Online CPR Certification Blog

When it comes to infants — babies under one year old — emergencies can unfold in seconds. A small object, a brief lapse in supervision, or an undiagnosed medical condition can suddenly stop a baby’s breathing or heartbeat. In such critical moments, knowing how to perform infant CPR (Cardiopulmonary Resuscitation) can be the difference between life and death.

This comprehensive guide will teach you exactly what to do — step by step — and how CPR for infants differs from adult and child CPR. You’ll also learn what signs to watch for, how to prevent cardiac emergencies, and how to stay calm when it matters most.

Why Infant CPR Is Different

Infant CPR is not simply “smaller adult CPR.” Babies’ bodies are delicate and physiologically unique. Their bones are softer, their airways narrower, and their lungs more fragile. The causes of cardiac arrest in infants are also different.

Common Causes of Infant Cardiac Arrest

• Choking on milk, formula, or small objects
• Sudden Infant Death Syndrome (SIDS)
• Respiratory distress (from infections, asthma, or pneumonia)
• Drowning or suffocation
• Severe allergic reaction (anaphylaxis)
• Trauma or head injury
• Congenital heart defects

Unlike adults, where heart disease often triggers cardiac arrest, infants usually experience arrest due to breathing problems or airway obstruction. Therefore, rescue breaths are crucial for infant survival.

Understanding the Infant Chain of Survival

The Pediatric Chain of Survival outlines the steps that dramatically increase the chances of survival in a cardiac emergency:

• Prevention of cardiac arrest (supervision, safe sleep, choking precautions).
• Early recognition and CPR with effective compressions and breaths.
• Prompt activation of emergency services (call 911).
• Rapid defibrillation with an AED (if needed).
• Advanced life support and post-resuscitation care by healthcare professionals.

Your goal as a parent or caregiver is to act immediately when you see signs of distress. Every second counts.

Step 1: Check Responsiveness and Breathing

• Ensure Safety:
  • Make sure the environment is safe for both you and the baby.
  • Remove hazards such as electrical cords, sharp edges, or loose objects.
• Check for Responsiveness:
  • Tap the baby gently on the foot or shoulder.
  • Say the baby’s name loudly: “Baby, are you okay?”
  • Watch for movement, crying, or any reaction.

If the baby does not respond, move immediately to check breathing.

• Check Breathing:
  • Look for chest movement.
  • Listen for breath sounds.
  • Feel for air on your cheek.
  • Do this for no more than 10 seconds.

If the baby isn’t breathing or is only gasping, begin CPR right away.

Step 2: Call for Help

If Someone Is With You:

• Have them call 911 immediately and bring an AED (Automated External Defibrillator) if available.
• Begin CPR immediately while they get help.

If You’re Alone:

• Perform 2 minutes (about 5 cycles) of CPR first, then call 911.
• If you have a cell phone, put it on speaker mode so you can continue CPR while talking to the dispatcher.

This order is important: infants often need immediate oxygenation before professional help arrives.

Step 3: Open the Airway

• Position the Baby:
  • Lay the baby on a firm, flat surface (like a table or the floor).
  • Keep their neck and spine aligned.
• Head Tilt–Chin Lift (Gentle!):
  • Place one hand on the baby’s forehead and two fingers under the chin.
  • Gently tilt the head back to open the airway.
  • Avoid tilting too far — excessive tilt may block the airway in infants.
• Look into the Mouth:
  • If you see a visible object (like food or mucus), sweep it out gently with your little finger.
  • Do not blind sweep — inserting your finger without seeing an object can push it deeper.

Step 4: Check for a Pulse

If you are trained to check a pulse:

• Use two fingers (index and middle) to feel the brachial pulse on the inside of the upper arm, halfway between the elbow and shoulder.
• Check for no more than 10 seconds.

If no pulse or you’re unsure, start chest compressions immediately.

Step 5: Start Chest Compressions

Hand Placement:

• Use two fingers (index and middle) in the center of the chest, just below the nipple line.
• Avoid pressing on the ribs or the bottom of the sternum.

Compression Technique:

• Press down about 1.5 inches (4 cm) deep.
• Allow the chest to fully rise after each compression.
• Keep your fingers perpendicular to the chest.
• Compress at a rate of 100–120 compressions per minute (roughly to the beat of “Stayin’ Alive” or “Baby Shark”).

Counting:

Perform 30 compressions, then give 2 rescue breaths.

Step 6: Give Rescue Breaths

Rescue breaths are critical in infant CPR because their cardiac arrest is usually caused by oxygen deprivation.

How to Give Rescue Breaths:

• Maintain the head tilt–chin lift position.
• Cover the baby’s nose and mouth with your mouth — forming a tight seal.
• Deliver 1 gentle puff of air (from your cheeks, not lungs) over 1 second.
  • The chest should rise visibly with each breath.
• If the chest doesn’t rise:
  • Reposition the head slightly and try again.
  • If it still doesn’t rise, resume compressions.

Compression-to-Breath Ratio:

• Single Rescuer: 30 compressions → 2 breaths
• Two Rescuers: 15 compressions → 2 breaths

Continue this cycle until the baby starts breathing, an AED arrives, or emergency responders take over.

Step 7: Use an AED (Automated External Defibrillator)

While rare in infants, some cardiac arrests are due to abnormal heart rhythms that can be corrected with a shock from an AED.

How to Use an AED on an Infant:

• Turn it on and follow the voice instructions.
• Use pediatric pads if available.
• Pad Placement:
  • One pad on the center of the chest.
  • One pad on the back between the shoulder blades (front-back placement).
• If only adult pads are available:
  • You may still use them — but ensure they do not touch each other.
• Once pads are in place, follow the AED prompts:
  • Stand clear during rhythm analysis and shock delivery.
• Immediately resume CPR after the shock or “no shock advised” message.

Step 8: Continue CPR Until Help Arrives

Do not stop unless:

• The baby starts breathing or moving.
• EMS arrives and takes over.
• The scene becomes unsafe.
• You are too exhausted to continue.

Remember, even if you feel unsure, some CPR is always better than none.

Infant CPR in Special Situations

1. Choking Infant (Conscious)

If the infant is choking but still conscious:

• Support the baby’s head and body.
• Deliver 5 firm back blows between the shoulder blades with the heel of your hand.
• If the object doesn’t come out, turn the baby over and give 5 chest thrusts (same as CPR compressions).
• Repeat 5 back blows + 5 chest thrusts until the object is expelled or the baby becomes unresponsive.
• If unresponsive, begin CPR immediately and check for obstruction each time you open the airway.

2. Drowning or Suffocation

• Start with 2 rescue breaths first before compressions.
• Then follow standard 30:2 CPR cycles.
• Early oxygenation is crucial in these cases.

Key Differences Between Infant and Adult/Child CPR

CPR Element	Adult	Child (1–8 yrs)	Infant (Under 1 yr)
Compression Depth	2 inches (5 cm)	2 inches (5 cm)	1.5 inches (4 cm)
Compression Method	Two hands	One or two hands	Two fingers
Rescue Breath Type	Mouth-to-mouth	Mouth-to-mouth	Mouth-to-mouth-and-nose
Compression-to-Breath Ratio	30:2	30:2 (single rescuer) / 15:2 (two rescuers)	30:2 (single rescuer) / 15:2 (two rescuers)
AED Pads	Adult pads	Child pads preferred	Pediatric pads preferred
Cause of Arrest	Cardiac	Respiratory	Respiratory

Common Mistakes During Infant CPR

• Pressing Too Hard or Too Soft:
  • The depth should be about 1.5 inches. Pressing too lightly won’t circulate blood; too deeply can cause injury.
• Forgetting Rescue Breaths:
  • Breathing is crucial for infants — don’t skip it unless trained for hands-only CPR.
• Tilting the Head Too Far Back:
  • A small tilt is enough. Overextending can block the airway.
• Not Allowing Chest Recoil:
  • Always let the chest return fully before the next compression.
• Stopping Too Soon:
  • Continue until professionals arrive or the baby breathes again.
• Fear of Hurting the Baby:
  • The real harm comes from not acting at all.

Preventing Infant Cardiac Arrest

Prevention starts at home. Parents and caregivers can significantly reduce risks by following these safety guidelines:

1. Safe Sleep

• Always place babies on their backs to sleep.
• Keep blankets, pillows, and toys out of the crib.
• Use a firm mattress with a fitted sheet.
• Avoid overheating or overdressing the baby.

2. Choking Prevention

• Avoid giving infants nuts, grapes, popcorn, or hard candies.
• Cut food into tiny, manageable pieces.
• Keep small objects and toys out of reach.
• Always supervise feeding and playtime.

3. Bath and Water Safety

• Never leave an infant unattended near water — even for a few seconds.
• Empty buckets, bathtubs, and pools after use.
• Use approved infant flotation devices.

4. Manage Illnesses Promptly

• Treat respiratory infections early.
• Keep up with vaccinations.
• Know your baby’s medical history — especially if there’s a heart defect or chronic illness.

Good Samaritan Protection

Many caregivers hesitate to perform CPR out of fear of legal consequences. However, Good Samaritan Laws protect individuals who act in good faith during emergencies.

You are protected as long as:

• You act voluntarily and responsibly.
• You don’t expect payment.
• You stay within your level of training.

So if you ever face an emergency, remember — you are legally safe to help.

Emotional Impact and Recovery

Performing CPR on a baby is emotionally taxing, even for professionals. After the incident:

• Take time to process your emotions.
• Talk to a counselor or join a support group.
• Reflect and learn from the experience — you took brave, lifesaving action.

Importance of Infant CPR Training

While reading about CPR is valuable, hands-on training builds the confidence you need to act quickly in real life.

Training Resources:

• American Heart Association (AHA) Pediatric First Aid and CPR Courses
• Red Cross Infant CPR and AED Certification
• Local hospitals or community centers often host parent CPR workshops.

Training teaches you:

• Realistic compressions on infant mannequins
• How to handle choking incidents
• How to use an AED safely
• How to stay calm under pressure

These courses usually take just a few hours — but they could save a lifetime.

Real-Life Story: A Mother’s Quick Thinking Saves Her Baby

When six-month-old Ava suddenly stopped breathing after choking on a small piece of fruit, her mother, Rachel, remembered the infant CPR class she took just two months earlier.

Rachel immediately laid Ava on a firm surface, cleared her airway, and began two-finger compressions with gentle rescue breaths. Within moments, Ava coughed and began breathing again.

By the time paramedics arrived, Ava was stable. Doctors later confirmed that Rachel’s quick response prevented brain damage and likely saved her life.

Stories like these highlight how one calm, trained caregiver can make the ultimate difference.

Dispatcher-Assisted Infant CPR

If you call 911, a trained dispatcher will:

• Help you identify cardiac arrest signs.
• Guide you through each compression and breath.
• Count rhythm for you and instruct AED use if available.

Even without formal training, dispatcher-assisted CPR significantly increases infant survival rates.

After the Emergency: What to Expect

If your baby needed CPR:

• Expect the medical team to run tests for oxygen levels, heart rhythm, and brain function.
• The infant may be monitored in a neonatal intensive care unit (NICU) for 24–48 hours.
• Emotional and psychological support for parents is encouraged.

Early CPR often leads to full recovery — especially when performed within the first 1–2 minutes of collapse.

Quick Recap: Step-by-Step Infant CPR

• Check for responsiveness and breathing.
• Call for help (911).
• Open the airway (gentle head tilt–chin lift).
• Check pulse (brachial artery).
• Give 30 chest compressions with two fingers (1.5-inch depth).
• Give 2 gentle rescue breaths (cover mouth and nose).
• Use AED if available (pediatric pads).
• Continue CPR cycles until help arrives or baby revives.

Conclusion

Knowing how to perform CPR on an infant isn’t just a valuable skill — it’s an act of love and preparedness. Emergencies happen fast, but with the right knowledge and composure, you can save a life that’s just beginning.