Baby First Aid: Quick Reference Guide

Before Anything Else: Get Trained

This guide is a reference — a way to refresh knowledge and have key steps in one place. It is not a replacement for hands-on baby first aid training, where you practise on a manikin until the actions become instinctive. The research on first aid outcomes is unambiguous: people who have practised act faster and more accurately under stress than people who have only read.

Choking: Back Blows and Chest Thrusts

Choking is one of the most frightening emergencies a parent can face — and one of the most important to know how to handle. The technique for a baby under 12 months is specific and different from the Heimlich manoeuvre used for adults and older children.

The key distinction to hold in mind: a baby who is coughing, crying, or making any sound has a partially open airway and is working to clear it. Encourage the cough; do not intervene with back blows yet. A baby who is silent, cannot cry, has gone blue or grey, and is not moving air is choking and needs immediate intervention.

Step-by-step: choking in a baby under 12 months

1. Call for help. If anyone else is present, send them to call 999. If you are alone, perform the steps below and call 999 after 1 minute if the obstruction has not cleared.
2. Hold the baby face-down along your forearm, supporting the head. Their head should be lower than their chest.
3. Give up to 5 firm back blows between the shoulder blades using the heel of your hand. Check the mouth after each blow — if you can see the obstruction, remove it with a finger. Never perform blind finger sweeps.
4. If back blows do not clear the obstruction, turn the baby face-up along your forearm. Place two fingers on the centre of the chest, one finger's width below the nipple line.
5. Give up to 5 chest thrusts — sharp, downward pushes at a rate of about one per second. Check the mouth between each thrust.
6. Alternate 5 back blows and 5 chest thrusts. If the baby becomes unconscious, call 999 immediately and begin infant CPR.

Infant CPR

Infant CPR is used when a baby is unconscious and not breathing normally. It combines rescue breaths (to deliver oxygen) with chest compressions (to circulate blood). Starting CPR early, even imperfectly, significantly improves outcomes — bystander CPR before ambulance arrival doubles or triples survival rates.

When to start infant CPR

Start CPR if your baby is: unconscious and not responding to stimulation, not breathing, or only making occasional gasping breaths (agonal breathing — this is not normal breathing). Do not delay CPR to check for a pulse — this is difficult to assess accurately and takes valuable time.

Step-by-step: infant CPR

1. Call 999 — or ask someone to call while you begin. Put the phone on speaker.
2. Open the airway — place one hand on the forehead and gently tilt the head back to a neutral position (not too far back in infants). Lift the chin with one finger under the bony part.
3. Give 5 rescue breaths — cover the baby's mouth and nose with your mouth. Give gentle puffs (not full adult breaths) — just enough to see the chest rise. Each breath takes about 1 second.
4. Begin chest compressions — place 2 fingers on the centre of the chest, one finger's width below the nipple line. Press down approximately one-third of the chest depth (about 4cm). Release fully between compressions.
5. Give 30 compressions at a rate of 100–120 per minute — the rhythm of "Baby Shark" or "Staying Alive" is approximately right.
6. Continue the ratio: 30 compressions to 2 rescue breaths. Do not stop unless the baby begins breathing normally, a trained responder takes over, or you are too exhausted to continue.

Fever

Fever — a temperature of 38°C or above — is extremely common in babies and young children and is usually a normal immune response to infection. In the vast majority of cases, it is not dangerous in itself. Knowing what context makes fever more serious, and what the threshold for calling for help is, prevents both unnecessary panic and dangerous delays.

Managing fever at home

For babies over 3 months with a straightforward fever: keep them lightly dressed in a comfortably warm room (not too hot, not cold). Offer fluids frequently — milk feeds for babies, water and milk for older infants. Paracetamol (e.g., Calpol) from 2 months and ibuprofen (e.g., Nurofen for Children) from 3 months can be used to relieve discomfort and bring the temperature down. Do not use both at the same time; alternate them if one alone is insufficient. Do not use ibuprofen if your child is dehydrated or has chickenpox. Do not use aspirin under any circumstances for children under 16.

Febrile convulsions (febrile seizures)

Febrile convulsions affect around 3% of children aged 6 months to 5 years and are caused by a rapid rise in temperature. They look alarming — the child's body stiffens, they lose consciousness, and limbs jerk — but simple febrile convulsions are not dangerous in themselves and do not cause brain damage. They typically last less than 5 minutes and resolve on their own.

• Do: stay calm. Lay the child on their side (recovery position) to prevent choking. Time the seizure. Clear the area of anything they might hit. Stay with them throughout.
• Do not: put anything in their mouth or restrain their movements.
• Call 999 if: the seizure lasts more than 5 minutes, the child does not recover fully within 30 minutes, the child has difficulty breathing, or this is their first seizure and you are unsure what is happening.
• Call 999 and go to A&E for any first febrile seizure, even if it has resolved — the child needs to be assessed.

Burns and Scalds

Scalds — burns caused by hot liquids or steam — are among the most common serious accidents affecting babies and young children. They can occur in seconds: a moment of distraction with a hot drink, a bath that is too hot, a pulled tablecloth. Immediate correct treatment significantly reduces the severity of the injury.

Immediate treatment for burns and scalds

1. Cool the burn immediately with cool running water for a minimum of 20 minutes. Do not use ice, ice packs, butter, toothpaste, or any other substance — these cause further damage.
2. Remove clothing and jewellery near the burn while cooling with water, unless it is stuck to the skin.
3. Cover loosely with cling film (lengthways, not wrapped) or a clean non-fluffy material once cooled. Do not use bandages, cotton wool, or plasters.
4. Call 999 or go to A&E for: any burn in a baby under 12 months, any burn larger than a 50p coin, any burn to the face, hands, feet, genitals, or joints, or any burn with blistering.

Poisoning

Young children explore the world by putting things in their mouths, which means accidental poisoning is a real risk once they are mobile. The most common sources of poisoning in under-5s are medicines (particularly paracetamol, iron tablets, and vitamins), cleaning products, button batteries, and plants.

If you suspect your baby has swallowed something harmful

• Call 111 for guidance if you are unsure whether what has been ingested is harmful — the 111 pharmacist can advise.
• Call 999 if your child is unconscious, having difficulty breathing, having a seizure, or has collapsed.
• Do not induce vomiting — unless specifically advised by a medical professional. Some substances cause more damage on the way back up.
• Take the container, plant, or substance to A&E with you — this significantly speeds up assessment and treatment.

Meningitis and Sepsis: The Signs Every Parent Must Know

Meningitis (infection of the membranes surrounding the brain and spinal cord) and sepsis (a life-threatening response to infection) can progress very rapidly in babies and young children. Early recognition is the most important factor in survival and outcome. Know the signs. Trust your instincts.

Signs of meningitis and sepsis in babies

• High fever — or, in very young babies, a low temperature or subnormal temperature
• Unusual high-pitched or moaning cry
• Refusing feeds
• Pale, mottled, or bluish skin
• Extreme lethargy — difficult to wake, floppy, not responding normally
• Bulging fontanelle — the soft spot on the head, when the baby is upright and calm
• Stiff neck — though this is harder to assess in young babies
• Dislike of bright light
• Non-blanching rash — small, red or purple spots or bruise-like patches that do NOT fade when pressed with a glass or finger. This is a late sign — do not wait for it.

The tumbler test (glass test)

Press a clear glass firmly against a rash. If the rash does not fade (blanch) under pressure — it remains visible through the glass — this is a non-blanching rash and a potential sign of meningococcal disease. Call 999 immediately. However, as the quote above illustrates, the rash may not yet be present even when a baby is seriously ill. The absence of a rash does not mean the absence of meningitis.

Head Injuries

Babies and young children fall — it is part of development. Most falls result in a bump, a cry, and rapid recovery. However, some head injuries require medical assessment, and knowing the difference matters.

If your baby cries immediately after a fall, feeds normally, and seems their usual self, they are likely fine — but monitor them for the next 24 hours for any of the signs above. A large soft "goose egg" bump is caused by bleeding under the scalp, not the skull, and is common and generally harmless. A flat, firm swelling is more concerning and warrants a GP or A&E assessment.