What to do if a child is choking

How to recognise choking

Choking happens when an object or piece of food blocks the airway. It is common in children, because they eat quickly, play with small objects and have narrower airways.

It is important to tell mild from severe obstruction. If the child is coughing hard, crying or talking, the airway is partly open: encourage them to keep coughing and stay with them. If they cannot cough, speak or cry, if breathing is noisy or absent, or if their face changes colour, the obstruction is severe and immediate action is needed.

Call for help

Shout for help and ask someone to call 166 or 112. If you are alone, start the steps below and call as soon as you can — ideally on speakerphone.

Infant (under 1 year)

According to international guidelines, for severe obstruction in an infant:

• Lay the infant face down along your forearm, head lower than the body, supporting the head by the jaw
• Give up to 5 back blows between the shoulder blades with the heel of your hand
• If the airway does not clear, turn the infant onto their back and give up to 5 chest thrusts with two fingers in the centre of the chest
• Keep alternating until the object comes out or the infant becomes unconscious
• Never give abdominal thrusts to an infant

Child (over 1 year)

For severe obstruction in a child:

• Lean the child slightly forward and give up to 5 back blows between the shoulder blades
• If the airway does not clear, give up to 5 abdominal thrusts (Heimlich manoeuvre), standing behind them
• Keep alternating until the object comes out or the child becomes unconscious

If they become unconscious

If the child becomes unconscious, place them on a firm surface, make sure 166 / 112 has been called and start CPR. Do not try to remove the object blindly with your fingers, as you may push it deeper.

Even if the object comes out, see a doctor — especially if abdominal or chest thrusts were given, or if the child keeps coughing or having difficulty.

Why practical training makes the difference

Reading the steps is a good start, but at the moment of choking panic is natural. Practising on infant and child manikins helps you know where to put your hands and how much force to use, so you can act without hesitation.

This guide is for information only and does not replace practical training or medical advice.