If a baby cannot breathe, cry or cough, treat it as choking and act immediately.
Spotting choking
- Mild (effective) cough: They can cough/cry and draw breath. Encourage coughing and keep watching closely.
- Severe (ineffective) cough: Quiet or silent, unable to breathe/cry/cough, possible colour change. Start first aid straight away.
Step-by-step first aid (severe choking)
1) Give up to 5 back blows
- Sit or kneel and lay the baby face-down along your forearm or thigh, head lower than body.
- Support the jaw and keep the mouth open.
- Using the heel of your hand, deliver up to five sharp blows between the shoulder blades.
- After each blow, check if the obstruction is out.
2) Give up to 5 chest thrusts
- If back blows don’t clear it, turn the baby face-up, still head-down.
- Place two fingers on the centre of the chest, just below the nipple line.
- Push inwards and upwards to a depth of about one-third of the chest (≈4 cm), up to five times. Check after each thrust.
3) Call 999 and repeat
- If the object hasn’t cleared, call 999 (use speakerphone if you’re alone) and alternate 5 back blows with 5 chest thrusts until help arrives or the baby starts breathing normally.
- Do not perform blind finger sweeps, only remove an object you can see easily.
If the baby becomes unresponsive
- Call 999 (speakerphone if alone).
- Open the airway (neutral head position) and try 5 rescue breaths.
- If no response, begin CPR and follow call-handler prompts: compressions and breaths (paediatric BLS).
Important notes
- For babies under one year, use back blows and chest thrusts (not abdominal thrusts).
- Begin CPR if the baby becomes unresponsive, and keep going until they breathe normally or emergency help takes over.
Learn with Med Learn Training
This guidance supports, not replaces, formal paediatric first aid training. We deliver regulated courses nationwide, including baby choking management and paediatric CPR/AED. Tell us about your setting and we’ll recommend the right course.