How to act if the baby chokes on milk?

Muhammad Usman Babar
5 min readSep 3, 2020

How to act if the baby chokes on milk?

The reality is that choking on milk is relatively frequent and is usually solved without doing too much, but just in case it happens to you, we are going to explain today how to act if your baby chokes on milk, either while breastfeeding, or be it taking a bottle.

If your baby chokes a lot

If it happens frequently to your baby, you may not need this paragraph, because you will have already mentioned it to the pediatrician and perhaps he has already given you the solution. And is that if a baby chokes very frequently, an assessment is usually made in case there is a swallowing disorder, gastroesophageal reflux, etc.

It may also happen that it is more of an external issue: that the milk from the bottle falls too fast for the baby to manage it effectively, or that the reflex to ejection breast milk is so strong that the first “jets” go straight to the baby’s throat, with force, causing him to choke.

In the first case, it will be necessary to adjust the flow of the milk outlet and even modify the way the baby is fed, making it more vertical (the Kassing method is a good option). In the second, it can help the mother to express a little milk before breastfeeding, so that when the child sucks it does not come out with as much force.

If one day he suddenly chokes

Although the scare you get is great, because we are talking about small babies, the good thing about choking on a liquid is that it is just that, a liquid, and it will hardly plug the airways in a very dangerous way.

The usual thing, when some liquid goes into the airway, is that the cough reflex is triggered to go, little by little, removing the milk to the outside. But sometimes, before the cough, we can find the child increasingly upset trying to catch air, and then the most logical thing is to put it upside down right away so that, due to gravity, it is easier for the liquid to go outside (many Sometimes they choke when they spit up some milk if they are looking up and do not know how to manage the milk that rises to them)

Beyond putting them on their stomach, you don’t have to do anything if the baby is coughing, because that way you are already solving the choking episode.

Now, if little by little the coughing stops, and instead of being better, it is worse, not only will we have to ask for help (someone calls the emergency room), but we will have to assess what the child’s state of consciousness is.

If you are conscious

According to the latest resuscitation guidelines of the European Resuscitation Council, if a child with airway obstruction is conscious but does not cough, or if the cough is not effective, we should start hitting him on the back with the heel of our hand.

If despite the blows, we see that the baby is not breathing (this is more common if he has choked on a solid object), we will do chest compressions. In both cases, an attempt is made to increase the baby’s intrathoracic pressure to produce an artificial cough and help him to move the object that is obstructing the airway.

If we still do not achieve our goal, we should continue with a sequence of five blows to the back and five chest compressions, but we insist, it is very, very unlikely that we will reach this point because the most common is that as soon as we modify the posture in which it is, the liquid comes out, helped by the baby’s cough.

What if we found him unconscious and out of breath?

Some people leave babies taking the bottle alone because they have seen that they are very capable of managing it. The baby remains to lie down, the bottle is supported in some strategic way, and he/she eats as he wants to eat the food.

This, is very dangerous, because the risk of choking is evident, and if we are not there to act when we arrive it may be too late.

In the same way, it is recommended that, at least for the first six months, the baby sleeps in the same room as the parents because, in case of any incident, they can act (I am thinking of a baby that spits up milk, for example or vomit, and no one is by your side to change your posture and not choke on these fluids)

If for whatever reason, we arrived and saw the unconscious baby, without breathing, we would not only have to try to clean the mouth to remove as much milk as possible or look for a possible object with our eyes, but we would have to start doing what was known as cardiopulmonary resuscitation or basic life support.

To do this, one begins with the so-called rescue breaths: opening the airway by throwing the head back slightly while opening the mouth (forehead-chin maneuver) and giving 5 rescue breaths, while observing that, when doing so, The baby’s chest rises and falls (if it does not, make sure that we have opened the airway wall with the extension of the head.

After the 5 ventilations, 15 chest compressions are made and from then on cycles of 15 compressions are completed with 2 ventilations. We continue like this until the emergency service relieves us, or until the baby begins to breathe and begins to regain consciousness.

As you can see, I have put myself in the worst, just in case. But I repeat, and in order not to scare you too much: most of the time it is enough to prevent choking episodes and, if they do happen, act quickly trying to get the baby to cough the milk out with its cough, in our arms, face down.

Originally published at on September 3, 2020.