If the baby is choking

First: is it actually choking?

• Coughing loudly, crying, going red: the airway is partly open. Let them cough — coughing is more effective than anything you can do. Stay with them, don't slap their back, don't put fingers in their mouth.
• Silent, unable to cry or cough, going blue, weak or ineffective cough: the airway is blocked. Act now.

The sequence for a baby under one

1. Back blows. Lay the baby face-down along your forearm or thigh, supporting the head and jaw, with the head lower than the chest. Give up to five firm blows between the shoulder blades with the heel of your hand. Check after each one to see if the blockage has cleared.
2. Chest thrusts. If back blows fail, turn the baby face-up along your other forearm, head still lower than the chest. Place two fingers on the breastbone, just below the nipple line. Give up to five sharp inward and upward thrusts. Check after each one.
3. Repeat. Keep alternating five back blows and five chest thrusts until the blockage clears or help arrives.
4. If they become unresponsive. Start infant CPR and keep the emergency call connected.

Afterwards

Have the baby checked by a doctor even if the object comes out and the baby seems fine — particularly after chest thrusts, and always if anything may have been inhaled rather than swallowed.

Do the course

Reading this page is not the same as having done it. Infant first-aid courses are a few hours, widely available, and cheap or free — St John in New Zealand, the Red Cross in the US, and equivalents elsewhere. Book it during the pregnancy, when you have time, rather than promising yourself you'll do it later.

• Grapes, cherry tomatoes, nuts, popcorn and hard sweets are the classic choking hazards for small children — cut round food lengthways, into quarters.
• Keep small objects, button batteries and magnets off the floor. Button batteries are a medical emergency in their own right, even without choking.
• Never prop a bottle and leave a baby to feed unattended.