🚑 Gagging vs Choking
Stick it on the fridge. The one every babysitter should read.
| Sign | Gagging (normal, let them work) | Choking (emergency, act now) |
|---|---|---|
| Sound | Loud: coughing, sputtering, retching noises | Silent, or a high squeak. Little or no air moving |
| Look | Red face, tongue pushed forward or out | Panicked, then limp. Lips, gums, or skin may turn blue |
| What it means | A protective reflex pushing food back to the front | The airway is blocked. Air cannot get in or out |
| What to do | Stay calm, stay close, let them bring it forward. Do not reach into the mouth | Start the steps below and call 911 right away |
- Shout for help. Someone else calls 911 while you start. Alone? Start now, and call 911 if baby is still choking after one round.
- 5 back blows. Lay baby face-down along your forearm, head lower than chest, and give up to five firm blows between the shoulder blades with the heel of your hand.
- 5 chest thrusts. Turn baby face-up, head still lower than chest, and give up to five quick thrusts with the heel of one hand on the middle of the breastbone, just below the nipples.
- Alternate 5 and 5 until the object comes out or help arrives. Only take out food you can clearly see; never sweep a finger blindly.
- If baby stops responding, start infant CPR. Alone? Call 911 after 2 minutes of CPR.
- Never use abdominal thrusts (the Heimlich) on a baby under 1.
Learned two fingers in a class? Same spot, same count. The 2025 AHA and AAP guidelines switched to the heel of one hand because two fingers often doesn’t press hard enough.
This chart is a reminder, not a substitute for a hands-on infant CPR and choking class, which every caregiver should take. General information, not medical advice. In an emergency, always call 911.
Sources: MedlinePlus (NIH) (medlineplus.gov): Choking, infant under 1 year; American Academy of Pediatrics (healthychildren.org): AHA and AAP update CPR guidelines (2025), Choking Prevention for Babies and Children; NHS (nhs.uk): Choking and gagging on food; British Red Cross (redcross.org.uk): First aid for a baby who is choking.