Pediatric CPR Guidelines - What Every Parent Should Know
The short answer
Every parent and caregiver should know infant CPR. The American Heart Association recommends starting CPR immediately if a baby is unresponsive and not breathing normally. Key differences between infant and adult CPR: use two fingers (or two-thumb encircling technique) for compressions rather than the heel of the hand, compress about 1.5 inches deep at a rate of 100-120 compressions per minute, and give 2 rescue breaths after every 30 compressions (for single rescuer). Infant CPR includes both compressions and breaths, unlike hands-only CPR for adults. Call 911 after 2 minutes of CPR if you are alone.
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By Age
What to expect by age
0-12 months (infant CPR)
For infants under 12 months, CPR technique differs from older children. Place the infant on a firm, flat surface. Use two fingers (middle and ring finger) on the breastbone, just below the nipple line. Compress about 1.5 inches deep at 100-120 compressions per minute. After every 30 compressions, tilt the head slightly back (not as far as adults), lift the chin, and give 2 gentle breaths covering both the mouth and nose. If you are alone, perform 2 minutes of CPR before calling 911. If choking: alternate 5 back blows (between shoulder blades with baby face-down on your forearm) and 5 chest thrusts (same location as CPR compressions with baby face-up) until the object is expelled.
1-8 years (child CPR)
For children over 1 year, use the heel of one hand (or two hands for larger children) for compressions on the lower half of the breastbone. Compress about 2 inches deep at 100-120 compressions per minute. Give 2 rescue breaths after every 30 compressions (single rescuer) or every 15 compressions (two rescuers). For choking in a child over 1 year, perform abdominal thrusts (Heimlich maneuver): stand behind the child, make a fist above the navel, and thrust inward and upward. Consider taking an in-person CPR class through the American Heart Association or Red Cross, as hands-on practice is far more effective than reading instructions alone.
Prevention across all ages
The best approach is prevention. Leading causes of cardiac arrest in children include choking, drowning, SIDS, trauma, and respiratory illness. Choking prevention includes cutting food into small pieces (grapes quartered lengthwise, hot dogs avoided), keeping small objects out of reach, and supervising all eating. Drowning prevention requires constant supervision near any water, including bathtubs. An AED (automated external defibrillator) can be used on infants and children with pediatric pads if available. Refresh your CPR training every 2 years, as guidelines are updated periodically.
What Should You Do?
When to take action
- You have completed an infant CPR class and feel prepared to respond in an emergency.
- Your baby is breathing normally, has good color, and is responsive.
- You experienced a brief choking scare that resolved on its own without intervention.
- You want a referral for an infant CPR and first aid class.
- Your baby has a medical condition that increases the risk of a breathing emergency and you want specific guidance.
- You had to perform choking rescue on your baby and want to discuss whether follow-up evaluation is needed.
- Your baby is unresponsive and not breathing normally - begin CPR immediately and call 911 (or have someone else call while you start CPR).
- Your baby is choking and cannot cry, cough, or breathe - begin infant choking protocol (back blows and chest thrusts) immediately.
- Your baby has turned blue, is limp, or has stopped breathing for any reason - this is a life-threatening emergency.
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Medical Concerns
My Baby Keeps Choking on Food
First, it's important to distinguish between gagging and choking. Gagging is a normal protective reflex that helps babies learn to eat, while true choking is silent and requires immediate intervention. Most "choking" episodes parents describe are actually gagging, which is common and expected as babies explore new textures. However, if your baby frequently struggles with swallowing or shows signs of true choking, it's worth discussing with your pediatrician.
Magnet Ingestion Danger in Babies and Toddlers
Magnet ingestion is a true pediatric emergency, especially when two or more magnets (or a magnet and a metal object) are swallowed. Multiple magnets can attract each other through intestinal walls, causing pressure necrosis, perforation, bowel obstruction, fistula formation, sepsis, and death. Emergency rooms report a 75% increase in magnet ingestion cases in recent years, largely due to high-powered rare-earth magnets in toys and household items. A single small magnet will usually pass harmlessly, but multiple magnets require urgent surgical evaluation.
My Baby Is Breathing Fast
Babies normally breathe faster than adults. A normal respiratory rate for a newborn is 30-60 breaths per minute, slowing to 20-40 by age 1. Brief episodes of faster breathing during excitement, crying, or feeding are normal. However, persistently rapid breathing (tachypnea) at rest, especially with other signs of respiratory distress, may indicate a lung or heart problem that needs prompt evaluation.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.
Adenoid Hypertrophy and Breathing
Adenoids are lymphoid tissue located behind the nose that help fight infection in young children. When adenoids become enlarged (adenoid hypertrophy), they can block the nasal airway, causing chronic mouth breathing, snoring, nasal speech, and sleep-disordered breathing. Enlarged adenoids are most common between ages 2-7 and are a leading cause of obstructive sleep apnea in young children. Treatment ranges from watchful waiting and nasal steroids to surgical removal (adenoidectomy) if breathing or sleep is significantly affected.