I’m a first aider and every parent must learn the 4 ‘S’ rules – it could save your child’s life

IT’S a parent’s worst nightmare, to imagine not being able to stop their child from chocking.

A British Red Cross survey released in 2018 found only five per cent of adults feel the have the skills to be able to be able to save an infant.


When it comes to chocking, prevention is always better than cureCredit: Getty

Thousands of children each year are still rushed to hospital after choking or swallowing something dangerous.

Instead of waiting for a horrible and often traumatic choking incident to happen, first aid experts from CPR Kids give four ‘S’ rules to follow which could prevent the accident in the first place.

“When it comes to chocking, prevention is always better than cure,” they said in an Instagram post.

1. Shape

Cut you little one’s food into “developmentally appropriate size shapes,” the experts said.

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“Round foods such as grapes, cherry tomatoes, large blueberries are the perfect shape to lodge in a toddler’s airway and should be cut into quarters.

“Cylindrical foods such as bananas, sausages and carrots cut into sticks,” they explained.

You should also avoid foods small hard foods like popcorn, sweets and nuts in young children, they add.

Other experts have warned against giving marshmallows pose to small kids.

When mixed with saliva the marshmallow’s consistency changes from soft and light to sticky, which can be challenging for children to swallow properly.

2. Sit down to eat

The risk of a chid choking increases if they are running around with food, or another object, in their mouth.

“Sitting down together to eat meals not only reduces the risk of choking, but is a great bonding experience too,” the experts said.

“Encourage your toddler to sit down when snacking too.”

“We know – this can be tricky task,” they added.

3. Supervise when eating

Always keep them in your direct line of sight, the first aiders warn.

“Although it is tempting to ‘get stuff done’ while your child is occupied eating and strapped into the high chair, chocking can be silent.

“Always keep them in your direct line of sight when they are eating so you can be aware and intervene quickly if chocking occurs,” they explain.

4. Search your home

Anything that can fit through a cardboard toilet paper tube is a choking risk for young children.

“Get down on your hands and knees and crawl around your house,” they suggest.

This will give you a better perspective as to what your child sees.

“What small objects are in reach?” they ask.

“Common household objects such as coins, erasers, button batteries, hair clips, marbles. bouncy balls, beads and small toy parts are all choking hazards and should be kept out of reach,” she adds.

What to do if your child chokes

It’s a parents worst nightmare to imagine a situation in which they have to save their child from choking.

But in that moment, it may be you that will have to step up and perform first aid.

The NHS says if you can see an object lodged in your child’s mouth, take care to remove it because blindly poking at it could make things worse.

If the child is coughing, encourage them to continue as they may be able to bring the object up – don’t leave them.

If the coughing isn’t effective (it is silent or they cannot breathe properly), shout for help immediately.

If the child is still conscious, use back blows. 

First aiders at St John Ambulance give the following advice based on the child’s age.


  1. Slap it out:
  • Lay the baby face down along your thigh and support their head  
  • Give five back blows between their shoulder blades  
  • Turn them over and check their mouth each time  

2. Squeeze it out:

  • Turn the baby over, face upwards, supported along your thigh 
  • Put two fingers in the centre of their chest just below the nipple line; push downwards to give up to five sharp chest thrusts 
  • Check the mouth each time  

3. If the item does not dislodge, call 999 or 112 for emergency help  

  • Take the baby with you to call  
  • Repeat the steps 1 and 2 until help arrives 
  • Start CPR if the baby becomes unresponsive (unconscious)  


1. Cough it out  

  • Encourage the casualty to keep coughing, if they can 

Five warning signs your child is choking

It’s important you understand the signs and how to help your little one if they are struggling

Here are the five you should look out for:

  1. Unable to cough
  2. Completely silent, no air, no crying, no speaking
  3. Making desperate attempts to breathe
  4. Clutching at throat
  5. Skin changing colour

Source: Tiny Hearts Foundation

2. Slap it out  

  • Lean them forwards, supporting them with one hand 
  • Give five sharp back blows between the shoulder blades 
  • Check their mouth each time but do not put your fingers in their mouth  

3. Squeeze it out  

  • Stand behind them with your arms around their waist, with one clenched fist between their belly button and the bottom of their chest 
  • Grasp the fist in the other hand and pull sharply inwards and upwards, giving up to five abdominal thrusts 
  • Check their mouth each time  

4. Call 999 or 112 for emergency help if the object does not dislodge  

  • Repeat steps 2 and 3 until help arrives 
  • Start CPR if the person becomes unresponsive (unconscious) 
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5. Always seek medical advice if abdominal thrusts are used 

All kids are at risk of choking – especially those under the age of three.

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