The infant recovery position (IRP) is a specialized first aid technique designed for babies under one year old. This maneuver protects an unconscious infant’s airway, ensuring they can continue to breathe freely while awaiting medical help. Its primary function is to prevent aspiration—the inhalation of stomach contents or fluids into the lungs—by using gravity to keep the airway clear. The IRP also prevents the tongue from falling back and blocking the throat, a common risk when an unconscious person is lying flat on their back.
When to Use the Infant Recovery Position
The infant recovery position must be used when an infant is completely unresponsive to stimuli, such as gently tapping or calling their name. Simultaneously, the infant must still be breathing normally on their own, meaning their breaths are smooth and regular.
Placing the infant in this position is a temporary measure to safeguard the airway until professional medical assistance arrives. Common situations necessitating the IRP include unconsciousness following a seizure, a severe illness, or after a successful attempt has been made to clear a choking obstruction. If the infant is unresponsive and not breathing normally, or is only making irregular, gasping breaths, the immediate action must be to begin Cardiopulmonary Resuscitation (CPR).
Positioning the Body and Airway Management
The first step is to ensure that emergency medical services have been called immediately. With help on the way, the focus turns to carefully positioning the infant to maintain an open airway and facilitate fluid drainage. The infant recovery position involves cradling the baby in the rescuer’s arms rather than placing them on the ground like an adult.
The core technique requires supporting the infant with one arm and gently turning them onto their side so they are facing the rescuer. The head must be supported and positioned lower than the rest of the body. This downward angle utilizes gravity to allow any fluid, such as vomit or saliva, to drain directly out of the mouth.
To secure the head, the rescuer’s hand or forearm cradles the back of the baby’s head and neck. While keeping the head lower than the chest, the infant’s head should be tilted slightly back, often referred to as the “neutral” or “sniffing” position. This slight tilt maintains the airway without causing hyperextension. This is important because an infant’s flexible trachea can collapse if the neck is tilted too far back. The other hand is used to stabilize the rest of the infant’s body. Continuous monitoring of the infant’s breathing and color is necessary until medical personnel take over.
Key Differences from Adult Positioning
The technique for infants differs from the adult recovery position due to anatomical differences. An infant’s head is proportionally much larger and heavier relative to their body size, and their neck muscles are weaker. This anatomy requires the rescuer to provide full support to the head and neck, which is why the infant is cradled and held, unlike an adult who is stabilized on the ground.
Another difference lies in the management of the airway. In adults, the recovery position involves a distinct head-tilt/chin-lift to open the airway. For an infant, this degree of tilting can obstruct the airway because the soft tissues and trachea are more pliable. Therefore, the infant’s head is only placed in the neutral or slightly extended position to maintain patency. Furthermore, the downward tilt of the infant’s head is a unique feature of the IRP, ensuring that gravity assists in drainage, a technique not employed in the standard adult recovery position.