* Put the baby facedown on your forearm so the baby's head is lower than his or her chest.
* Support the baby's head in your palm, against your thigh. Don't cover the baby's mouth or twist his or her neck.
* Use the heel of one hand to give up to 4 firm thumps (back blows) between the baby's shoulder blades. See Illustration C.
* If the object does not pop out, support the baby's head and turn him or her faceup on your thigh. The baby's head should point toward the floor.
* Place 2 or 3 fingers on the lower part of the baby's breastbone, and give up to 5 upward thrusts. See Illustration D.
* Look for an object in the baby's mouth. If you can see one, remove it. Then give 2 rescue breaths. To give rescue breaths:
o Place one hand on the baby's forehead, and tilt the bay's chin up to keep the airway open.
o Then place your mouth over the baby's mouth and nose and slowly blow air in until the baby's chest rises.
o Between breaths, remove your mouth, take a breath, and watch for the baby's chest to fall.
* If the object does not come out with these steps, call 911 or other emergency services.
* Continue with back blows, chest thrusts, looking for the object, and rescue breaths until the baby coughs up the object and starts breathing on his or her own, or until help arrives.
