Infant and child CPR follows the same DRSABCD action plan (Danger, Response, Send for help, Airway, Breathing, CPR and Defibrillation) as adult CPR, including 30 compressions to 2 breaths at 100 to 120 compressions a minute. What changes is the technique, which uses two fingers on a baby's chest and one or two hands on a child's, a depth of about 4 cm for a baby and 5 cm for a child, a neutral head position for babies, gentler breaths and child pads on the automated external defibrillator (AED) for under-8s if available.
The clinical details below come from the current ANZCOR (Australian and New Zealand Committee on Resuscitation) guidelines, which nationally recognised CPR training in Australia follows.
What counts as an infant or a child in CPR?
ANZCOR defines an infant as a baby under one year old and a child as anyone from their first birthday up to 18. If you do not know their age, use the onset of puberty as the line between child and adult (ANZCOR Guideline 4). AED pads use a different cut-off of 8 years, which is covered below.
In an emergency, you should go by what you see. ANZCOR's advice is to use child technique if the patient looks like a child and adult technique if they look like an adult, and if someone you treated as a child turns out to be a young adult, it is unlikely that any harm has been done.
When should you call Triple Zero (000)?
Call Triple Zero (000) as soon as you find a baby or child who does not respond. This is the S, for send for help, in the DRSABCD action plan.
If anyone else is with you, ask them to make the call and bring an AED while you start CPR. Ambulance Victoria says that the call-taker will talk you through CPR and using an AED, so you need to stay on the line until they tell you to hang up.
Should you tilt a baby's head back?
You should not tilt it the way you would for an older child or adult. Keep a baby's head in a neutral position, with the head and neck kept in line and without tipping the head back, while you support the jaw at the point of the chin (ANZCOR Guideline 4).
Because a baby's windpipe is narrow and soft, tilting the head too far back can bend it out of shape and block the airway. Keep your fingers off the soft tissue of the neck, and tilt the head back only if the neutral position does not give a clear airway, and then only very slightly and gently.
For a child, use head tilt and chin lift, as you would for an adult.
What hand position do you use for infant and child CPR?
At every age, you press on the lower half of the breastbone, in the centre of the chest, although what you press with depends on the patient's age and size (ANZCOR Guideline 6):
- Infant: two fingers. ANZCOR suggests this for lay rescuers because it allows you to move quickly between compressions and breaths.
- Child: the heel of one hand, or two hands as for an adult, whichever allows you to reach the right depth.
- Adult, for comparison: the heel of one hand with the other hand on top.
Before you start, lay the baby or child on their back on a firm surface, as this makes compressions more effective.
You may have seen the two-thumb technique, in which both hands wrap around a baby's chest and the thumbs press on the breastbone. This is ANZCOR's method for health professionals trained in paediatric life support (Guideline 12.1, updated April 2026), while first aiders use two fingers.
How deep and how fast should you push?
Push down about one third of the depth of the chest, which ANZCOR Guideline 6 puts at about 4 cm for an infant and 5 cm for a child, compared with more than 5 cm for an adult.
The rate does not change with age and stays at 100 to 120 compressions a minute, which is almost two a second. Make sure to let the chest come all the way back up after each compression.
Do not hold back because the chest is small, as ANZCOR's view is that the risk of compressions being too shallow outweighs the risk of them being too deep.
Is child CPR still 30 compressions to 2 breaths?
Yes, for first aiders. ANZCOR Guideline 8 recommends 30 compressions to 2 breaths for all ages, although health professionals trained in paediatric life support use 15:2 (Guideline 12.1), so you may hear both.
Because a child's cardiac arrest usually follows a breathing problem, and one that starts in the heart is less common, ANZCOR puts extra weight on rescue breaths for children. To give breaths (ANZCOR Guideline 5):
- For a baby, cover their mouth and nose with your mouth.
- For a child, pinch the nose closed and seal your mouth over theirs.
- Blow for about one second, with just enough air to make the chest rise. For a baby, this is a small, gentle breath. Do not over-inflate the chest.
- If the chest does not rise, check the head position and your seal before the next breath.
If you cannot give breaths, keep doing compressions, as ANZCOR asks every rescuer to do at least that.
Can you use an AED on a child or baby?
Yes, including on babies under one. ANZCOR Guideline 7 says that standard adult AED pads are suitable for children older than 8. For younger children and babies, the ideal is to use paediatric pads and an AED with a paediatric mode, but if the AED has neither, you should go ahead with the adult pads.
When you place the pads:
- Follow the diagram on the pads. The standard position on the bare chest, for children as for adults, is one pad below the right collarbone and one on the left side, below the armpit.
- Make sure that the pads do not touch each other.
- On a small chest where they would touch, put one on the upper back between the shoulder blades and the other on the front of the chest, slightly to the left if possible.
Keep doing CPR until the AED is on and the pads are attached, then follow its prompts and make sure that no one touches the child during a shock. Our guide to what an AED's pads, prompts and shock button do explains the device itself.
Where can you practise infant CPR?
This article provides general information and is not a substitute for hands-on training. You can practise infant CPR on a manikin in a nationally recognised CPR or first aid course, as the assessment requirements for HLTAID009 Provide CPR, like those for HLTAID011 Provide First Aid, include at least 2 minutes of uninterrupted CPR on an infant manikin on a firm surface.
If you work in early childhood education and care, please make sure to check your regulator's first aid requirements before you enrol, as those roles may need a different unit.
If you are considering Scope Institute, both of our nationally recognised courses include infant CPR. The HLTAID009 Provide CPR course covers CPR on its own, while HLTAID011 Provide First Aid is the full first aid certificate, with the same CPR skills as well as injury and illness management. For a team, we can also run either course at your workplace in metropolitan Melbourne, and you are welcome to ask about on-site group training.
Sources
- Guideline 4 – Airway – ANZCOR
- Guideline 5 – Breathing – ANZCOR
- Guideline 6 – Compressions – ANZCOR
- Guideline 7 – Automated External Defibrillation in Basic Life Support – ANZCOR
- Guideline 8 – Cardiopulmonary Resuscitation (CPR) – ANZCOR
- Guideline 12.1 – Paediatric Basic Life Support (PBLS) for health professionals – ANZCOR
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