Baby First Aid: Choking, Collapse, Seizures and the Steps That Save Lives

A grape gone down the wrong way, a baby who goes completely limp in your arms, a feverish child who stiffens and shakes. In moments like these, help always takes a few minutes to arrive, and it is the parents who are there. Knowing baby first aid means knowing what to do during those minutes.

This guide covers the basic steps recommended by health authorities in Quebec, the United Kingdom, France and the United States. It prepares you; it does not replace a course. The INSPQ says so itself, and the right reflexes come from practising on a manikin.

The basic reflex: call 141, or have someone call

The first step is almost always to raise the alarm. If there are two of you, one calls while the other acts. If you are alone, shout to attract someone, and begin the steps.

On the phone, the SAMU dispatcher guides you step by step: keep the speaker on and answer their questions calmly. Give the exact address, your child's age and what you see (breathing or not, responding or not). If 141 is unavailable, dial 15 (Civil Protection).

Baby is choking: how do you recognise it and react?

Everything depends on one question: can they still cough hard?

If they are coughing, crying or talking, the blockage is partial. The INSPQ advises not intervening and encouraging them to cough: it is their best way of getting the object out. Stay close and watch. If their breathing worries you, call 141.

If they can no longer cough, cry, speak or make any sound, if they put their hands to their throat, turn bluish or slump, the blockage is complete. The American Academy of Pediatrics lists these as signs of choking that requires immediate action. Have someone call 141 and start straight away.

For a baby under one year old

1. Lay them face down along your forearm, head a little lower than the body, holding their jaw between your fingers without pressing on the throat. Rest your arm on your thigh.
2. Give 5 firm back blows between the shoulder blades with the heel of your hand.
3. Turn them onto their back, along your other forearm, still supporting the head.
4. Give 5 firm chest compressions with two fingers, in the middle of the chest, just below the imaginary line joining the nipples.
5. Alternate 5 back blows and 5 chest compressions until they breathe, cough or cry.

If they lose consciousness, move on to the steps in the next section.

For a child aged one and over

Stand behind them, at their level. Place a clenched fist just above the belly button, cover it with your other hand, and pull firmly toward you and upward, in a "J" shape. Repeat until they breathe, cough, speak or cry. The INSPQ then recommends having them examined in the emergency room, as complications are possible.

Baby is unresponsive: what should you do?

An unconscious child is limp, still, and does not react to your voice or to gentle taps on the feet or shoulders.

1. Call or have someone call 141 right away.
2. If they may have hurt their head, neck or back (a fall, an accident), do not move them unless there is immediate danger.
3. Check whether they are breathing: do the chest or belly rise normally?
4. If they are breathing, place them on their side (see below) and watch their breathing until help arrives.
5. If they are not breathing, or only gasping, lay them on their back on a hard surface and begin chest compressions.

Chest compressions (CPR)

According to the INSPQ, you press firmly on the middle of the chest toward the floor, then release completely, in a quick, continuous back-and-forth movement:

• under one year: with two fingers, just below the nipple line;
• over one year: with the heel of one hand, in the middle of the chest.

Carry on without stopping until the child responds or breathes, or until help arrives. The 141 dispatcher can give you the rhythm. People who are trained combine compressions with rescue breaths (mouth-to-mouth): this is one of the reasons a course makes a difference.

Even if they regain consciousness, the child must be taken to the emergency room.

The recovery position

This is the waiting position for an unconscious child who is breathing, or for a child coming out of a seizure. It stops them choking on saliva or vomit.

• A baby is held in your arms, lying on their side, head slightly lower than the body.
• An older child lies on their side, with the upper leg bent to steady them, head tilted slightly back, mouth toward the floor.

Check regularly that they are breathing. If they stop breathing, return them to their back and begin compressions.

Seizures: the right steps

The most common seizure in young children happens with a fever. It is alarming (stiffness, jerking, fixed gaze), but usually brief: 1 to 5 minutes according to the Assurance Maladie.

During the seizure:

• note the start time;
• protect their head with your hands or a cushion, move dangerous objects away;
• do not restrain them or try to stop the movements;
• put nothing in their mouth, no finger, no object, no medicine;
• do not put them in cold water to bring down the fever, the NHS specifies.

After the seizure, place them in the recovery position and let them recover. They will often be drowsy.

Call 141 if it is their first seizure, if it lasts more than 5 minutes, if they are breathing badly, if the jerking affects only one side of the body, if they stay unusually asleep for more than an hour, or if they have another seizure within 24 hours: these are the NHS criteria. The Assurance Maladie adds a child under one year old and a seizure without fever. The fever itself is managed according to our advice on fever in babies.

Why take a course?

Because a step you have read is not a step you have learned. On a manikin, with an instructor, you feel the force needed for a back blow, the depth of a compression, the right rhythm. You also learn to keep a cool head.

In Morocco, information circulates mostly locally. Ask your paediatrician, your maternity unit, your child's nursery or school, and first-aid associations near you. A session of a few hours is often enough for the basic steps. Suggest it to grandparents and to whoever looks after your child, too.

The other emergency situations have their own articles: what to watch after a fall on the head, preventing drowning and our guide to household accidents.