Few situations are as terrifying for a parent or caregiver as a baby who has stopped breathing. In those frantic seconds, your brain may scramble to remember everything you’ve seen in movies or read in passing. However, providing first aid to an infant is not simply a “smaller” version of helping an adult. Because of their unique physiology, the techniques required are specific and vital.
As London’s leading provider of emergency care training, Practical First Aid is committed to ensuring every Londoner feels confident in these high-stakes moments. This guide explores the critical steps to take when an infant is unresponsive and dives deep into the difference between adult and paediatric CPR, ensuring you have the theoretical and practical knowledge to act.
Immediate Action: What to Do if a Baby Stops Breathing
If you find an infant (under one year old) who is unresponsive and not breathing normally, you must act immediately. Follow the DRSABCD protocol, tailored specifically for infants.
1. Danger
Ensure the area is safe for you and the baby. Move any hazards away before you begin.
2. Response
Gently tap the baby’s foot or flick their tunic. Never shake a baby. Shaking can cause permanent brain damage (Shaken Baby Syndrome). Talk loudly to them. If there is no response, they are unconscious.
3. Send for Help
If you are alone, perform one minute of CPR (about five cycles) before pausing to call 999 or 112. If someone is with you, have them call immediately and locate an Automated External Defibrillator (AED).
4. Airways
Lay the baby on a flat, firm surface. Carefully open the airway by placing one hand on the forehead and very gently tilting the head back into a “neutral” position. Unlike adults, over-extending an infant’s neck can actually block their delicate airway.
5. Breathing
Look, listen, and feel for breath for no more than 10 seconds. If they aren’t breathing or are making infrequent “gasping” noises (agonal gasps), you must begin CPR.
6. CPR (Cardiopulmonary Resuscitation)
For an infant, start with 5 initial rescue breaths. Then, proceed with the cycle of compressions and breaths.
The Crucial Difference Between Adult and Paediatric CPR
When training at our London centres, the most frequent question we receive is: “Can’t I just do what I saw on TV for adults?” The answer is a firm no. Understanding the difference between adult and paediatric CPR is the cornerstone of effective paediatric first aid.
1. The Sequence of Intervention
-
Adults: Most adult cardiac arrests are “sudden cardiac deaths” caused by a primary heart issue (like an arrhythmia). Therefore, the focus is on compressions first (C-A-B) to keep oxygenated blood moving to the brain.
-
Infants/Children: Cardiac arrest in children is rarely a primary heart problem; it is usually respiratory in nature (choking, drowning, or respiratory infection). Because the baby has likely run out of oxygen before the heart stopped, we start with 5 rescue breaths before any compressions.
2. Hand Placement and Pressure
-
Adults: Use two interlocking hands in the centre of the chest, using body weight to compress at least 5-6cm deep.
-
Infants: Use two fingers in the centre of the chest (just below the nipple line). You should compress to a depth of about one-third of the chest diameter (approx. 4cm).
3. Airway Management
-
Adults: We use a “head-tilt, chin-lift” to significantly extend the neck.
-
Infants: A baby’s anatomy is different; their tongue is relatively large, and their trachea (windpipe) is soft. A heavy head tilt can “kink” the airway. We aim for a neutral position, where the face is parallel to the ceiling.
What are the two main differences between adult and child CPR?
While there are many nuances, the two “big” differences are:
-
The Starting Point: Child CPR begins with 5 rescue breaths; adult CPR begins with 30 compressions.
-
The Technique: Adults require two hands and significant force; children/infants require one hand or two fingers to avoid damaging the ribcage and internal organs.
Is child CPR 15 or 30 compressions?
This is a point of confusion for many. In a layperson/community setting (which applies to most parents and caregivers), the Resuscitation Council UK recommends a ratio of 30 compressions to 2 rescue breaths to keep things simple and consistent with adult protocols.
However, healthcare professionals or those trained in advanced paediatric life support often use a ratio of 15 compressions to 2 rescue breaths because children benefit more from frequent oxygenation. For the general public, 30:2 is the standard taught in most UK first aid courses to ensure the rescuer doesn’t get confused during a crisis.
How is performing CPR on a small child different than an adult?
A “small child” (aged 1 to puberty) sits in the middle of the spectrum. You still start with 5 rescue breaths, but instead of two fingers, you generally use one hand for compressions. The depth remains one-third of the chest’s depth.
How is performing CPR on a child different to an adult theory test?
If you are preparing for a theory test (such as the Driving Theory Test or a Workplace First Aid exam), remember these keywords: Respiratory vs. Cardiac, 5 Initial Breaths, and One-third depth. Tests often focus on the fact that children need oxygen immediately, whereas adults need the “pump” (compressions) immediately.
Comparison Table: Adult vs. Infant CPR
| Feature | Adult (Puberty +) | Infant (Under 1 Year) |
| Primary Cause of Arrest | Cardiac (Heart) | Respiratory (Breathing) |
| Initial Step | Call 999 & 30 Compressions | 5 Rescue Breaths |
| Compression Technique | Two interlocking hands | Two fingers |
| Compression Depth | 5 – 6 cm | 1/3 of chest depth (approx. 4cm) |
| Head Tilt | Full extension | Neutral position |
| Rescue Breath Method | Mouth-to-Mouth (pinch nose) | Mouth-to-Mouth-and-Nose |
Step-by-Step: Performing Infant CPR
If the baby is not breathing, follow this cycle exactly:
-
5 Rescue Breaths: Place your mouth over the baby’s nose and mouth at the same time to create a seal. Blow steadily for about 1 second—just enough to see the chest rise.
-
30 Compressions: Use two fingers. Push down firmly and fast at a rate of 100-120 beats per minute (to the beat of “Stayin’ Alive”).
-
2 Rescue Breaths: Continue the 30:2 ratio.
-
Repeat: Do not stop until professional help arrives, the baby starts breathing, or you become physically unable to continue.
Why You Should Choose a London-Based First Aid Course
Reading an article is a great first step, but “muscle memory” is what saves lives. At Practical First Aid, our London-based instructors provide hands-on experience with infant manikins that provide real-time feedback on compression depth and breath volume.
Our courses cover:
-
Paediatric First Aid (Ofsted Compliant): Ideal for nannies, childminders, and teachers.
-
Emergency First Aid at Work: Essential for any London business.
-
Parent & Baby Classes: Short, punchy sessions designed for busy parents in areas like Richmond, Kensington, and Greenwich.
Why British Standards Matter
In the UK, we follow the Resuscitation Council UK (RCUK) guidelines. These are updated based on the latest scientific evidence. If you are watching YouTube videos from the US or other regions, be aware that the ratios and techniques can differ slightly. Training with a UK provider like Practical First Aid ensures you are compliant with local emergency services and legal standards.
The Bottom Line
Knowing the difference between adult and paediatric CPR isn’t just about passing a test; it’s about recognising that a baby’s body has different needs during a crisis. By focusing on oxygen first and using a gentler, more precise compression technique, you significantly increase the chances of a positive outcome.
Don’t wait for an emergency to happen before you learn what to do.
