Infant and Child CPR: What Every Parent Should Know

This guide provides a comprehensive overview of infant and child CPR and choking response. It is not a substitute for hands-on training — reading these instructions will help you understand the concepts and sequence, but practicing on a mannequin is what builds the muscle memory your hands will rely on when adrenaline is flooding your brain in a real emergency. The American Heart Association and American Red Cross offer in-person and online CPR courses specifically designed for parents and caregivers. Take one. It's a few hours that could save your child's life. That said, knowing the information here is far better than knowing nothing at all, and in an emergency, imperfect CPR is vastly better than no CPR.

When to Start CPR

Start CPR when a child is unresponsive and not breathing normally. The assessment takes only seconds. For an older infant or child, tap their shoulders firmly and shout their name loudly: "Are you okay?" For a young infant, flick the bottom of their foot firmly while calling their name. Look for any response — eye opening, movement, crying, moaning. If there's no response and the child is not breathing or is only gasping (agonal breathing — irregular, gasping breaths that are not effective breathing), they need CPR immediately.

If someone else is present, have them call 911 immediately while you begin CPR. If you're alone with an infant or child, perform 2 minutes of CPR before stopping to call 911 — in pediatric emergencies, the cause is most often respiratory (choking, drowning) rather than cardiac, which means those first 2 minutes of CPR providing oxygen to the brain are critically important. After calling 911, return immediately to CPR and continue until the child responds, professional help arrives, an AED becomes available, or you are physically unable to continue.

Infant CPR (Under 1 Year)

Step 1: Position the Infant

Place the infant on a firm, flat surface — the floor, a table, or any hard surface available. A soft surface like a bed or couch absorbs the force of compressions and makes them less effective. If you suspect a neck or spine injury, move the baby as little as possible while still placing them on a firm surface.

Step 2: Chest Compressions

Place two fingers — your index finger and middle finger — on the center of the infant's chest, just below the nipple line (on the breastbone, not on the end of the breastbone). Push straight down approximately 1.5 inches, which is about one-third the depth of the infant's chest. This feels like a lot and it feels like you might hurt them — compress firmly. Ineffective, too-gentle compressions don't circulate blood. Compress at a rate of 100 to 120 compressions per minute, which is the tempo of "Staying Alive" by the Bee Gees or "Baby Shark." Allow the chest to fully recoil (come back up completely) between each compression — full recoil is essential because it allows the heart to refill with blood before the next compression. Don't lift your fingers off the chest between compressions — let the chest rise fully under your fingertips while maintaining contact.

Step 3: Rescue Breaths

After 30 compressions, provide rescue breaths. Tilt the infant's head back slightly into a neutral or "sniffing" position — a very slight head tilt, not the dramatic extension you'd use for an adult. Over-extending an infant's neck can actually kink their small, flexible airway. Cover the infant's nose and mouth completely with your mouth, creating a seal. Give 2 gentle breaths, each lasting about 1 second — just enough to see the chest visibly rise. Don't blow hard — infant lungs are tiny and overinflation can cause injury. If the chest doesn't rise, reposition the head (the most common problem is incorrect head positioning) and try the breaths again.

Step 4: Continue the Cycle

Continue the cycle: 30 compressions, then 2 breaths. 30 compressions, then 2 breaths. Don't stop to check for signs of life unless the child clearly responds (cries, moves, breathes normally). Continue until the child responds, emergency medical services arrive and take over, an AED is available and ready to use, or you are physically too exhausted to continue (in which case, if another trained person is present, they should take over immediately).

Child CPR (Ages 1-8)

For children over 1 year, the principles are the same but the technique adjusts for the larger body. Use the heel of one hand (or two hands for larger children) placed on the center of the chest on the lower half of the breastbone. Compress approximately 2 inches deep — this is deeper than infant compressions and requires more force. Maintain the same rate: 100 to 120 compressions per minute. Maintain the same ratio: 30 compressions to 2 rescue breaths.

For rescue breaths, tilt the child's head back further than you would for an infant to open the airway — the "head tilt, chin lift" maneuver. Pinch the child's nose closed with your fingers, seal your mouth over theirs, and deliver 2 breaths, each lasting about 1 second, watching for visible chest rise. Continue the 30:2 cycle without interruption.

Key differences to remember: Infant CPR uses 2 fingers for compressions, slight head tilt, and covers nose and mouth together for breaths. Child CPR uses 1-2 hands for compressions, more head tilt, and pinches the nose while covering the mouth for breaths. Compression depth is 1.5 inches for infants, 2 inches for children over 1.

Hands-Only CPR: When You're Unsure

If you haven't been trained or don't feel confident providing rescue breaths, hands-only CPR (continuous chest compressions without breaths) is still significantly better than doing nothing. Push hard and fast on the center of the chest at 100 to 120 compressions per minute without stopping. While rescue breaths are particularly important in pediatric emergencies (which are more often respiratory in origin), chest compressions alone still circulate oxygenated blood and dramatically improve survival compared to no intervention. Don't let uncertainty about technique stop you from acting — any CPR is better than no CPR.

Choking Response: Infant (Under 1 Year)

If an infant is choking — unable to cry, cough effectively, or breathe, silent or making only high-pitched squeaking sounds — act immediately. Place the infant face-down along your forearm with their head lower than their body, supporting the jaw and head with your hand. Brace your forearm against your thigh for stability. Give 5 firm back blows between the shoulder blades using the heel of your free hand. Each blow should be a distinct, forceful strike. Turn the infant face-up on your other forearm, keeping the head lower than the body. Give 5 chest thrusts using 2 fingers on the center of the breastbone, pressing down about 1.5 inches. Check the mouth — if you can see the object, carefully remove it with a finger sweep. Do not blindly sweep the mouth if you can't see an object, as this can push it deeper.

Repeat the cycle: 5 back blows, 5 chest thrusts, alternating until the object is expelled, the infant begins to breathe and cry, or the infant becomes unresponsive. If the infant becomes unresponsive, place them on a firm surface and begin infant CPR. Before giving rescue breaths during CPR, look in the mouth — if you see the object, remove it, then give the breaths.

Choking Response: Child (Over 1 Year)

For children over 1 year who are choking, perform abdominal thrusts (the Heimlich maneuver). Stand or kneel behind the child. Wrap your arms around their waist. Make a fist with one hand and place the thumb side against the child's abdomen, above the navel and well below the breastbone. Grasp your fist with your other hand. Give quick, inward-and-upward thrusts. Each thrust should be a distinct, forceful movement aimed at creating enough pressure to expel the object from the airway. Repeat until the object is expelled or the child becomes unresponsive. If the child becomes unresponsive, lower them carefully to the ground and begin CPR, checking the mouth for the object before each set of rescue breaths.

Related: Baby Choking: What to Do and How to Prevent It

Take a Class — This Is the Most Important Section

Reading about CPR gives you the knowledge. Practicing gives you the skill. In a real emergency, you won't calmly recall these written instructions — you'll rely on muscle memory built through physical practice. The American Heart Association, American Red Cross, and many local hospitals and community centers offer parent-focused infant and child CPR classes that take just 2 to 3 hours. Some offer online courses with practice mannequin kits shipped to your home. Many birthing centers and hospitals offer classes specifically for expectant parents. Some pediatricians' offices organize group classes. The investment is minimal — a few hours and a modest fee — and the return is the ability to save your child's life in the worst moment of yours. Consider retaking the class every 2 years, as guidelines are updated periodically and skills degrade without practice.