In an infant under 12 months old who is choking but responsive, the rescuer attempts to use back blows and chest thrusts instead of abdominal thrusts to relieve an obstruction:

1. First, 5 back slaps are given:
   1. The baby is held by the jaw with the rescuer’s hands and cradled across their arm. 
   2. The baby is then positioned at a 45-degree angle head-down.
   3. The rescuer performs 5 slaps at the center of the baby’s back between the scapulae using the heel of their hand.
2. If the infant is still choking after 5 back slaps, the rescuer gives 5 chest thrusts:
   • 1. From the back-slap position, the baby is turned face-up.
     2. The infant’s body is kept resting against the rescuer’s arm and the neck supported with their hand.
     3. The baby’s head is kept pointing downward at a 45-degree angle.
     4. 5 chest-thrusts are performed:

1. 1. 1. 1. With the index and middle fingers of their dominant hand (or whichever is comfortable), the rescuer locates the center of the chest just below the nipple line.
         2. The chest is then compressed about 1-½ inches or about 1/3 of the infant’s anterior-posterior chest diameter.

Infant Back Slaps (left) and Chest Thrusts (right)

3. The rescuer checks to see if the foreign body is expelled after these actions. 
4. If the foreign body cannot be visualized, 2 rescue breaths should be given.
5. The rescuer repeats step 1 if the patient is still responsive.
6. If the patient becomes unresponsive, the steps for an unresponsive infant should be followed (below).