New Choking Guidelines for Children and Infants
In October 2025, the American Heart Association (AHA), in collaboration with the American Academy of Pediatrics (AAP), released its first major CPR and emergency care update since 2020. One of the most significant changes focuses on how to respond when an infant or child is choking. Choking emergencies unfold in seconds, and knowing the correct steps can truly save a life.
What’s Changed? Key Updates in Choking Response:
- Alternating Back Blows and Abdominal Thrusts for Children:
Under the new guidelines for conscious children, it is recommended to alternate five black blows followed by five abdominal thrusts until the object is expelled, or the child becomes unresponsive.
Change – Prior focus was almost exclusively on abdominal thrusts, now should alternate back blows and chest thrusts.
- Major Infant Update:
For infants (children under 1 year old), the AHA recommends eliminating abdominal thrusts all together. Instead, five back blows followed by five CHEST thrusts using the heel of one hand. The new guidelines state to repeat those cycles until the airway is clear, or the infant becomes unresponsive.
Change – no more abdominal thrusts in infants, poses a higher risk of causing injury. Instead, use back blows and chest thrusts until better or becomes unresponsive.
- Unified Approach for All Ages:
The 2025 CPR guidelines have streamlined a “single chain of survival” for cardiac emergencies, regardless of age (infant, child, or adult) or whether the person is in or out of the hospital. Change – Simplify the response steps in an emergency.
Why Did the AHA Update Their Guidelines?
- New Evidence: The AHA’s updates are grounded in the latest scientific research on what truly works in real-life emergencies. Ashish Panchal, M.D., Ph.D., volunteer chair of the American Heart Association Emergency Cardiovascular Care Science Committee and a physician and professor of emergency medicine at The Ohio State University reiterated,”As the science continues to evolve, it’s important that we continue to review new research specific to the scientific questions considered of greatest clinical significance that affect how we deliver life-saving care.”
- Safety: The move away from abdominal thrusts in infants reflects increased awareness of the potential harm.
- Clarity: Simplifying the choking response and streamlining a survival chain makes it more intuitive for responders.
What This Means for Parents, Caregivers, and Everyday Heroes
These changes are practical and actionable. Here’s how they impact you:
- Learn the Updated Technique
- If you care for children, make sure your first-aid or CPR training is up to date.
- For conscious children, practice the cycle of 5 back blows + 5 abdominal thrusts
- For infants, practice 5 back blows + 5 CHEST thrusts gently, using the heel of one hand.
- Take a CPR Class or a Refresher Course:
The AHA and American Academy of Pediatrics (AAP) are rolling out new training materials aligned with the 2025 guidelines. Consider signing up for a CPR/first-aid class (or retaking one) to feel confident.
- Spread Awareness
Talk with friends, family, and fellow parents about these updates. Emergencies don’t always happen with first responders present, being prepared is a huge part of protecting your community.
- Stay Calm, Act Quickly
If choking occurs, every second counts. Use the recommended method, but if things don’t improve, call 911 immediately and be ready to start CPR if the person becomes unresponsive.
- CPR Training for Children 12+
The new update backed by scientific evidence suggests that children 12 and over are now able to be taught effective CPR and defibrillation. If your child is in this age group, consider enrolling them in a certified CPR course.
Final Thoughts
The AHA’s 2025 updates on choking response reflect both scientific progress and making lifesaving techniques more accessible. By learning and practicing these new steps, especially the alternation between back blows and thrusts for children and infants, you’re preparing yourself to act confidently and effectively in a high-stress situation.
Whether you’re a parent, caregiver, or just someone who wants to be ready, these guidelines empower you to be a real-life hero. After all, knowing exactly what to do in a choking emergency could be the difference between a scary moment and a saved life.
Cited Source:
American Heart Association. (2025, October 22). Updated CPR guidelines tackle choking response, opioid-related emergencies and a revised chain of survival. AHA Newsroom. Retrieved from https://newsroom.heart.org/news/updated-cpr-guidelines-tackle-choking-response-opioid-related-emergencies-and-a-revised-chain-of-survival
Roebuck, S. (2025, October 23). 2025 AHA CPR guidelines: Changes to mechanical CPR, choking, single chain of survival. EMS1. https://www.ems1.com/cpr/2025-aha-cpr-guidelines-changes-to-mechanical-cpr-choking-single-chain-of-survival
