How To Do Infant & Baby CPR
Infant CPR & First Aid
Every Parent Should Know
Infant cardiac arrest is almost always caused by oxygen deprivation – not a heart problem. That changes the infant or baby CPR technique required, and why rescue breaths matter as much as compressions.
4.74×
survival odds with bystander CPR
30:2
ANZCOR ratio for community
responders
~4 cm
Target compression depth
Key Differences
How Is Infant CPR Different from Adult CPR & First Aid?
The same DRSABCD framework applies when doing CPR for infants or CPR on babies, but the physiology is fundamentally different. In adults, cardiac arrest is usually a cardiac event, which is why compression-only CPR is often acceptable. In infants, the cause is almost always asphyxia: oxygen deprivation from choking, airway obstruction, SIDS, drowning, or a respiratory event. That makes rescue breaths non-negotiable, and it changes head position, compression technique & seal.
| Infant (under 12 months) | Adult | |
|---|---|---|
|
PRIMARY CAUSE |
Asphyxia (oxygen loss) |
Cardiac event |
|
HEAD POSITION |
Neutral — face straight up |
Full tilt-back |
|
AIRWAY SEAL |
Mouth over mouth and nose |
Mouth over mouth only |
|
TECHNIQUE |
Two-thumb encircling (preferred) |
Two-hand heel of palm |
|
DEPTH |
~4 cm (⅓ chest) |
5–6 cm |
|
RATIO |
30:2 |
30:2 |
|
RESCUE BREATHS |
Always required |
Optional (compression-only OK) |
Head position is the most commonly misapplied element. Overextending an infant’s neck can close the airway rather than open it — infants’ proportionally large heads and soft tracheas make them highly susceptible. ANZCOR guidelines specify a neutral position for infants under 12 months.
Official Infant & Baby CPR Guidelines
ANZCOR Infant CPR Guidelines: What Community Responders Need to Know
ANZCOR (Australian and New Zealand Committee on Resuscitation) sets the evidence-based standards used to train first aid providers across Australia. It’s important to understand which guidelines apply in which context. The clinical newborn resuscitation guidelines (13.1–13.10) are for health professionals in hospital settings with equipment and drugs. For parents, carers, and bystanders, ANZCOR explicitly states the Basic Life Support Guidelines (2 to 8) are the appropriate framework.
Ratio
30:2
Compressions to rescue breaths
Rate
100–120
Compressions per minute
Depth
~4 cm
⅓ of chest depth
Head
Neutral
Not tilted back
The ANZCOR Guideline 13.6 recommends the two-thumb encircling technique over two-finger compressions because it achieves superior peak systolic and coronary perfusion pressure, delivers compressions more consistently over time, and is less fatiguing for the rescuer. For trained health professionals performing paediatric BLS, Guideline 12.1 specifies a 15:2 ratio. Community responders use 30:2.
Why It Matters
Why Infant CPR Training Saves Lives: Australian Survival Statistics
4.74×
8.4%
of paediatric OHCA patients survive to hospital discharge overall
42%
survival with good outcome when bystander CPR is given and patient reaches ICU
PubMed 28651511
2%→19%
infant OHCA survival over 30 years as CPR awareness improved
The gap between 8.4% and 42% is largely explained by whether a bystander acted. Over 25,000 Australians experience cardiac arrest in the community each year, but only 40% receive bystander CPR before the ambulance arrives. The Australian Resuscitation Council has identified low bystander CPR rates as the primary modifiable factor in cardiac arrest survival outcomes.
Emergency Response
DRSABCD For Babies: Infant First Aid & Step-by-Step Emergency Response
The standard Australian emergency framework applies to infants, with a few critical adaptations at each step.
Infant CPR Compression Rate
How To Perform Infant CPR Chest Compressions
Once you’ve confirmed the infant is unresponsive and not breathing normally, start compressions immediately. Place the infant on a firm, flat surface. Find the landmark: centre of the chest, just below the nipple line on the lower half of the sternum. Avoid the very tip of the breastbone (the xiphisternum).
ANZCOR Preferred
Wrap both hands around the chest. Thumbs side by side on the lower sternum, fingers supporting the back. Preferred for superior compression depth, coronary perfusion pressure, and lower fatigue over a sustained resuscitation.
Alternative
Two fingers on the lower sternum when you cannot encircle the chest or are working alone. Per ANZCOR, this is the backup option only.
Larger infants
Heel of the dominant hand on the centre of the chest, straight arm. Compress one third of the chest depth at 100–120 per minute.
Compress approximately 4 cm (one third of the chest’s depth) at 100–120 per minute. Allow full chest recoil between compressions without lifting your hands. After every 30 compressions, deliver 2 rescue breaths and return immediately.
CPR Metronome — Practise Your Compression Rate
ANZCOR specifies 100–120 compressions per minute. Start the beat and compress in time with each pulse.
Ventilation
How To Give Rescue Breaths For Infant CPR
After every 30 compressions, give 2 rescue breaths. This is where infant first aid technique differs most from adult CPR – head position and breath volume are both critical.
Common errors
Common Infant CPR Mistakes and How First Aid Training Helps You Avoid Them
Hands-on training is where these are identified and corrected — before they matter in a real emergency.
- Keep the head neutral. Face straight up. Most important single adaptation in infant CPR.
- nclude rescue breaths every cycle. 30 compressions then 2 breaths, every time.
- Use the two-thumb encircling technique. ANZCOR's preferred method for superior depth and consistency.
- Compress to ~4 cm depth. Commit to one third of the chest — shallow compressions don't circulate blood.
- Allow full chest recoil between compressions without removing your hands.
- Tilting the head back. Kinks the infant trachea. Closes the airway instead of opening it.
- Skipping rescue breaths. Compression-only CPR is never appropriate for infants.
- Blowing too hard. Over-inflating causes vomiting and reduces ventilation effectiveness.
- Stopping too often to check. Interruptions drop coronary perfusion pressure immediately. Minimise pauses.
- Compressing too softly. Timid compressions don't circulate blood. Full depth required every time.
Defibrillation
Using an AED in Infant and Child First Aid Emergencies
AEDs analyse heart rhythm and deliver a shock only when a shockable rhythm is detected. If one is available, use it — anyone can operate one. For infants, pad placement differs from adults: one pad on the centre of the chest and one on the centre of the back. Do not place pads side by side on an infant’s small chest.
Power On
Open and switch on. Follow voice prompts throughout every step.
Attach Pads
Paediatric pads preferred — one on the centre of the chest, one on the centre of the back.
Clear & Analyse
Ensure nobody touches the infant while the AED analyses. Stand clear when prompted.
Resume CPR
Resume 30:2 immediately after a shock or if no shock is advised. Keep going until EMS arrives.
Questions Answered
Frequently Asked Questions
What compression-to-ventilation ratio does ANZCOR recommend for infant CPR?
Community responders (parents, carers, bystanders) should use 30:2 — 30 chest compressions followed by 2 rescue breaths — per the ANZCOR Basic Life Support guidelines. The 15:2 ratio applies to trained health professionals. The 3:1 ratio is for newborn resuscitation in clinical hospital settings only.
Why do infants need a neutral head position rather than head tilt in CPR?
Infants have proportionally large heads and a softer trachea than adults. Tilting the head back too far flexes the neck and can compress or close the airway. ANZCOR guidelines specify a neutral head position for infants under 12 months, keeping the face pointing straight up so the airway is fully open.
Should rescue breaths always be included in infant CPR?
Yes, always. Unlike adult CPR — where compression-only is often acceptable — infant cardiac arrests are almost always caused by oxygen deprivation. Rescue breaths are the most critical element of infant resuscitation. Compression-only CPR is not recommended for infants or young children.
What is the difference between infant, child, and adult CPR?
Infants (under 12 months): neutral head position, mouth-over-mouth-and-nose seal, two-thumb or two-finger technique, ~4 cm depth. Children: slight head tilt, mouth-to-mouth, one or two hands. Adults: full head tilt, mouth-to-mouth, two-handed compressions to 5–6 cm. Rescue breaths are more critical for infants and children because their arrests are oxygen events, not cardiac events.
Can an AED be used on a baby during a first aid emergency?
Yes. Use paediatric pads with an attenuator where available — one on the centre of the chest, one on the centre of the back. If only adult pads are available, use them in the same positions. Follow the AED voice instructions and continue CPR between shocks.
How deep should infant CPR chest compressions be?
ANZCOR guidelines specify approximately one third of the chest’s front-to-back depth — around 4 cm for most infants. Allow full chest recoil between every compression without lifting your hands.
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