A little girl clutches her throat to show that she is choking.


Choking is one of the biggest fears of both parents and child carers. It is  also one of the first questions we get asked  on Safe and Sound First Aid Courses, and while most children will have choking episodes it is rare that a child dies from choking. But it does happen.

About half of all choking accidents in young children involve food and most of you will have read in the newspapers about a child choking on a grape or a sweet or a small object but they can also choke on soft food.  Millie Thompson was 9 months when she choked while eating shepherds pie at her Nursery. Her death sparked off a huge campaign to ensure that all nursery staff were trained in paediatric first aid.

Children, particularly those between the ages of one and five, often put objects in their mouth. This is a normal part of how they explore the world. Obviously the best way to avoid this is to make sure that small objects are kept out of a child’s reach and to watch while they are eating, but no matter how careful you are, it is likely that they will, at some point in the first five years of their life, have a choking episode.


Should this happen it is most important to remain calm.  You need to reassure the child that everything is going to be ok. They are looking to you to solve the situation. If you panic it will exacerbate the situation.

If the baby or child is choking but still coughing effectively, encourage them to cough – it’s still the best way to clear an airway.

Choking Child (over 1 year)

Back Blows

Call for Help, but don’t leave the child

  • Bend the child forwards, if they are small enough lean them  over your knee, so the head is lower than the chest
  • Give up to 5 firm blows between the shoulder blades with the palm of your hand. Check between blows and stop if the obstruction is cleared.

If back blows are ineffective:

Abdominal thrusts

 Stand or kneel behind the child. Put both arms around their waist

  • Make a fist with one hand and place it just above the belly button (below the ribs) with your thumb inwards. Grasp this fist with your other hand.
  • Thrust sharply inwards and upwards. Do this up to 5 times, but check between thrusts and stop if the obstruction is cleared.

Keep repeating Back Blows and Chest Thrusts – if it is not working shout for help and ask someone to call 999/112 for emergency help, but carry on doing this while the child is still conscious.


If they stop breathing start CPR



Choking Baby (under 12 months)

The baby may try to cough and if the choking is mild this may clear the obstruction.

If the obstruction is not cleared

Back Blows

Call for help but don’t leave the baby

  • Lay the baby over your arm, face down, the head below the chest
  • Give up to 5 blows between the shoulder blades with the palms of your fingers, keeping the head low, check between blows and stop if the obstruction is cleared.

If the obstructions is not cleared:

Chest Thrusts

Turn the baby over, chest uppermost (by laying them on your arm) and lower the head below the level of the chest

  • Use two fingers on the middle of the chest between the nipples and give up to 5 chests thrusts.  These are similar to chest compressions but sharper and done at a slower rate.  Keeping the head low, check between thrusts and stop if the obstruction is cleared.

Never perform abdominal thrusts on a baby

If the obstruction does not clear after three cycles of back blows and chest thrusts, dial 999 (or 112) for an ambulance. Continue giving baby back blows and chest thrusts until help arrives.


If they stop breathing start CPR.

Even if they seem to be fully recovered from the choking episode, take them to your doctor that day.

Monitor their breathing for at least an hour post choking (small particles of food on the lung will cause the lung to fill with fluid to wash away the debris). Watch for a persistent cough or wheezing post choking. If the child has a persistent cough seek immediate attention.

Also watch for cyanosis post choking (it maybe that you think you cleared the hazard but didn’t.)


For more information about Safe and Sound First Aid Courses check out the  courses section on our website  www.safeandsound.uk.net