Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 27 Aug 2026Clinical review pending
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Choking or anaphylaxis
Inability to breathe or cough, silent cyanosis or reduced consciousness during eating indicates choking. Sudden airway, breathing or circulation compromise after food indicates anaphylaxis, even without a rash.
Action: For choking, use the age-appropriate basic life-support sequence, call 999 and begin CPR if unresponsive; do not perform blind finger sweeps. For anaphylaxis, give intramuscular adrenaline into the anterolateral thigh using the age-appropriate dose, call 999, position according to physiology and repeat after 5 minutes if airway, breathing or circulation problems persist.
Synopsis
Support families to introduce varied safe foods from around 6 months while breast milk or first infant formula remains central, recognise developmental readiness, introduce allergens safely, progress textures, prevent choking and nutritional deficiency, and respect cultural and family preferences.
Introduce complementary foods at around 6 months when the infant can remain seated with steady head control, coordinate eyes, hands and mouth, and swallow food rather than push it out.
Do not use night waking, fist chewing or wanting extra milk alone as readiness signs. Avoid routine solids before 4 months; seek individual advice for preterm or developmentally delayed infants.
Breast milk or first infant formula remains the main drink through the first year. Follow-on formula is unnecessary, and unmodified cow's milk should not be the main drink before 12 months.
Key red flags
Coughing, choking, wet breathing, colour change, recurrent chest infection or prolonged exhaustion with meals suggests dysphagia and aspiration.
Investigation priorities
01
First-line: feeding and growth assessmentFirst stepFirst line
Confirm readiness, nutritional adequacy, texture safety and growth trajectory.
Management branches
StartBegin responsively around 6 months
The infant shows all three developmental readiness signs.
Seat upright, offer a small amount when alert and continue usual breast milk or first infant formula.
Include vegetables, an iron-rich food and safe finger foods while progressing texture.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.