If your child is choking but can still cough, encourage them to keep coughing, don’t hit their back, as this can push a partial blockage into a complete one. If they can’t cough, cry, or breathe, give up to 5 firm back blows between the shoulder blades, followed by up to 5 chest thrusts if needed, and call 000 immediately. The right response depends entirely on whether it’s a partial or complete blockage, here’s how to tell the difference and what to do for each.
I’m Aaron, a practicing paramedic and founder of Train4Life. Choking is one of the scariest things that can happen to a child, and it’s a topic we built specifically around the calls paramedics actually attend, not generic advice.
Why Are Babies and Young Children So Prone to Choking?
From as early as 2 months old, babies begin exploring the world by putting objects in their mouths, and their small airways make them especially vulnerable. Common choking hazards include:
- Food — nuts, lollies, grapes, whole cherry tomatoes.
- Small objects — coins, batteries, pins, buttons.
- Toys — marbles, bouncy balls, small or detachable parts.
- Household items — curtain and blind cords.
- Jewellery — necklaces and small accessories.
What’s the Difference Between Partial and Complete Choking?
This distinction changes what you should actually do, so it’s worth knowing before an emergency happens.
Partial choking means the airway isn’t fully blocked. Signs include:
- Noisy breathing, such as stridor
- Coughing
- Crying
- Some drooling
If your child can still cough, let them keep coughing: coughing is the body’s most effective way of clearing an obstruction on its own. Giving back blows at this stage can actually push the object further and turn a partial blockage into a complete one.
Complete choking means the airway is fully blocked. Signs include:
- Silence — no crying, coughing, or noisy breathing
- Mouth wide open, tongue out
- Excessive drooling
- Lips turning blue rapidly
This is when back blows and chest thrusts are needed immediately.
What Do I Do If My Child Has a Complete Airway Blockage?
If coughing isn’t working, or they’ve stopped breathing:
- Call 000 immediately (or have someone else call while you start first aid).
- Give up to 5 firm back blows with the heel of your hand between their shoulder blades. Check after each blow whether the object has dislodged and they can breathe.
- If back blows don’t work, give up to 5 chest thrusts. Turn the child onto their side or back, and press firmly on the centre of the chest using the same hand position as CPR.
- Alternate between back blows and chest thrusts until the object dislodges or the ambulance arrives.
- If they become unconscious, begin CPR immediately.
Should I Ever Do Back Blows If My Child Is Still Coughing?
No. If your child can still cough, cry, or breathe with noisy sounds like stridor, that means air is still getting through, this is partial choking. Back blows in this situation can dislodge the object further into the airway and turn a manageable situation into a complete blockage. Encourage coughing, stay calm, and monitor closely instead.
When Should I Call an Ambulance for Choking?
Call 000 straight away if your child is choking and:
- They stop breathing or become silent.
- Their lips or face start turning blue.
- Back blows or chest thrusts don’t dislodge the object.
- They become unconscious, begin CPR while waiting for the ambulance.
Even if the object does dislodge, it’s worth having your child checked by a doctor, particularly if they inhaled something small like a battery or a piece of food.
How Can I Prevent Choking in the First Place?
- Cut food into small pieces, especially round foods like grapes and cherry tomatoes.
- Supervise eating closely, particularly for babies and toddlers.
- Keep small objects and choking hazards out of reach, coins, batteries, small toy parts, cords, and jewellery.
Key Takeaways
- Partial choking (coughing, crying, noisy breathing) — let them keep coughing, don’t give back blows.
- Complete choking (silent, blue lips, wide open mouth) — 5 back blows, then 5 chest thrusts if needed, alternating until help arrives.
- Call 000 immediately for any complete blockage or if breathing stops.
- If your child becomes unconscious, start CPR right away.
This article is for educational purposes and isn’t a substitute for accredited first aid training. In an emergency, always call 000. Want to practise these steps? Book a hands-on in-person workshop, or explore our online Baby & Child First Aid Workshop, taught by a practising Intensive Care Paramedic.