How to Perform Infant CPR

Any adult who spends time around an infant or small child can benefit from knowing how to
perform CPR, should the need arise. Having this special knowledge can help you be prepared to respond quickly and assist in the event that an emergency occurs.

What Is CPR?

CPR stands for cardiopulmonary resuscitation. When you administer CPR to someone, you are trying to revive them when their heart stops beating and is therefore no longer pumping blood throughout their body. By performing CPR, you are keeping some of the blood flowing, which supports the circulation of oxygen. Even partial blood flow is better than nothing.

There are actually two types of CPR: Chest compressions combined with mouth-to-mouth rescue
breathing, and chest compressions only.

Why two versions? According to the American Heart Association (AHA), the combined version is mostly intended for healthcare providers and people who are trained in CPR, noting that general bystanders might not feel totally prepared to administer this version.

With that in mind, the AHA released a set of recommendations for bystanders in 2008 featuring a chest-compression-only version of CPR for an adult in crisis. In fact, research has found that people may be more willing to try CPR as a bystander if they only have to do the chest compression version.

However, it's important to note that the chest compression-only form of CPR is solely recommended for adults. The recommendations for infants and children still include rescue breathing to keep oxygen flowing to their lungs, as permanent brain damage can begin in as little as four minutes without oxygen.

How to Perform Infant CPR (Ages 0-1)

Performing CPR on a baby is similar to performing CPR on a child or adult, but there are a couple of
key differences. Babies are obviously much tinier than fully-grown adults, so you have to adapt your technique to accommodate a smaller body.

“With an infant, you use two thumbs or fingers to give chest compressions," says David Markenson, MD, chief medical officer for American Red Cross Training Services.

When you use two thumbs or fingers, it helps you achieve the depth needed for chest compressions that are proportionate for an infant. Meaning, you can’t press down quite as far with two fingers as you could with two hands, but that’s appropriate for a baby's size.

Here are the steps to perform infant CPR, as recommended by the American Red Cross.

Check the Baby for Responsiveness

Call their name loudly, tap them on the shoulder, and call their name again. If the baby doesn’t respond within about 10 seconds, proceed.

Call for Help

Make sure someone calls 911 as soon as possible.

Position the Baby

Put the baby down on a hard, flat surface, then stand or kneel next to them.

Position Your Hands and Begin Compressions

Put both of your thumbs (or two fingers) side by side in the center of the baby’s chest, just below the nipple line, and push down hard—about 1 ½ inches. Perform 30 chest compressions.

Administer Rescue Breaths

First, lift the baby’s chin to open their airway. The American Red Cross suggests aiming for a "neutral" position by using a head tilt / chin lift approach. Breathe into the baby’s mouth for one second. Repeat with another breath.

Repeat the Cycle

Repeat the entire cycle, with 30 chest compressions and two breaths. Continue to perform the entire series until the baby responds or emergency help arrives—whichever occurs first.

Things to Keep in Mind When Performing Infant CPR

The American Red Cross recommends giving “hard and fast” chest compressions at a rate of 100-120 per minute, and you need to maintain that rate the entire time for optimum results.

“It’s easier to go faster, but if you go too fast, you don’t allow the chest [enough time] to expand back,” explains Susan Fuchs, MD, a pediatrician in Chicago who helped develop the American Academy of Pediatrics’ First Aid/CPR/Choking chart.

But those counts can be hard to gauge when your own blood is racing during an emergency. So, think “Stayin’ Alive”—quite literally. The Bee Gees’ hit 1977 song provides the perfect guidance for administering CPR. In fact, it’s even been scientifically proven, as a study in the Annals of Emergency Medicine verified that giving compressions to the song’s beat helped people maintain the correct rate.

You also want to be mindful of an infant's head position while administering CPR. According to Dr. Fuchs, you may need to put a rolled-up towel or newspaper under their shoulder blades to position them so that their chin is fully off of their chest.

Then, when you give the breaths, watch the baby for movement. “If you don’t see the chest rise, you
may need to tilt the head back a little more,” says Dr. Fuchs.

How Is Child CPR (Ages 1-8) Different?

If you ever need to perform CPR on a child between the ages of 1 and 8, you will still give
30 compressions, followed by two breaths. But you will need to slightly adjust your hand position and technique on the child’s chest.

“You could not compress the chest enough with two fingers on a seven-year-old child,” says Dr.
Markenson.

With a smaller child, you can use the heel of one hand to give chest compressions, and can put one hand on top of the other with a larger child. Either way, make sure the child’s chest returns to its normal position after each pump of your hands. You also want to make sure the child’s chest rises every time you give them a rescue breath.

You may worry that you’re going to hurt them with those hard, fast compressions, but don’t let that deter you if the child is unresponsive and in cardiac arrest, says Dr. Markenson. With your efforts, you can work to keep blood and oxygen circulating in their body, reducing the likelihood of permanent brain injury or even death.

The Benefits of CPR Certification

The purpose of the CPR certification process is to make sure you understand how to perform CPR correctly—and to give you both practice and confidence in case you ever are called to put your skills to use. Understanding how to do CPR is great, but formal training and certification can be extremely beneficial.

You can check with your local chapter of the American Red Cross to get a schedule of upcoming certification opportunities in your area. And if you’ve been certified in the past but your certification has expired, consider getting re-certified. You can make sure that your skills are up to date and that you remember how to perform CPR correctly.

A Word from Verywell

It’s scary when something happens to a baby or a small child. It may even feel overwhelming. But training and certification in CPR can help you be prepared. And an easy way to remember what to do is what Dr. Markenson calls the Three Cs:

·    Check the scene to make sure it’s safe, and check the baby to see how they’re doing

·    Call 9-1-1

·    Provide Care to the baby

Whatever you do, just do your best and know that your effort is important. Any effort that you undertake is likely to be helpful to the infant in crisis, and the only mistake is to stand by and not take any action at all.