Cardiopulmonary resuscitation (CPR) for infants is a life-saving skill. Knowing how to respond promptly and correctly when an infant’s breathing or heartbeat stops can improve outcomes. Preparedness is therefore important for anyone who cares for infants.
Recognizing the Need for Infant CPR
Before initiating CPR, a single rescuer must assess the infant’s condition. Gently tap the infant’s foot or shoulder and speak to them to check for responsiveness. Never shake an infant, as this can cause injury.
Observe for normal breathing by looking for chest movement, listening for breath sounds, and feeling for breath on your cheek. Gasping is not normal breathing and indicates a need for intervention.
If the infant is unresponsive and not breathing normally, immediately call emergency medical services (EMS). If another person is present, instruct them to call 911 and retrieve an automated external defibrillator (AED) if available. If alone, perform approximately two minutes of CPR before pausing to call 911 yourself.
The 1-Rescuer Infant CPR Protocol
For a single rescuer, the recommended compression-to-breath ratio for infant CPR is 30 compressions followed by 2 rescue breaths. This ratio is consistent with guidelines from organizations like the American Heart Association (AHA) and the American Red Cross. Place the infant on their back on a firm, flat surface. Position two fingers in the center of the infant’s chest, just below the nipple line, avoiding the very end of the breastbone.
Compress the chest approximately 1.5 inches (about 4 cm) deep, roughly one-third the depth of the infant’s chest. Deliver compressions at a rate of 100 to 120 per minute, allowing the chest to fully recoil after each. After 30 compressions, open the infant’s airway by gently tilting the head back slightly and lifting the chin.
Place your mouth over the infant’s mouth and nose, creating a complete seal. Deliver each rescue breath over about 1 second, observing for visible chest rise to confirm effectiveness. If the chest does not rise, reposition the airway and attempt another breath, ensuring a proper seal. Continue this cycle of 30 compressions and 2 breaths, maintaining a consistent rhythm.
Critical Aspects of Infant CPR
Minimizing interruptions to chest compressions is important, with pauses for breaths ideally lasting less than 10 seconds. Ensure each rescue breath makes the infant’s chest visibly rise, confirming air enters the lungs. If the chest does not rise, it may indicate an obstructed airway or an inadequate seal, requiring re-evaluation of head position and seal.
If another trained individual becomes available, rescuers should switch roles approximately every two minutes, or after about five cycles of 30 compressions and 2 breaths, to prevent fatigue and maintain high-quality compressions. CPR should be continued until emergency medical services personnel arrive and take over care, the infant shows clear signs of life such as normal breathing or movement, or the rescuer becomes too exhausted to continue.