CPR for Babies and Children: Special Considerations for Little Heroes


There are noble and indispensable skills that you hope you may never have to use. But when the occasion arises, you better be prepared. One such competence is performing cardiopulmonary resuscitation on a child or a baby, learning the elements of basic life support, and operating an AED unit.  

Unfortunately, emergency response cases in the US show that these little angels can be the victims of various dangerous scenarios. But, with proper training in CPR and other lifesaving techniques, experience, and good decision-making, many little heroes are saved.

Whether you had previous training or have basic knowledge of CPR for babies and children, keeping these skills fresh and updated is crucial and can mark the difference between life and death.

Here are the basic principles of CPR for infants and children, the specifics and differences in procedures for infants, and the best resources available for acting swiftly and professionally.

Basic Principles for CPR for Babies and Children

In the US, reporting all the cases of sudden death in juveniles is not obligatory, so the incidence of OHCA in children is challenging to estimate and remains a complex issue. However, the number of 7,037 children who suffered OHCA in 2015 and received help from emergency services shows that many little ones needed CPR by first responders. 

In such moments you shouldn’t panic but remain calm and focused and remember that infant or child CPR differs from CPR for adults. Observe the situation, make quick but informed assumptions, prepare the victim for receiving help, and use all the items and equipment that can be helpful.

There are special considerations for little heroes in emergencies, so regular education and preparedness for the worst can help avoid a fatal outcome.

General Preparedness

Most certified CPR, BLS, and First Aid courses provide textbooks and training guides. Keep these books to refresh your memory whenever you can, as they have all the necessary information about CPR procedures.

You can always find resources online from the American Heart Association, Red Cross, and others. Print them and keep them in the first aid box.

As time passes, it is easy to forget the hands-on and practical training, so it’s recommended to jog your memory by watching official videos of the procedures. One video is more than enough to recall the correct CPR steps and techniques.

Actions Before Providing CPR

Before administering CPR, essential steps include observing the situation and assessing the course of action.

Cardiac arrest in babies is rare but can be caused by respiratory failure or airway obstruction. Some cases include Sudden Infant Death Syndrome (SIDS), the most common cause of death in newborns through the age of six months. Usually, the infant is not breathing, with weak or no pulse at all. When this is the case, immediate CPR is necessary. 

SCA in infants is characterized by unresponsiveness, lack of response to stimuli, dilated pupils, and seizures. Once the possible causes for distress are considered, you can begin with preparation for CPR. 

  • Check for hard surfaces and avoid cushions, pillows, and blankets.
  • Take steps for personal protection if the scene is contaminated or hazardous.
  • If the parents or guardians are present, ask for permission and tell them to call 911 and look for an AED.
  • If possible, grab adequate equipment or use objects in the surrounding that can be helpful.
  • If no one else is around, provide CPR for two minutes and then call 911 or look for an AED.

How to Provide CPR for Babies and Children

First, you must find the most suitable position for providing proper CPR. You can kneel or stand, whichever is more comfortable; make sure you have clear reach to their chest and mouth.

Always Count the Compressions

Standard CPR for babies and children starts with 30 compressions. For a baby, you can use the two fingers technique, combining the index and the middle finger. You should remove all thick clothes and place the fingers in the center of the chest, just below the line of the nipple.

The depth of the compressions should be 1,5 inches, and you should allow the chest to recoil after each compression.

For a child, place one hand in the center of their chest and then overlap both palms to perform deep and continuous compressions. The depth of the compressions for a bigger child is 2 inches.

According to medical experts, the compression rate for both categories is 100-120 per minute. If you get tired, ask for a replacement, but keep in mind that the rate must be consistent. 

Breaths are Important

Between each set of 30 compressions, you should administer 2 breaths, monitoring the chest to see if it’s rising.

The difference between babies and children is the area of the rescue breaths. If the victim is a baby, you should cover both their nose and mouth with your mouth, and for a bigger child, you should pinch the nose and provide mouth-to-mouth resuscitation.

It is of utmost importance to adjust the infant’s head, which must be slightly lifted. Always ensure the airway path is clean and open, so lift the baby’s chin and check for foreign objects. If the chest isn’t rising, then the child is choking.

You can try to remove anything blocking the airway, such as food, vomit, or phlegm, but only if you can reach it. If you can’t firmly grasp the object and it’s stuck, don’t try to remove it; you’ll only push it further down and worsen the situation.

Follow these steps until you get a clear sign of life, pulse, and movement of the chest that indicate restoration of breathing. Also, you can stop providing CPR when EMS arrive at the scene and begin medical care.

How to Help When a Child Is Choking

Choking and suffocation are extremely dangerous for children under 5 and are the fourth leading cause of death in this age group. If you want to help a child that is not breathing and/or is unconscious, you should learn the Heimlich maneuver and several other methods for infants and children. 

When you notice a child in distress, you should ask them, “Are you choking?” several times, and if they nod, reassure them that you’re going to help. To try and dislodge the object blocking the esophagus in a 1-8-years-olds, you should:

  • Stand behind the child, make a fist, and place it above the belly button.
  • Grasp it with the other hand and push inwards and upwards.
  • Repeat this until the object comes out or the EMS arrives.

For infants, you should:

  • Place the baby over your thighs, facing downward.
  • Provide 5 strong blows. With the heel of the hand, make five strong blows on the back, between the shoulder blades.

If that doesn’t help:

  • Place the infant on your thighs with the head slightly downwards.
  • Put two fingers in the center of the chest below the nipples.
  • Press strongly 5 times. Then give the baby 5 back blows again.
  • Continue like this until the object comes out.
  • If the infant becomes unresponsive, start performing CPR.

Reduce Choking Risks for Children

To reduce the risks of suffocation in babies and children, following a simple set of rules can lead to a safe environment that doesn’t hinder children’s curiosity and playfulness. 

You should be careful what they play with and avoid small toys and marbles that can be swallowed. Everyday objects can cause significant consequences, including pen caps, badges, buttons, nuts, forgotten coins, and many other small items.

Also, watch out for clothes with cords and chains on the upper part, around the neck and limbs, which can become entangled and cause suffocation.

Pay attention to the diet, which should correspond to the child’s age. Fruits and vegetables with seeds, snacks including popcorn, chips, and chewing gum should be avoided at least until age four.

Monitor every meal of your child or the child in your care from the moment they take the food. The position of the body should always allow an unobstructed flow in the esophagus, meaning that they should sit upright.

It is recommended to avoid distractions, such as watching TV or other electronic devices, and establish the rule “don`t talk with your mouth full.”

Special Considerations for Little Heroes: Final Thoughts

The survival rate of SCA is 6.5% in infants and 14.4% for children until 12 years of age. If you wish to see these statistics improved, you should refresh your previous knowledge of CPR for babies in children.

If you’re a parent or someone’s relative, or if you care for a child in a professional capacity, it is recommended that you acquire or renew an official CPR certificate through on-site training.

In the Lanham area, among the certified providers of training in CPR, First Aid, BLS, or a combination of these techniques are the courses offered by CPR Certification Lanham. It is a training site aligned with the American Heart Association, with in-person and hands-on training, offering widely accepted CPR certification.