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Choking in a Toddler (1-3 Years)

Content reviewed against published AAP, AHA, Red Cross guidelines

Editorial policy

Last reviewed:

A choking toddler who cannot cough, speak, or breathe requires immediate abdominal thrusts (Heimlich maneuver). For children over 1 year, the technique differs from infant back blows.

Immediate actions

  • Call 911 immediately
  • If child cannot cough, cry, or breathe — begin abdominal thrusts immediately
  • DO NOT: Do NOT perform blind finger sweeps — you may push the object deeper

Step-by-Step Response

1

Assess the situation

If child is coughing forcefully, let them try to clear it. If child cannot cough, speak, or breathe, or is making high-pitched sounds, proceed immediately.

2

Position yourself

Kneel or stand behind the child. Wrap your arms around their waist. For a small toddler, you may need to kneel.

3

Make a fist

Place the thumb side of your fist just above the belly button and well below the breastbone.

4

Perform abdominal thrusts

Grasp your fist with your other hand. Give quick, upward thrusts into the abdomen. Each thrust should be a distinct, forceful movement.

5

Give up to 5 thrusts

Continue giving abdominal thrusts until the object is expelled or the child can breathe, cough, or cry.

6

Check mouth

If the object becomes visible, carefully remove it. Do NOT perform blind sweeps.

7

Repeat

Continue cycles of 5 abdominal thrusts until the object is cleared, the child starts breathing, or the child becomes unresponsive.

8

If child becomes unresponsive

Lower child to the ground. Begin CPR immediately. Call 911 if not already done. After 30 compressions, look in the mouth before giving breaths.

What NOT to Do

  • ✕Do NOT perform blind finger sweeps — you may push the object deeper
  • ✕Do NOT interfere if the child is coughing forcefully
  • ✕Do NOT give water or food to try to wash the object down
  • ✕Do NOT hold the child upside down
  • ✕Do NOT slap the child on the back if they are standing upright (use abdominal thrusts instead)

When to Seek Help

Call 911 if:

  • Child cannot breathe, speak, or cough
  • Child is turning blue or losing consciousness
  • Child becomes unresponsive
  • Abdominal thrusts are not clearing the object
  • Child was choking and is now lethargic or confused

Go to ER if:

  • Child was choking and is now having difficulty breathing or swallowing
  • Child is drooling excessively after the episode
  • Child choked on a battery, magnet, or sharp object
  • Abdominal thrusts caused visible injury or severe pain

Call your doctor if:

  • After any choking episode, even if child seems fine
  • Child has persistent cough or sore throat after episode
  • Child complains of abdominal pain after receiving abdominal thrusts
  • You suspect child swallowed something but is currently breathing normally

Age-Specific Guidance

1-2 years

Toddlers are still learning to chew effectively and may stuff too much food in their mouths. Cut all food into small pieces. Be especially cautious with round, firm foods.

2-3 years

Children are more mobile and may eat while running or playing. Enforce sitting during mealtimes. Be aware of non-food items like coins, small toy parts, and balloons that pose choking risks.

3+ years

Children should be taught to take small bites and chew thoroughly. Hot dogs, grapes, and popcorn remain high-risk. Latex balloons are the leading cause of non-food choking death in children.

Prevention

  • Cut round foods (grapes, hot dogs, cherry tomatoes) lengthwise into quarters
  • Avoid high-risk foods: whole nuts, popcorn, hard candy, chunks of raw vegetables, whole grapes
  • Supervise all meals and snacks — child should be seated and not running or playing while eating
  • Teach child to chew food thoroughly before swallowing
  • Keep small objects out of reach (coins, buttons, small toy parts, balloons)
  • Check toy labels for age-appropriate warnings
  • All caregivers should learn child choking first aid

Frequently asked questions

Should I call 911 for choking in a toddler (1-3 years)?
Yes. Child cannot breathe, speak, or cough
What should I do first?
If child cannot cough, cry, or breathe — begin abdominal thrusts immediately. Call 911 or have someone else call while you begin first aid. Stand or kneel behind the child for the Heimlich maneuver. If child is coughing forcefully, encourage them to keep coughing
What should I NOT do?
Do NOT perform blind finger sweeps — you may push the object deeper. Do NOT interfere if the child is coughing forcefully. Do NOT give water or food to try to wash the object down. Do NOT hold the child upside down. Do NOT slap the child on the back if they are standing upright (use abdominal thrusts instead)
How can I prevent this?
Cut round foods (grapes, hot dogs, cherry tomatoes) lengthwise into quarters. Avoid high-risk foods: whole nuts, popcorn, hard candy, chunks of raw vegetables, whole grapes. Supervise all meals and snacks — child should be seated and not running or playing while eating

Sources

AAPAHARED CROSS

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources

Related Emergency Guides

choking infantcpr toddlerforeign object

Bottom line

This is a serious emergency. Always call 911 first, then follow the steps above while help is on the way.

You are doing the right thing by learning what to do in an emergency. Being prepared is one of the best things you can do for your child.