If a child or infant suddenly cannot breathe, cry or cough effectively, treat it as severe choking. Call 995 or ask someone else to call while you help. Use speaker mode if alone. Tell the dispatcher the child’s age and whether they are responsive. Singapore Paediatric Life Support Guidelines 2026 · Singapore 2026 CPR, AED and choking guidelines
If the child can still cough forcefully and breathe, encourage coughing and watch closely for deterioration. Severe choking needs different first aid for an infant under one year and an older child. Singapore Paediatric Life Support Guidelines 2026
- Effective cough → encourage coughing and watch breathing closely.
- Severe choking in a responsive infant → up to five back blows, then up to five chest thrusts if needed.
- Severe choking in a responsive older child → up to five back blows, then up to five abdominal thrusts if needed.
On this page · Recognise an Ineffective Cough · If a Responsive Infant Is Choking Severely · If a Responsive Older Child Is Choking Severely · If the Child Becomes Unresponsive · After the Obstruction Clears · Frequently Asked Questions
Recognise an Ineffective Cough
Severe choking can be quiet. A child may try to cough or cry but produce little or no sound. If they are breathing and coughing effectively, give them a chance to clear the object. If the cough becomes ineffective or breathing becomes difficult, act immediately. Avoid offering food or water to clear an obstruction. Singapore Paediatric Life Support Guidelines 2026
If a Responsive Infant Is Choking Severely
Support the infant’s head and neck and hold the infant face down with their head lower than their chest. Give up to five back blows between the shoulder blades. If the obstruction remains, turn the infant face up while supporting the head and neck and give up to five chest thrusts. Follow dispatcher guidance on positioning and technique. Keep alternating while the infant is responsive and the obstruction remains. Avoid abdominal thrusts in infants. Singapore Paediatric Life Support Guidelines 2026
If a Responsive Older Child Is Choking Severely
Lean the child forward and give up to five back blows between the shoulder blades. If the blockage remains, give up to five abdominal thrusts. Keep alternating while the child is responsive and the obstruction remains. The Singapore 2026 guidelines start with back blows for older children. Follow the dispatcher’s instructions. Singapore Paediatric Life Support Guidelines 2026 · Singapore 2026 CPR, AED and choking guidelines
If the Child Becomes Unresponsive
Tell 995 immediately. Place the child on a firm, flat surface and start CPR as the dispatcher directs. Remove an object from the mouth only if it is visible and you can remove it safely. A blind finger sweep can push an object deeper. Singapore Paediatric Life Support Guidelines 2026
After the Obstruction Clears
Tell the dispatcher how the child is breathing and what you did. Follow their advice about assessment, especially if coughing or breathing difficulty continues or thrusts were needed. Note what the child was eating or playing with. A caregiver can give that information to the medical team.
Frequently Asked Questions
Should I give a child water to wash the object down?
Keep food and drink away during a choking incident. If the child can cough effectively, encourage coughing and watch closely. Singapore Paediatric Life Support Guidelines 2026
Should I use the same thrusts for a baby and an older child?
Use chest thrusts for an infant and abdominal thrusts for an older child after ineffective back blows. Tell 995 the child’s age so they can guide you. Singapore Paediatric Life Support Guidelines 2026
How can caregivers practise safely?
Use an infant and child first-aid course with manikins. Ask grandparents, babysitters and other caregivers to learn where to call from and how to give the home address. Singapore Red Cross first-aid training
Continue With the Singapore Emergency Playbook
- Cardiac Arrest in Singapore | How to Call 995, Start CPR and Use an AED
- Severe Allergic Reaction in Singapore | When to Use an Adrenaline Auto-Injector and Call 995
- Seizure First Aid in Singapore | What to Do and When to Call 995
- Emergency Numbers in Singapore
- Child Medical Emergency in Singapore
Guidance checked 8 November 2026.