Infant CPR step-by-step

This is not a substitute for an in-person infant CPR class. It is a reference for parents who took the class and want to see the steps written out before the panic kicks in.

The basics: what CPR does

CPR (cardiopulmonary resuscitation) does two things: it forces blood through the body via chest compressions, and it forces oxygen into the lungs via rescue breaths. Both keep tissue alive — especially the brain — until paramedics arrive with defibrillators, IV access, and medications.

CPR does not restart a baby's heart. The point is to buy time. So the answer to "should I keep going" is always "yes, until help arrives."

Step 1: confirm unresponsive and not breathing

1. Tap the bottom of baby's foot or rub their breastbone firmly.
2. Call their name loudly.
3. Look for normal breathing — chest rising and falling — for no more than 10 seconds.
4. If no response and no normal breathing, start CPR.

Gasping is not normal breathing. If baby is gasping irregularly, start CPR.

Step 2: position

1. Place baby on a firm, flat surface — the floor is better than a couch, which absorbs compression force.
2. Make sure their head is in a neutral or slightly tilted-back position.
3. Strip clothing off the chest if you can do it in 3 seconds. Otherwise leave it.

Step 3: open the airway and check for an obstruction

1. One hand on baby's forehead, two fingers under their chin — gentle head-tilt-chin-lift.
2. Look into their mouth for a visible obstruction. If you see something, sweep it out with one finger. Never blind-sweep — you can push it deeper.

Step 4: 2 rescue breaths

1. Place your mouth over both baby's mouth and nose. (Adult-sized mouths cover both at once.)
2. Give 2 small puffs of air. Just enough to see the chest rise. About 1 second per breath.
3. If the chest doesn't rise, reposition the head and try again.
4. If still no chest rise, the airway is blocked — go to back blows + chest thrusts (see choking infant guide).

Do not blow hard. Adult lung volumes will damage infant lungs. Think "puff," not "breath."

Step 5: 30 chest compressions

1. Place 2 fingers (index and middle) on the breastbone, just below the nipple line, in the center of the chest.
2. Press straight down 1.5 inches (about 1/3 the depth of the baby's chest).
3. Let the chest fully come back up between each compression.
4. Rate: 100-120 compressions per minute. The beat of "Staying Alive" or "Baby Shark" works.
5. Count out loud: "1, 2, 3, 4 ... 28, 29, 30."

If two rescuers are present, switch to a 15:2 ratio (15 compressions per 2 breaths). The second rescuer does breaths. Switch every 2 minutes to prevent fatigue.

Step 6: repeat 30:2 until help arrives

1. Give 30 compressions.
2. Give 2 breaths.
3. Repeat. Do not stop unless baby starts moving, breathing, or paramedics take over.

If you are alone with no phone, do 2 minutes of CPR (about 5 cycles), then call 911 and put it on speaker. If you have a phone within reach, call 911 first, then start CPR while the dispatcher coaches you.

What changes after baby turns 1

For children ages 1 to puberty:

• Compression depth: 2 inches (still 1/3 the chest depth, but the chest is bigger).
• Compression hand: heel of one hand (not 2 fingers). Two hands for larger children.
• Compression rate: still 100-120 per minute.
• Compression-to-breath ratio: 30:2 if alone, 15:2 if two rescuers.

If your home has an AED

Use the AED as soon as it arrives. Most AEDs have child or infant pads. If only adult pads are available, place one on the front of the chest and one on the back. Follow the AED's voice prompts. It will tell you when to deliver a shock or continue CPR.

Common mistakes

• Compressions too shallow. Most parents under-press in CPR class. Push hard enough that you feel resistance.
• Compressions too slow. Use a beat. Faster than you'd think.
• Breaths too big. A small puff is enough. You will damage lungs with adult-sized breaths.
• Stopping too early. Keep going until help arrives, even if it feels hopeless. Brains recover from longer-than-you-think CPR.
• Not calling 911 because you are doing CPR. Call first if a phone is within reach. Put on speaker.

What to do right now

• Sign up for a 2-hour in-person infant + child CPR class within the next month. American Red Cross, AHA, or local hospital. $45-75.
• Save Poison Control (1-800-222-1222) and 911 in your phone favorites.
• Print this page, fold it, tuck it in your diaper bag.
• Tell every adult who watches your baby where the printout is.
• Refresh every 6 months. CPR muscle memory fades fast.

When to call the pediatrician (after the emergency)

• Any episode that required CPR or rescue breaths — ER, then follow-up with pediatrician.
• Any "near miss" — baby was unresponsive briefly, then revived without CPR — same day pediatrician visit minimum.
• Any apnea (breathing pause longer than 20 seconds) in an infant under 6 months — go to the ER.
• Any choking episode that resolved without help, especially if baby is still coughing 1 hour later — pediatrician.