3. Turn your baby face up on your other forearm
4. Give 5 chest thrusts — same position and technique as CPR compressions
5. Check the mouth — look to see if the object has been dislodged (only remove if clearly visible; never do a blind finger sweep)
6. Repeat: 5 back blows + 5 chest thrusts

Call 911 if the object does not come free.

Choking in Children Over 1 Year

1. Lean the child forward and give 5 back blows between the shoulder blades
2. If that doesn't work: stand behind the child, place a fist between the navel and the breastbone
3. Give 5 quick abdominal thrusts inward and upward (Heimlich maneuver)
4. Alternate: 5 back blows + 5 abdominal thrusts
5. Call 911 if the object doesn't come free

If the child becomes unconscious: Begin CPR with 5 rescue breaths. Look into the mouth for the object before each breath.

Prevention: How to Avoid Emergencies

The best first aid is the kind you never need. Here are the most common risks and how to prevent them:

Choking Hazards

• Cut food into appropriate pieces — grapes, hot dogs, and cherry tomatoes should be halved or quartered lengthwise
• Avoid whole nuts, popcorn, raw carrots, and hard candy for children under 3–4 years
• Remove small objects from your baby's reach (buttons, coins, batteries, small toy parts)
• Stay present during meals — never leave a young child to eat alone

Falls

• Never step away from your baby on a changing table
• Use safety gates at the top and bottom of stairs
• Anchor heavy furniture to the wall

Burns

• Never hold hot drinks while holding your baby
• Test bath water with your elbow (should be around 98–100°F/37–38°C)
• Keep your baby away from the stove and oven

Drowning

• A child can drown in just a few centimeters of water
• Always stay within arm's reach near water
• Empty buckets, inflatable pools, and bathtubs after use

Home First Aid Kit Checklist

Keep these items easily accessible:

• Assorted adhesive bandages
• Sterile gauze pads
• Bandage rolls
• Medical scissors and tweezers
• Digital thermometer
• Saline nasal drops
• Infant/child acetaminophen or ibuprofen (check with your pediatrician for correct dosing)
• Poison Control number: 1-800-222-1222

Frequently Asked Questions

How many chest compressions per minute for child CPR?

100–120 compressions per minute, regardless of age. The ratio is 30 compressions followed by 2 rescue breaths (30:2).

Can I hurt my baby with CPR?

In a cardiac arrest, without treatment, the baby will die. The risk of injury from CPR is very low compared to the consequences of doing nothing. Always attempt CPR if your baby is unconscious and not breathing.

When should I call 911?

Call 911 for unconsciousness, stopped breathing, serious choking that doesn't resolve, severe bleeding, seizures, or a severe allergic reaction. If in doubt — call. It is always better to call once too many times than once too few.

Should both parents take a first aid course?

Yes. Everyone who cares for children should know basic first aid — parents, grandparents, babysitters, and childcare workers.

Summary

Knowing first aid can save your child's life. The key points:

1. Call 911 in life-threatening situations — the dispatcher will guide you
2. Infant CPR: 5 rescue breaths, then 30 chest compressions + 2 rescue breaths (30:2)
3. Infant choking: 5 back blows + 5 chest thrusts, never abdominal thrusts
4. Prevention is most important — cut food properly, remove small objects, supervise meals

Read More

• First Week Home with a Newborn
• Fever in Children — When to Call the Doctor
• Baby's Immune System Guide

Sources

1. American Heart Association — CPR Guidelines
2. American Red Cross — Infant and Child First Aid
3. AAP — Choking Prevention and First Aid