Infant CPR Basics: What Parents Should Know and Where to Get Certified

Infant CPR is the emergency sequence used when a baby younger than 1 year is unresponsive and not breathing normally or is only gasping. For a lone lay rescuer, the core cycle is 30 compressions followed by 2 breaths, repeated while emergency help and an AED are coming. Current 2025 guidance recommends either a one-hand chest-compression technique or the two-thumb encircling-hands technique. The older two-finger method is no longer the recommended infant technique.^[1]

Reading that sentence is not the same as feeling the right depth on a manikin, correcting an airway angle, or hearing an instructor coach your rhythm. Use this guide to learn the current shape of the response, replace outdated memory, and make a training plan. If a real emergency is unfolding, call now and let the dispatcher lead.

I would rather you remember four plain verbs under pressure than carry a beautifully formatted algorithm you cannot retrieve. “Wake, breathe, call, compress” gets the room moving. The dispatcher and your hands-on training supply the next correction.

This guide applies to infants younger than 1 year outside the moment of birth. Resuscitation of a newborn during delivery follows a different professional protocol. It also does not diagnose why a baby collapsed. Breathing problems, submersion, choking, infection, injury, heart conditions, seizures, poisoning, and other emergencies can lead to unresponsiveness; the first job is recognizing absent normal breathing and starting the emergency response, not naming the cause.

How to recognize when a baby may need CPR

A sleeping baby can be deeply still. A baby in cardiac arrest is unresponsive and is not breathing normally. Check those two things quickly and together. Tap the bottom of one foot and call the baby’s name. Watch the chest and face for normal breathing. Keep the check to no more than 10 seconds.^[2]

Occasional snorts, irregular newborn breathing, and brief pauses can frighten parents, but you should not try to classify a suspicious pattern for a full minute while a baby remains unresponsive. Gasping may look like an isolated gulp, jaw movement, or strained breath separated by silence. Gasping is not normal breathing. If the baby will not respond and is not breathing normally, call and begin CPR.

Do not spend emergency time trying to feel an infant pulse unless your current professional training specifically requires it. Pulse checks are difficult for lay rescuers and can delay compressions. Do not troubleshoot a monitor, camera, sock, app, or alarm before touching and looking at the baby. The device may be wrong; the baby’s responsiveness and breathing decide the next action.

A blue, gray, very pale, or mottled appearance can accompany a severe breathing or circulation problem, but skin color is not the gate for action. Changes may be harder to see on some skin tones, and good lighting may be unavailable. Responsiveness and normal breathing are the practical checks.

If the baby is injured, move them only as much as necessary to give care and follow the dispatcher. If you suspect an opioid exposure, poisoning, or another cause, tell 911 immediately, but do not let that explanation delay CPR. If naloxone is available and the dispatcher directs its use, CPR and ventilation still matter.

Infant CPR steps: the current 30:2 sequence

Once you have recognized an unresponsive infant who is not breathing normally, place the baby face-up on a firm, flat surface. A floor or firm table gives the chest something stable to compress against. A soft mattress absorbs force. Move from a crib or soft bed only as quickly and safely as the situation allows; do not spend time creating a perfect training setup.

Count aloud. A steady “one, two, three” helps another person hear where you are, gives the dispatcher something to correct, and makes rescuer changes cleaner. The target is 100 to 120 compressions per minute, but a metronome is not worth delaying care. If the phone is already on speaker, the dispatcher can coach pace.

Depth matters. Tiny timid pushes may not circulate blood; uncontrolled leaning prevents the chest from refilling. The current target is about one-third of the chest’s depth, approximately 1.5 inches. Let the chest return fully after each push. Keep pauses as short as possible when you move to breaths or attach AED pads.^[1][2]

CPR can cause injury, and a parent may feel terrified of pressing on such a small chest. When an infant is truly unresponsive and not breathing normally, the danger of doing nothing is greater. Use the correct position and depth, follow dispatch coaching, and continue. This is exactly why a manikin class matters: your hands learn what the written number feels like before a real emergency.

How to switch rescuers without losing the rhythm

If another trained adult is present, one person can call, bring the AED, and prepare pads while the other compresses. If the compressor becomes tired, change during the brief transition between cycles or when the AED is analyzing. Say the count and the plan out loud: “Take over after 30.” Avoid long discussions over which person remembers more.

Two trained rescuers may use a different compression-to-breath ratio taught in pediatric CPR courses. Do not attempt to reconstruct a two-rescuer professional algorithm from this page during an emergency. Follow current training and the dispatcher. The 30:2 sequence here is the clear lone lay-rescuer orientation.

When can CPR stop?

Continue until the baby shows clear signs of life and begins breathing normally, trained responders take over, the AED directs a pause, the scene becomes unsafe, or you are physically unable to continue. A single gasp, twitch, cough, or brief movement does not automatically mean normal breathing has returned. Tell the dispatcher what changed and follow instructions.

If the baby begins breathing normally, stop compressions, keep the airway open, monitor continuously, and stay on the line. Do not cancel emergency help because the baby “looks better.” A baby who needed CPR or lost responsiveness needs urgent professional evaluation even if recovery seems complete.

The 2025 hand-position update parents should know

Old handouts and older web pages may tell a lone rescuer to use two fingers for infant chest compressions. The 2025 AHA/AAP pediatric basic-life-support guideline removed that technique from its recommendation. Current guidance recommends either the heel of one hand or the two-thumb encircling-hands technique.^[1]

Hand size, the infant manikin, your body position, and the available surface affect which current option feels controlled. A qualified instructor can correct whether you are too high, too low, too shallow, leaning, or pressing from an angle. That correction is the part a paragraph cannot deliver.

Official technique supplement

Watch the current one-hand option, then practice it on a manikin

This 32-second American Red Cross video shows one current infant compression technique. It does not teach the full recognition, call, breath, AED, or choking sequence and does not replace a class.

Takeaway: watch for a straight-down push at the center of the chest and complete recoil. Then book instructor-observed practice so hand position, depth, rate, and fatigue are corrected in real time.

How rescue breaths fit into infant CPR

Infants often develop cardiac arrest after a breathing problem, which makes effective breaths especially important. After 30 compressions, open the airway with a gentle head-tilt/chin-lift. An infant’s airway is small; bending the head far back can narrow it. Aim for a neutral position rather than the deeper tilt used for an adult.

Place your mouth over both the baby’s mouth and nose to make a seal. Give one breath over about one second, using only enough air to make the chest visibly rise. Let the air come out, then give a second breath. Return to compressions without an extended pause.^[2]

Too much air or a forceful breath can send air into the stomach and cause vomiting. You are looking for a visible chest rise, not a large breath. If the baby vomits, turn the whole body to the side long enough to clear the mouth, return the baby face-up on the firm surface, and resume CPR. Follow dispatch guidance about suspected neck or spine injury.

A face shield or infant pocket mask may reduce exposure if it is within reach and you know how to use it. Do not let equipment assembly become a reason to delay. If you are unable or unwilling to give breaths, begin continuous chest compressions and follow 911 instructions. Compression-only care is better than doing nothing, but breaths remain especially valuable in infant arrest.

If there is a known or suspected submersion, breathing support is particularly important. Call emergency services and follow current CPR training. A baby who seems normal after a brief water scare may need a different observation plan; the separate guide on what to do if a baby swallowed pool water covers that stable post-event question. Unresponsiveness or abnormal breathing never belongs in a wait-and-watch lane.

Can you use an AED on an infant?

Yes. Use an automated external defibrillator as soon as one is available. An AED analyzes the heart rhythm and gives a shock only when its program identifies a shockable rhythm. You do not decide whether to shock. Turn it on and follow its voice and picture prompts.^[1][3]

Use pediatric pads or a pediatric setting if they are available, but do not withhold an AED because only adult pads are present. On a small infant, the pads must not touch. If the pictured front placement would make them overlap, place one pad on the chest and the other on the back as the device diagrams direct. Never cut a pad or improvise a smaller one.

Dry a wet chest quickly so the pads adhere. Move medication patches only if the AED directions or dispatcher tell you how; do not delay care searching for rare exceptions. Keep oxygen, water, and bystanders away from the chest during a shock. If a helper is available, they can manage the AED while you minimize pauses in compressions.

Homes are not required to buy an AED simply because a baby lives there. Learn where AEDs are located in the places your family spends time: the community center, pool, gym, airport, school, place of worship, or childcare building. The more useful household purchase is often a hands-on infant CPR/AED class for every regular caregiver.

Infant choking and infant CPR are not the same starting sequence

A responsive choking baby needs airway-obstruction care, not chest compressions on a flat surface. An unresponsive baby who is not breathing normally needs CPR. The transition can happen quickly, so the first distinction is whether the baby is responsive and moving air.

A baby who can cough forcefully, cry, or make sound is moving some air. Stay close, let the cough work, and be ready to act if it becomes weak or silent. Do not slap the back of a baby who is coughing effectively, do not put fingers into the mouth to hunt for an object, and do not hang the baby upside down.

Signs of severe airway obstruction can include an ineffective or silent cough, inability to cry or make sound, inability to breathe, increasing panic or limpness, and blue or gray color. Call 911. For a responsive infant with severe choking, give five back blows followed by five chest thrusts. Repeat those cycles until the object comes out or the baby becomes unresponsive.^[1]

How to give five back blows and five chest thrusts

Sit or kneel so you can support the baby securely. Place the infant face-down along your forearm with the head lower than the chest, supporting the head and jaw without covering the mouth. Give five firm back blows between the shoulder blades with the heel of your hand. Then turn the infant face-up while supporting the head, keeping the head lower than the chest, and give five chest thrusts on the breastbone. Repeat.

Chest thrusts for conscious choking are distinct, deliberate thrusts; they are not an invitation to improvise abdominal pressure. Do not use abdominal thrusts on a baby younger than 1 year because of the risk of injury. A current hands-on class lets you practice the safe hold, turning motion, back-blow location, and chest-thrust position on an infant manikin.

If the baby becomes unresponsive, lower them to a firm, flat surface, call 911 if that has not happened, and begin CPR with 30 compressions. Each time you open the airway to give breaths, look in the mouth. Remove an object only if you can clearly see and easily reach it. Never sweep blindly; a finger can push an object deeper or injure delicate tissue.

Gagging during feeding is often noisy and may include coughing, retching, or a red face; severe choking may be quiet because little or no air is moving. Do not use color alone. Feeding readiness, upright support, food preparation, and direct supervision reduce risk but do not replace rescue training. The baby-led weaning guide owns that feeding pathway. The guide for the stage when a baby puts everything in their mouth helps you scan the floor, furniture edges, sibling zones, and bags for small-object hazards.

After a choking episode that required back blows or chest thrusts, call the baby’s clinician or follow emergency guidance even if the object came out. Seek emergency care for ongoing cough, noisy or difficult breathing, drooling, swallowing trouble, wheezing, blue or gray color, unusual sleepiness, or any loss of responsiveness. Do not assume an object fully cleared because the baby cried once.

What to do after the baby responds

Recovery does not erase the emergency. If the baby received CPR, an AED shock, choking thrusts followed by CPR, or had a period of unresponsiveness or abnormal breathing, keep emergency help coming. Watch breathing continuously, keep the airway open, and follow 911 instructions. Do not give food, drink, or medicine unless responders direct it.

Give responders a short sequence: when the baby was last seen responsive; what you noticed; when 911 was called; when CPR began; whether breaths made the chest rise; whether an AED advised or delivered a shock; whether choking, submersion, injury, medicine, or another exposure is possible; and what changed. If another adult is present, have them unlock the door, secure pets, gather medications, and meet responders without leaving the baby alone.

If the baby is stable and a clinician directs you to urgent care rather than emergency transport, use the separate guide for taking a baby to urgent care to plan records and travel. An unresponsive baby, a baby who is not breathing normally, or a baby who just required CPR is not a self-transport-to-urgent-care problem unless emergency professionals explicitly make that plan.

After the medical handoff, the adults may shake, cry, repeat the scene, or feel unsure whether they did each step perfectly. That is a human response to an emergency, not evidence that you failed. Ask the medical team what follow-up the baby needs and where the rescuers can find support. Replace used first-aid supplies, document the event while details are fresh, and schedule a skills refresh rather than privately replaying an old instruction card.

How to choose an infant CPR class

The best class is one you can attend, that explicitly includes infant CPR, infant choking, and AED practice, and that gives you instructor-observed time on an infant manikin. The course should reflect current guidance, including the 2025 hand-position update. Ask before enrolling; “CPR class” can mean adult-only skills, a brief awareness video, workplace certification, or a full pediatric course.

Use the American Red Cross CPR class finder or the American Heart Association course finder, and filter for infant or pediatric content. Hospitals, birthing centers, fire departments, community colleges, pediatric practices, and public-health programs may also host classes. Verify the curriculum and instructor rather than assuming the location guarantees the format.

Questions to ask before paying

• Does every learner practice on an infant manikin?
• Does the instructor observe and correct compression rate, depth, recoil, airway position, and breaths?
• Does the course cover responsive infant choking and the transition to CPR?
• Will learners practice with an AED trainer and pediatric pad placement?
• Does the class teach the current one-hand and two-thumb encircling-hands techniques?
• Is this an awareness class, a skills session, or a certification course?
• What credential does the instructor hold, and when was the curriculum updated?
• Will I receive a completion or certification card, and what organization recognizes it?

Red Cross CPR certification is valid for two years.^[5] That is an expiration date, not a guarantee that the skill will feel available under stress for two full years. Refresh sooner after a guideline change, if you cannot confidently talk through the response, if a new caregiver joins the household, or after a frightening event exposes a gap.

Parents, grandparents, babysitters, nannies, older teen caregivers, and anyone regularly alone with the baby benefit from the same current hands-on baseline. One trained person in a household is not enough if that person is at work when the emergency happens. When touring childcare, ask who holds current pediatric CPR and first-aid certification, how often drills occur, where the AED is, who calls the parent, and how coverage works when the trained person is absent. The daycare tour guide helps carry those questions into the wider visit.

Build a two-minute household response before you need it

Training gives your hands a skill. A household plan removes avoidable friction around that skill. The useful rehearsal is short enough to repeat and specific enough that every adult can move without asking who is “in charge.” Practice the spoken handoff around an empty firm surface, and practice the physical skill only on an infant manikin; never press on a baby.

Post the exact home address, apartment or gate instructions, and emergency number where caregivers can find them without unlocking a phone. In a hotel or rental, learn the address and how emergency responders enter. If your family travels across countries, know the local emergency number rather than assuming 911 works everywhere.

Keep cribs and sleep spaces clear enough that an adult can reach the baby quickly, but do not turn emergency readiness into extra products inside the crib. A CPR mask, first-aid supplies, emergency card, and medication list belong in an accessible adult-controlled place. The baby’s sleep surface stays firm, flat, level, and empty except for the fitted sheet.

Replace old magnets and handouts when guidance changes. Put the date of the last hands-on class on the household card. Store current medical information for responders: the baby’s full name and birth date, allergies, conditions, medications, clinician, and emergency contacts. Do not place private medical details in a public-facing window or luggage tag.

Common questions about infant CPR

Do I call 911 before starting infant CPR?

If a phone is within reach, call 911 on speaker immediately so the dispatcher can coach while you begin. If another person is present, send that person to call and bring an AED while you start care. If you are truly alone without a reachable phone, start CPR and follow the timing taught in your current course for briefly activating emergency help. Do not leave an unresponsive baby to search for a phone charger, a web page, or a preferred hospital.

Should I check for a pulse?

Not as an untrained parent or lay rescuer. Pulse checks are difficult and can delay CPR. Check responsiveness and normal breathing for no more than 10 seconds. If the baby is unresponsive and not breathing normally or is only gasping, call and start CPR. Healthcare professionals follow pulse-based protocols from their training.

Where do I press on an infant’s chest?

Press on the center of the breastbone just below the nipple line, using either the heel of one hand or two thumbs with the hands encircling the chest. Do not press on the tip of the breastbone, the abdomen, or the ribs from the sides. A manikin instructor should correct the exact position before you rely on memory.

Are two fingers still recommended for infant CPR?

No. The 2025 AHA/AAP guideline recommends the one-hand technique or the two-thumb encircling-hands technique and eliminated the two-finger technique from the recommendation.^[1] Replace older teaching cards and take a current skills refresher.

How deep and how fast are infant CPR compressions?

Compress about one-third of the chest’s front-to-back depth, approximately 1.5 inches (4 cm), at 100 to 120 compressions per minute. Let the chest recoil fully and keep pauses short. Depth and recoil are best learned on a feedback manikin.

What if I am afraid of breaking a rib?

CPR can cause injury, but an unresponsive infant who is not breathing normally needs blood flow immediately. Use the correct position, depth, and straight-down motion, follow the dispatcher, and continue. Fear of injury should not become a reason to withhold CPR when it is needed.

What if I cannot give rescue breaths?

Begin chest compressions and follow 911 instructions. Continuous compressions are better than doing nothing. Because infant cardiac arrest often follows a breathing problem, breaths are especially valuable; a hands-on class can make the mouth-and-nose seal and neutral airway position much less mysterious.

What if the baby’s chest does not rise with a breath?

Return the head to neutral, lift the chin gently, reseal over the mouth and nose, and try one more breath. Look for an object only when the mouth is open, and remove it only if clearly visible. Never perform a blind finger sweep. Resume compressions rather than spending a long pause troubleshooting.

Can I use adult AED pads on a baby?

Yes, when pediatric pads or a pediatric setting are unavailable. Use pediatric equipment when available, but do not withhold an AED because the only pads are adult size. Place the pads so they do not touch; a front-and-back arrangement may be needed on a small chest. Follow the AED diagrams and voice prompts.^[3]

What if the baby starts crying or breathing?

Stop compressions when there are clear signs of life and normal breathing has returned. Keep the airway open, watch continuously, stay on the emergency call, and follow instructions. Do not cancel responders. Tell them exactly what changed and whether CPR or an AED was used.

Is infant CPR different from newborn resuscitation?

Yes. This guide covers infant basic life support outside the moment of birth. Resuscitation during delivery uses a newborn-specific professional protocol, equipment, and ventilation priorities. If a newborn at home is unresponsive or not breathing normally, call emergency services immediately and follow the dispatcher rather than trying to reproduce a delivery-room algorithm.

Can I practice infant CPR on my baby?

Never practice chest compressions, rescue breaths, back blows, or chest thrusts on a healthy baby. Practice on an infant manikin under qualified instruction. You can safely rehearse the spoken handoff, find the address card, locate the phone and AED, and point to the firm surface without touching the baby’s chest.

Does an online infant CPR class count?

Online learning can introduce the sequence and refresh concepts, but no instructor can feel your compression depth or correct your seal through a prerecorded lesson. American Red Cross online-only courses do not include a skills demonstration and may not meet workplace certification requirements.^[4] Choose in-person or blended training with an observed manikin session when you want usable hands-on skill.

How often should infant CPR training be renewed?

Red Cross CPR certification lasts two years.^[5] Refresh sooner if technique guidance changes, you cannot confidently explain the sequence, you have never practiced infant choking, a new caregiver joins the household, or a real event exposes uncertainty. Brief skill refreshers between certification dates protect recall.

Should grandparents and babysitters take the same class?

Yes. Every person who may be alone with the baby should know current infant CPR, choking care, AED use, the exact address, and the emergency handoff. Ask for hands-on pediatric content rather than accepting “I took CPR once” as the whole plan.

What is the bottom line?

If a baby is unresponsive and not breathing normally or is only gasping, call 911, begin 30 compressions and 2 breaths, and use an AED as soon as it is available. Current infant compressions use one hand or two-thumb encircling hands, not the old two-finger method. Learn the sequence here, then make it physical and correct with an instructor-observed infant manikin class.

Sources

1. AHA/AAP: 2025 Pediatric Basic Life Support Guideline (doi: 10.1542/peds.2025-074350)
2. American Red Cross: Child and Baby CPR
3. American Red Cross: AED Steps
4. American Red Cross: CPR Classes
5. American Red Cross: CPR Certification

Train the hands, rehearse the call, protect the next rest

Put emergency readiness beside your sleep plan, not inside the crib

Book the hands-on infant CPR class, teach every caregiver the same current sequence, and keep the sleep space simple enough to reach quickly. When the emergency plan is current, the ordinary night has fewer unanswered questions.

SleepBaby does not replace 911, dispatch instructions, medical care, or certified skills training. If a baby is unresponsive and not breathing normally, call now and begin CPR.

Build a calmer, safer sleep plan