Every five years, the Resuscitation Council UK produces revised guidelines in conjunction with the International Liaison Committee on Resuscitation (ILCOR) and the European Resuscitation Council (ERC) in order to comply with new scientific research, clinical data, technological advances and public health trends.

The most recent updates released at the end of 2025 announced the following revisions with regards to choking in babies:

Choking baby (under 1 year)

Suspect choking if your baby is unable to cry aloud, especially during feeding, eating or playing unsupervised. Chest thrusts are now delivered using the 2 thumbs encircling technique as opposed to the former two fingers technique. If your baby becomes unconscious, ensure someone has called 999 and start CPR.

Here’s what to do if your baby is choking:-

• Administer up to 5 firm back blows between the shoulder blades
• Give up to 5 chest/abdominal thrusts if back blows are not effective
• Turn the infant onto their back and lay them on your knees
• Use the two-thumb encircling technique to perform chest thrusts as advised for chest compressions, but compressing the sternum more sharply
• Repeat until the obstruction is relieved or the casualty becomes unresponsive which then requires you to start CPR.

For children over one year the method remains the same.

• Support your child in a forward leaning position and give 5 back blows from behind.
• Use abdominal thrusts for children over 1 year.
• Stand or kneel behind your child.
• Place your arms under the child’s arms and around their upper abdomen. Clench your fist and place it between the navel and ribs. Grasp this hand with your other hand and pull sharply inwards and upwards.
• Repeat up to 5 times.

Take a look at this video demonstation showing how to deliver thrusts and back blows to a baby, as per the new guidelines:-

Suction Based Devices

New 2025 Resuscitation Council UK (RCUK) and European Resuscitation Council (ERC) guidelines say that there isn’t enough evidence to recommend for or against the use of suction based devices marketed for clearing a blocked airway.

In other words, whilst these devices exist, the guidelines do not currently endorse their use as standard intervention.

Standard choking management, including back blows, abdominal or chest thrusts and CPR should be administered if necessary.