If your baby can't clear her airway on her own and you believe something is trapped there, carefully position her face down on your forearm with your hand supporting her head and neck. Rest the arm holding your baby on your thigh.
Support your baby so that her head is lower than the rest of her body. Then, using the heel of your hand, give her five firm and distinct back blows between her shoulder blades to try to dislodge the object.
Next, place your free hand (the one that had been delivering the back blows) on the back of your baby's head with your arm along her spine. Carefully turn her over while supporting her head and neck. Support your baby face up with your forearm resting on your thigh, still keeping her head lower than the rest of her body.
Place the pads of two or three fingers just below an imaginary line running between your baby's nipples. To give a chest thrust, push straight down on the chest 1/2 to 1 inch, then allow the chest to come back to its normal position.
Give five chest thrusts. The chest thrusts should be smooth, not jerky.
Continue the sequence of five back blows and five chest thrusts until the object is forced out or your baby starts to cough. If she's coughing, let her try to cough up the object. If she becomes unconscious, she'll need CPR.
Give her two rescue breaths. If air doesn't go in (you don't see her chest rise), retilt her head and try two rescue breaths again.
If her chest still doesn't rise, give her 30 chest compressions. Look in her mouth and remove the object if you see it. Give her two more rescue breaths, repeat the chest compressions, and so on, until help arrives.
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