The concept of doing infant CPR may fill you with fear and anxiety. No parent wants to think about a situation where their baby needs help staying alive. These thoughts can easily keep you up at night. But learning infant CPR could save your or another baby’s life. This article goes over what infant CPR is, the infant CPR ratio, how it’s different from adult CPR, and when you might need to perform infant CPR.
What is Infant CPR?
Infant CPR is a modified version of adult CPR. CPR is an acronym that describes heart (cardio) and lung (pulmonary) resuscitation. The “C” and “P” represent the two main targets of this practice:
- Cardio: Compressing the heart to keep blood pumping.
- Pulmonary: Inflating the lungs to provide oxygen.
To perform CPR, you — the rescuer — provides a series of breaths followed by chest compressions. These actions mimic the body’s life-giving processes and can keep essential organs from failing due to a lack of oxygen. CPR for infants looks a little different than the adult version.
Infant CPR is Different Than Adult CPR
An infant is defined as a baby under one year of age. If you think about a 2-month-old baby lying next to a 40-year-old adult, you’ll likely see why CPR would need to be modified a bit for the baby.1
Infant CPR is different than adult CPR in that it requires the following:
- 15 or 30 chest compressions per cycle, depending on the number of rescuers
- A different method for providing rescue breaths
- A different method of checking for a pulse
- Lighter chest compressions
- Shallower rescue breaths
The adult CPR ratio tends to provide for more compressions compared to breaths than the infant CPR ratio. A CPR ratio refers to the number of breaths to the number of compressions, like two breaths to 30 compressions. We’ll get into more on that below.2
Why Infant CPR is Important to Know
Knowing infant CPR is crucial for parents, caregivers, and even bystanders, as it can be a lifesaver in emergencies. The American Heart Association (AHA) reports that about 7,000 children under 18 experience cardiac arrest yearly. When high-quality CPR is given, it can double or even triple someone’s chances of survival.3,4
By learning this valuable skill, you can feel empowered to act quickly and confidently in an emergency, potentially giving an infant a second chance at life. Besides cardiac arrest, CPR can also help in cases of choking, drowning, and suffocation—common hazards for young children.5
Being able to perform infant CPR provides peace of mind and creates a safer environment for the little ones around you.
When to Perform CPR on an Infant
CPR saves lives, and it’s essential to understand the right moment to step in and start the process. All CPR instructors will tell you the first step of giving CPR is deciding if the person needs CPR.
These symptoms in your infant mean you should call for help and start CPR right away:6
- No pulse
- Not breathing
- Unresponsive or unconscious
First, always call for professional medical help (911) when you suspect an emergency. While waiting for help to arrive, check if the infant is responsive. Tap or flick the bottom of their foot and see if they react. If the baby doesn’t respond to you and is not breathing or is awake but gasping for air, it’s time to start infant CPR.
To check for a pulse, place the pads of two fingers on the inside of the baby’s bicep. Rest your fingers there momentarily, and don’t push too hard. You should feel a light pulse under your fingertips. If not, call for help and start CPR.
How to Properly Perform Infant CPR
Once you establish the baby has no pulse and is not breathing, you can start CPR. The steps to infant CPR can differ slightly depending on how many rescuers are there to help. These steps provided by the AHA will apply to a two-rescuer scenario, and we will cover one-rescuer differences afterward.
For Two Rescuers Providing Infant CPR
Step 1: Make sure the scene is safe
You cannot help anyone if you and other rescuers are in danger. Make sure your surroundings are safe before you begin.
Step 2: Call for help
Call 911 or tell someone close by to call 911. CPR is a placeholder, and EMS will bring the supplies needed to take over for you.
Step 3: If available, use an AED
An automated external defibrillator (AED) can help the baby in distress by discovering if a heart rhythm is causing the problem. If the rhythm can be fixed with a shock from the device, the AED can sometimes reverse the cause of cardiac arrest.7
AEDs are designed for the public and guide you through each step. One rescuer should use the AED while the other does compressions and breaths.
Step 4: Begin compressions
Place the pads of two fingers on the baby’s sternum, or breastbone, just under the nipple line. You can also use an encircling hands technique. Press down to about 1½ inches or ⅓ of the chest diameter, and release, letting the chest expand fully. Continue to press down at a regular rhythm (100-120 beats per minute) and repeat 15 times per the infant CPR ratio.2,8
You can see illustrations of the two-finger and encircling hands techniques here.
Step 5: Rescue breaths
Quickly give two rescue breaths by pressing your open mouth over the baby’s nose and mouth. Lift the chin slightly with a finger, and breathe into the baby’s nose and mouth, careful not to over-inflate. You should see the baby’s chest rise and fall with your breaths.
Step 6: Repeat the cycle
Continue to give baby 15 compressions and two rescue breaths until help arrives.
For Single-Rescuer Infant CPR
You can still do it solo if you are alone with a baby who needs CPR. First, call 911. Then follow the same steps as above but do 30 compressions every two breaths (30:2 infant CPR ratio). If another rescuer comes along, you can switch to the 15:2 infant CPR ratio.
How and Where to Get Infant CPR Certified
Several organizations offer classes if you want hands-on training with infant CPR. In these classes, you can work with a mannequin that will give you a feel for how hard to press, how much air to breathe out, and how fast to do compressions.
You can find available infant CPR classes in your area from the following sites:
You want to ensure you take a certified CPR program because CPR recommendations are constantly scrutinized and updated often. Any class offering AHA or Red Cross certifications is a good choice.
Tips for How to Properly Perform Infant CPR
CPR can feel intimidating, so why not take some tips from health professionals who have done it?
How Fast Should I Do Compressions?
It’s easy to say, “Compress at a rate of 100-120 beats per minute,” but math may not be your strong suit in an emergency. You can use the “Staying Alive” tune by the Bee Gees to keep you in rhythm. Compress at each capital letter: “Ah Ah Ah Ah Stayin’ a Live, Stayin’ a Live!”
How Do I Know My Rescue Breaths Are Working?
It can be tough to know if your rescue breaths are working. You want to see the chest rise with each breath. If the belly starts to get big, you might be blowing air into the stomach. If you don’t see the chest rise, the baby’s airway might be blocked.
Put the palm of one hand on the baby’s forehead and two fingers of the other hand under the chin, lifting it gently to open the airway. If you still don’t see the chest rise, raise or lower your chin to find the sweet spot.
Do I Have to Do Rescue Breathing?
Hands-only CPR has grown in popularity and recommendations for out-of-hospital cardiac arrest. If you don’t have a mouth barrier, you may not want to put your mouth on a stranger’s mouth.9
You can do CPR with just compressions—it’s better than nothing. But infants most often go into cardiac arrest because of a breathing problem, and their growing brains need oxygen desperately, so if you feel comfortable, include rescue breaths in your CPR.10
Once you know CPR and how to perform infant CPR, you may feel equally relieved to own this knowledge, while terrified you may have to do it. But rest assured, this skill is critical to have as a parent or anyone who spends time with infants and small children. Hopefully, you will never need to use it, but you’ll be ready if you do!