As the baby grows it acquires the ability to move, turn, observe and take everything to your mouth. Any object within your reach, will increase the risk of choking from four months of age.

The pieces of food, the pieces of some toys that you can reach or the objects other children in your environment give you can cause choking.

What to do when the child chokes

If, after choking, the infant or child babbles, cries, speaks or coughs, it's a sign that the air is passing through the airways, so we are probably facing a situation of partial obstruction. Cough is the most powerful reflex mechanism capable of reversing this situation.

What should we do?
Stimulate and facilitate the cough to continue producing. Instinctively, sometimes, bumps are struck on the back with the intention of helping, but this should not be done because the foreign body can move and the partial obstruction can become total. So that avoid giving the child blows to the back, compress the abdomen and offer him something to drink.

If there is no cough or it is clearly ineffective, we can face a total obstruction of the respiratory tract, that will have to be differentiated if the child is conscious or unconscious.

The child is conscious:

• Call emergency.
• Place the child standing and bowed, with the head lower than the body. He runs a hand through his armpits to hold his chest and with the other hand dale up to 5 strokes with the lower part of the palm of the hand in the upper part of the back between their shoulder blades.
• If you have not succeeded in expelling the foreign body, you must start the Abdominal compressions or Heimlich maneuver, up to 5 times This maneuver is to stand behind the child and surround the waist with arms. Close one hand and place the thumb knuckle above the navel, at the level of the mouth of the stomach, between the navel and the thorax. Take the fist with the other hand and make a strong pressure inwards and upwards, which will cause an increase in the pressure in the thorax, forcing out into the air that remains inside the lungs, dragging the foreign body. The maneuver should continue until the arrival of help or until the loss of knowledge.

The child is unconscious:

Given the lack of knowledge, emergency help should be requested immediately. While medical help arrives, he performs 30 chest compressions, followed by two air blows in the child's mouth until recovery.

Conscious lactant:

• Call emergency.
• Place the infant face down on the forearm, with the head lower than the body. Hold the infant's chin with your hand and place a finger on his lower lip so that the mouth remains open and feel if the foreign body comes out.
• With the other hand, give up to 5 hits on the back between the shoulder blades. If there is no expulsion of the foreign body, it is necessary to turn the infant over and place it on the forearm facing upwards and holding the neck with the hand. You can also place it on a hard surface. Apply up to 5 chest compressions with the fingers of the hand in a vertical position in the center of the chest, a little below an imaginary line drawn between the two nipples. - Repeats the entire cycle until recovery and until the arrival of help or loss of knowledge.

Unconscious breastfeeding:

• The maniobra de Heimlich no es una técnica adecuada para realizar en un lactante o menor de un año, por el riesgo de ocasionarle lesiones en las vísceras abdominales. Antes de la llegada del personal sanitario o la recuperación de la respiración, realiza 30 compresiones torácicas seguidas de 2 insuflaciones.
• Cuando se realiza una reanimación en una obstrucción de la vía aérea por un cuerpo extraño, es habitual que el aire no entre, no eleve el tórax o cueste mucho introducirlo. En el supuesto de que el tórax se elevara con facilidad, reevalúa la situación pero, si sigue inconsciente y no respira normalmente, deberás proseguir con las maniobras hasta la llegada de los sanitarios.