Child and infant CPR: what to do step by step

If a child or baby is unresponsive and not breathing normally, they need CPR straight away: 5 initial rescue breaths and then chest compressions, while you call 112 on speaker. The protocol is shared for children and infants, with only a few differences in technique. It sounds frightening, but it's simpler than it seems — and the minutes until the ambulance arrives are held by you.

When CPR is needed

According to the ERC, an infant is a child under one year old, and a child is from one year to puberty. Start CPR when both of these are true:

• They are unresponsive: they don't wake, don't move, don't react to your voice or touch.
• They are not breathing normally: not breathing at all, or only taking occasional, noisy, gasping breaths.

Don't waste time looking for a pulse. If they're unresponsive and not breathing normally, begin.

How to do child and infant CPR, step by step

1. Safety. Make sure the area is safe for you and the child.
2. Check for a response. Never shake a child or baby.
   • Infant: tap the sole of the foot and call to them.
   • Child: tap the shoulders gently and call to them loudly.
3. Immediately call 112 on speaker and, at the same time, check breathing. Put 112 on speaker so your hands are free. At the same moment open the airway and, for up to 10 seconds, look at the chest, listen and feel for breathing. If someone is with you, send them to fetch a defibrillator.
   • Infant: head in a neutral position — level, not tilted back, because in a baby that closes the airway. Gently lift the chin.
   • Child: slight backward tilt of the head and chin lift.
4. If they're not breathing normally, give 5 initial rescue breaths (about 1 second each, just enough to make the chest rise slightly — with the air in your mouth, not with force).
   • Infant: cover both the nose and mouth with your mouth.
   • Child: pinch the nose, keep the head slightly tilted and give mouth-to-mouth breaths.
5. Give 15 chest compressions on the lower half of the breastbone, at a rate of 100–120 per minute, letting the chest fully recoil each time.
   • Infant: two-thumb technique (encircle the chest, both thumbs on the breastbone), depth at least one-third of the chest (~4 cm).
   • Child: with the heel of one hand — or both hands, if needed to reach the depth — at least one-third of the chest (~5 cm).
6. Continue 15 compressions to 2 breaths, without long pauses, until help arrives.

The 15:2 ratio is taught in paediatric CPR (PBLS). If you haven't been trained and aren't sure, use 30:2 as for an adult. And if you can't give breaths, do compressions only — anything is far better than doing nothing.

Defibrillator (AED) in a child and infant

Yes, a defibrillator is used on both. As soon as one is available, use it and follow its voice prompts.

• If it has paediatric pads or a paediatric setting (for children under 8 and infants), use them.
• If it only has adult pads, use those — we don't skip defibrillation. On an infant and a small child, so the pads don't touch, place one on the centre of the chest and the other on the back.

When to stop

Continue CPR until: the child starts breathing normally or responds, the ambulance crew takes over, or you can no longer continue from exhaustion.

Differences by age

Infant (under 1 year)

• Head position: neutral (level)
• Compressions: two thumbs, on the lower half of the breastbone
• Depth: about one-third of the chest (~4 cm)
• Initial breaths: 5
• Ratio (if trained): 15:2

Child (1 year – puberty)

• Head position: slight tilt
• Compressions: one or two hands, on the lower half of the breastbone
• Depth: about one-third of the chest (~5 cm)
• Initial breaths: 5
• Ratio (if trained): 15:2

Adult (for comparison)

• Head position: full tilt
• Compressions: two hands, in the centre of the chest
• Depth: 5–6 cm
• Initial breaths: start straight with compressions
• Ratio: 30:2

Common mistakes

• Wrong head position: in a baby, tilting the head back closes the airway (keep it neutral); in a child, by contrast, you need a slight tilt.
• Breaths that are too forceful. Just enough to make the chest rise slightly.
• Shallow compressions, or not letting the chest fully recoil.
• Wasting time looking for a pulse.
• Long, frequent pauses in compressions.

If the child or baby is choking (not in arrest)

If the airway is blocked by food or a foreign object, the response is different. See in detail: Choking in a child and infant.

Why hands-on training makes the difference

Reading the steps helps, but in the moment what counts is having done them with your own hands on a manikin: how much force, how deep, how fast. A PBLS course lets you practise exactly that, calmly and with guidance, so you can respond with confidence if you ever need to.

This article is for information only and does not replace hands-on training. In any emergency, call 112.