If it is happening right now — start at step 1
A baby who is coughing, spluttering and going red is clearing it themselves. That is the good outcome. Stay close, stay quiet, let them finish. The steps below are for when the noise stops.
Do not intervene. Watch.
Start the steps below now.
Yell for whoever else is in the house and tell them to call emergency services now and put it on speaker. Seconds matter more than tidy explanations.
If you are alone: start the cycles below straight away and call after about a minute — or dial on speaker with one hand while you work.
Never walk away to find your phone, and never try to drive to hospital with a choking baby. Take the baby with you or shout.Sit and rest your arm on your thigh. Lay the baby face down along your forearm, with the head lower than the chest — gravity does half the work.
Support the jaw between your thumb and fingers. Do not press on the soft throat.
With the heel of your other hand, give five separate, firm blows between the shoulder blades. Not five taps, and not one long rub. Stop after each one to see if the object has come out.
The head must be lower than the chest. Hitting the back of a baby sitting upright can drive the object further down.Still blocked? Turn the baby face up along your other forearm, head still lower than the chest, and cradle the head in your hand.
Put two fingers on the breastbone, just below the nipple line — the centre of the chest.
Push straight down about a third of the depth of the chest, five times. Slower and sharper than CPR compressions — roughly one per second, letting the chest come all the way back up each time.
Never do abdominal thrusts — the Heimlich — on a baby under 1. Their liver sits low and unprotected and it will be injured.Between every set, look inside. Only hook out something you can clearly see and get a proper grip on, with one finger, in one movement.
No blind finger sweeps, ever. A finger you can't see pushes the object deeper and wedges it into the airway.Keep alternating 5 back blows / 5 chest thrusts, checking the mouth in between, until the object comes out or the baby stops responding.
Do not stop because it feels like it isn't working. Objects often shift after several full cycles.
If the baby goes limp or unresponsive at any point, move to the red panel below immediately.A strong cough shifts more than you can. Stay right beside them, keep them leaning forward, and tell them calmly to keep coughing.
Shout for someone to call emergency services the moment the cough goes weak or silent.
Move on only when they cannot cough, speak, cry or breathe.Get low — kneel or sit so you are beside them, not above them. Lean them well forward so anything that comes loose falls out rather than back down.
Support the chest with one hand. With the heel of the other, give five firm separate blows between the shoulder blades, checking after each.
A small toddler can be laid face down over your knees, head low, exactly like a baby.Kneel or stand behind them and put both arms around the waist. Make a fist and place it thumb side in, just above the belly button and well below the ribs.
Grasp that fist with your other hand and pull sharply inwards and upwards, five times. Each thrust is a separate, distinct movement.
Anyone who has had abdominal thrusts must be checked by a doctor afterwards, even if they seem completely fine. Internal injury is possible.Look inside between sets. Remove only what you can clearly see and grip — no blind finger sweeps.
Keep cycling 5 back blows / 5 abdominal thrusts until it clears or they stop responding.
If they go limp, move to the red panel below immediately.If they stop responding
Emergency services on speaker, now, if that hasn't happened. Put them on a firm flat surface — floor or table, not a sofa or a bed. Open the mouth and take out an object only if you can see it. Then begin.
Things that make it worse
Afterwards
Nuts and small hard fragments can slip into a lung and cause an infection days later, with nothing obvious in between.
Prevention
A 7-month-old's airway is roughly the width of a drinking straw. Round, firm and airway-sized is the dangerous combination — which is why the fixes below are mostly about shape.
Book a hands-on infant first aid course. Two hours, usually free or cheap through a local hospital, ambulance service, Red Cross or St John.
Holding a weighted doll face down along your own forearm, and feeling how hard a real back blow has to be, is the part that reading cannot give you. People who have done it once do not freeze.
Send this page to everyone who looks after your baby — grandparents, childminder, babysitter.
Complementary feeding · 6–12 months
Until the first birthday, breast milk or formula supplies most of the calories. Solid food at 7 months is doing two other jobs: delivering iron, which runs out around 6 months, and teaching a mouth how to move food around and swallow it. Volume comes later.
Babies are born with an iron store that runs down at around six months, and breast milk is low in iron. A shortfall here shows up as pallor, poor appetite and slower development, and it is the single most common nutritional gap in the second half of the first year.
Aim for one obviously iron-rich food every day, and serve it alongside something with vitamin C — pepper, broccoli, tomato, strawberry, kiwi, a squeeze of orange. Vitamin C can multiply the iron your baby absorbs from plant sources several times over. Large volumes of cow's milk and any tea block it.
Never low-fat. Babies need the fat and the calories. Full-fat yoghurt, full-fat cheese, whole-milk everything.
These are delivery methods, not diets — the milk, the iron and the allergens above apply to all three. Most families end up mixing them, and that is a legitimate answer rather than a failure to pick one.
| Compared on | Purée-ledTraditional · spoon first | BLWBaby-led weaning | BLISSBaby-led + three rules |
|---|---|---|---|
| The idea | You spoon in smooth food, thicken it over weeks, add lumps, then finger food. | Skip purée and spoons entirely. From day one the baby self-feeds graspable pieces of family food. | BLW with three rules added, developed at the University of Otago specifically to close BLW's gaps on iron, energy and choking. |
| Who leads | You do. Baby opens; you decide the pace. | Baby does, completely. Nothing is put into their mouth. | Baby does, same as BLW. You control only what goes on the tray. |
| First textures | Smooth → thick → lumpy mash → minced → chopped, with finger food joining around 7 months. | Soft finger strips from the first meal. No purée stage at all. | Soft self-fed pieces — but every piece has to pass a test before it reaches the tray. |
| Iron plan | Easy to guarantee. Fortified cereal, puréed meat and lentils go in reliably and you can see how much. | None built in. This is the known weak point — iron-rich foods are the hardest to serve as a strip a baby can hold. | One high-iron food at every meal — red meat, liver, iron-fortified cereal or legumes. It is rule one of three. |
| Energy plan | Controlled by you, so intake is easy to top up. | None built in. Early intake can be small while the skill develops. | One high-energy food at every meal. Rule two of three. |
| Choking rule | Smooth food carries little risk — but the risk simply arrives later, when lumps and finger food do. | Relies on the baby controlling what enters their own mouth. The method ships with no exclusion list. | Rule three: an explicit avoid-list, plus a test — every piece must be soft enough to mash with your tongue against the roof of your mouth. Parents are also taught to tell gagging from choking. |
| What the trial found | The long-standing default. Nutrient intake is the easiest of the three to control and to measure. | Compared with BLISS at 6 months, unmodified BLW families offered 3.24 servings a day of choking-risk food and 0.8 servings of iron-rich food. | The same comparison: 0.17 servings a day of choking-risk food and 2.4 servings of iron-rich food. |
| Suits you if | You want to know exactly how much iron went in, or choking anxiety would otherwise stop you starting at all. | You want the baby to set the pace, you eat together anyway, and you are relaxed about mess and slow early intake. | You like the BLW philosophy but want the iron and choking gaps closed on purpose rather than by luck. |
| The catch | Easy to stall on smooth past 9–10 months, which is linked to later texture refusal. You also control the spoon, so it is easier to overshoot your baby's own fullness cues. | Without a deliberate iron plan, intake can fall short at exactly the age iron stores run out. | More planning per meal. Its avoid-list is stricter than most — it rules out peas, corn, berries and rice crackers too. |
Swipe the table sideways →
In the randomised trial that tested BLISS against ordinary feeding, across 206 babies, 35% choked at least once between 6 and 8 months — and there was no significant difference between the baby-led group and the traditionally fed group at any point.
High proportions of babies in both groups were still being offered foods that pose a choking risk. So the method is not the thing that protects your baby. What protects them is how the food is cut, staying within arm's reach, and knowing the steps at the top of this page.
Babies who are still on smooth purée at 9 or 10 months are more likely to refuse lumps and struggle with textures well into toddlerhood. Move up steadily, even though every step is messier than the last. Gagging on the way up is normal and expected — it is the mouth learning.
Thick purée and mash, no longer runny. Add finger strips the length of your finger, soft enough to squash between your thumb and forefinger: steamed carrot baton, roasted sweet potato wedge, half a banana in its skin, soft-cooked pasta, a strip of omelette, toast fingers with thin nut butter, a steamed broccoli floret with a stalk to hold.
Lumpy mash and minced food. Finger foods at every meal. Start an open cup of water. Softer versions of whatever you are eating, taken out before you season it.
The pincer grasp arrives, so switch to small chopped pieces — pea-sized, still soft. Chopped rather than mashed. More of your food, less of theirs.
Family food, chopped, at the family table. Still no whole nuts, whole grapes, popcorn or hard raw veg.
Before the pincer grasp (roughly under 8–9 months) a baby holds food in a fist and eats the bit that sticks out of the top. So cut it long — finger-length batons, wider than a piece that could go straight down.
After the pincer grasp, they pick up small things deliberately. So cut it small — pea-sized and soft. The dangerous size is the one in between: a round, firm piece about as wide as the airway.
Delaying the common allergens raises the risk of allergy rather than lowering it. From around 6 months, once the first few foods are going in without drama, introduce them deliberately — and then keep them in the diet, about twice a week each. Tolerance is maintained by regular exposure, not by a single tasting.
How: at home, in the morning, not on a day with illness or a vaccination. Start with about ¼ teaspoon, wait, then give more the same day if all is well. Repeat within a few days. Only one new allergen at a time — although you don't need to wait between ordinary new foods.
If your baby has severe eczema or a known egg allergy, speak to your doctor before introducing peanut.
Stop that food. Give antihistamine only if your doctor has already advised it. Talk to your doctor before trying again — don't quietly drop the food, since avoidance can make things worse.
Lie them flat with legs raised — not upright, not walking. Use an adrenaline auto-injector first if one has been prescribed, then call.
Including in baked goods, cereal bars and cough remedies. Risk of infant botulism until 12 months.
Fine in food from 6 months — yoghurt, cheese, in cooking. As a main drink, from 12 months, full-fat. Rice drinks not before 5 years.
Under 1, the limit is about 1 g of salt (0.4 g sodium) a day, and the kidneys can't clear more. Watch stock cubes, gravy, soy sauce, bacon, cheese, bread, ready meals. Cook your own food and lift the baby's portion out before you season it.
Sweetened yoghurt, biscuits, chocolate, puddings, and anything with syrup or concentrate high on the label.
Not needed at all this year. Water or milk only.
Choking risk until 4–5 years, regardless of how well they chew.
Unpasteurised milk and juice, soft mould-ripened and blue cheeses, raw or runny egg unless it carries a safety mark, raw shellfish, undercooked meat.
No shark, swordfish or marlin. Limit tuna. Oily fish 1–2 portions a week is ideal.
Rice cakes and rice cereal every day add up on arsenic. Rotate oats, barley, quinoa, corn and wheat.
Babies need fat for the brain and the calories. Full-fat versions across the board.
Water from 6 months, in an open cup or a free-flow cup — small sips with meals, roughly 100–200 ml across the day at first. An open cup builds the right swallow pattern and is far better for teeth than a valved spout. It will go everywhere. That's fine.
Vitamin D. Breastfed and mixed-fed babies need a daily supplement — around 400 IU (8.5–10 µg) — all year round, from birth. Formula-fed babies taking at least 500 ml a day are already covered. Check the recommendation where you live; it varies.
Bowels will change. Colour, smell and consistency all shift when solids start, and some constipation is common. Offer water with meals, and lean on pear, prune, kiwi and apricot. Whole sweetcorn and other bits coming out intact is completely normal.
You choose what, when and where. Your baby chooses whether, and how much. Hold that line and most feeding battles never start.
Full looks like: turning the head away, lips pressed shut, pushing the spoon or bowl away, batting your hand, throwing food over the side, arching back, losing interest. All of it means the same thing. Stop.
Never force, never bribe, never the aeroplane, never one more spoon after a no. A new food can need 10–15 exposures before it's accepted — so keep offering it, without pressure and without comment. Eat the same thing at the same time where you can; babies copy far more than they're persuaded.
Judge intake across a week, not a meal. A day of eating nothing means nothing at all.
An example of the shape of a day, not a prescription. Times bend around naps; the order is the point.
Purée-led, BLW, BLISS, or all three on the same tray — see the comparison above. What matters is that iron arrives daily, textures keep moving forward, and your baby is the one deciding how much goes in.